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preserveAspectRatio="none"><path fill="none" stroke="#000" stroke-width="36" stroke-linecap="round" style="fill:#FFF" d="m320,350a153,153 0 1,0-2,2l170,170m-91-117 110,110-26,26-110-110"></path></svg></a><a id="jr-fip-done" class="wsprkl btn" title="Dismiss find">✘</a></nav><nav id="jr-fip-info-p"><a id="jr-fip-prev" class="wsprkl btn" title="Jump to previuos match">◀</a><button id="jr-fip-matches">no matches yet</button><a id="jr-fip-next" class="wsprkl btn" title="Jump to next match">▶</a></nav></nav></div><div id="jr-epub-interstitial" class="hidden"></div><div id="jr-content"><article data-type="main"><div class="main-content lit-style"><div class="fm-sec bkr_bottom_sep"><div class="bkr_thumb"><a href="https://www.nice.org.uk" title="National Institute for Health and Care Excellence (NICE)" class="img_link icnblk_img" ref="pagearea=logo&targetsite=external&targetcat=link&targettype=publisher"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-niceng226er7-lrg.png" alt="Cover of Evidence review for the clinical and cost effectiveness of electrotherapy for the management of osteoarthritis" /></a></div><div class="bkr_bib"><h1 id="_NBK589223_"><span itemprop="name">Evidence review for the clinical and cost effectiveness of electrotherapy for the management of osteoarthritis</span></h1><div class="subtitle">Osteoarthritis in over 16s: diagnosis and management</div><p><b>Evidence review G</b></p><p><i>NICE Guideline, No. 226</i></p><div class="half_rhythm">London: <a href="https://www.nice.org.uk" ref="pagearea=meta&targetsite=external&targetcat=link&targettype=publisher"><span itemprop="publisher">National Institute for Health and Care Excellence (NICE)</span></a>; <span itemprop="datePublished">2022 Oct</span>.<div class="small">ISBN-13: <span itemprop="isbn">978-1-4731-4740-9</span></div></div><div><a href="/books/about/copyright/">Copyright</a> © NICE 2022.</div></div><div class="bkr_clear"></div></div><div id="niceng226er7.s1"><h2 id="_niceng226er7_s1_">1. Electrotherapy for people with osteoarthritis</h2><div id="niceng226er7.s1.1"><h3>1.1. Review question</h3><p>What is the clinical and cost-effectiveness of electrotherapy for the management of osteoarthritis?</p><div id="niceng226er7.s1.1.1"><h4>1.1.1. Introduction</h4><p>Electrotherapy can be used to provide pain relief in a range of conditions including osteoarthritis. Although Transcutaneous Electrical Nerve Stimulation (TENS) was recommended as an intervention to consider in NICE Osteoarthritis guideline CG177 it is not thought to be widely used within the NHS. TENS is available over the counter, however, so may be recommended by NHS healthcare professionals. Reviewing and updating the evidence again may help determine whether electrotherapy should be recommended as part of NHS treatment.</p><p>This review aims to evaluate the effectiveness of electrotherapeutic interventions (including pulsed short-wave therapy, interferential therapy, laser, transcutaneous electrical nerve stimulation, and ultrasound) in the management of osteoarthritis in adults.</p></div><div id="niceng226er7.s1.1.2"><h4>1.1.2. Summary of the protocol</h4><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab1"><a href="/books/NBK589223/table/niceng226er7.tab1/?report=objectonly" target="object" title="Table 1" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab1" rid-ob="figobniceng226er7tab1"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab1/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab1/?report=previmg" alt="Table 1. PICO characteristics of review question." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab1"><a href="/books/NBK589223/table/niceng226er7.tab1/?report=objectonly" target="object" rid-ob="figobniceng226er7tab1">Table 1</a></h4><p class="float-caption no_bottom_margin">PICO characteristics of review question. </p></div></div><p>For full details see the review protocol in <a href="#niceng226er7.appa">Appendix A</a>.</p></div><div id="niceng226er7.s1.1.3"><h4>1.1.3. Methods and process</h4><p>This evidence review was developed using the methods and process described in <a href="https://www.nice.org.uk/process/pmg20/chapter/introduction-and-overview" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a>. Methods specific to this review question are described in the review protocol in <a href="#niceng226er7.appa">Appendix A</a> and the <a href="/books/NBK589223/bin/methods-report-pdf-11251849933.pdf">methods</a> document.</p><p>Declarations of interest were recorded according to <a href="https://www.nice.org.uk/about/who-we-are/policies-and-procedures" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NICE’s conflicts of interest policy</a>.</p></div><div id="niceng226er7.s1.1.4"><h4>1.1.4. Effectiveness evidence</h4><div id="niceng226er7.s1.1.4.1"><h5>1.1.4.1. Included studies</h5><p>Eighty-one randomised controlled trial studies (eighty-five papers) were included in the review;<a class="bibr" href="#niceng226er7.s1.1.ref6" rid="niceng226er7.s1.1.ref6"><sup>6</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng226er7.s1.1.ref8" rid="niceng226er7.s1.1.ref8"><sup>8</sup></a><sup>,</sup>
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|
<a class="bibr" href="#niceng226er7.s1.1.ref10" rid="niceng226er7.s1.1.ref10"><sup>10</sup></a><sup>–</sup><a class="bibr" href="#niceng226er7.s1.1.ref13" rid="niceng226er7.s1.1.ref13"><sup>13</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng226er7.s1.1.ref15" rid="niceng226er7.s1.1.ref15"><sup>15</sup></a><sup>–</sup><a class="bibr" href="#niceng226er7.s1.1.ref17" rid="niceng226er7.s1.1.ref17"><sup>17</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng226er7.s1.1.ref21" rid="niceng226er7.s1.1.ref21"><sup>21</sup></a><sup>,</sup>
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|
<a class="bibr" href="#niceng226er7.s1.1.ref22" rid="niceng226er7.s1.1.ref22"><sup>22</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng226er7.s1.1.ref27" rid="niceng226er7.s1.1.ref27"><sup>27</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng226er7.s1.1.ref29" rid="niceng226er7.s1.1.ref29"><sup>29</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng226er7.s1.1.ref35" rid="niceng226er7.s1.1.ref35"><sup>35</sup></a><sup>–</sup><a class="bibr" href="#niceng226er7.s1.1.ref38" rid="niceng226er7.s1.1.ref38"><sup>38</sup></a><sup>,</sup>
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|
<a class="bibr" href="#niceng226er7.s1.1.ref40" rid="niceng226er7.s1.1.ref40"><sup>40</sup></a><sup>–</sup><a class="bibr" href="#niceng226er7.s1.1.ref42" rid="niceng226er7.s1.1.ref42"><sup>42</sup></a><sup>,</sup>
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|
<a class="bibr" href="#niceng226er7.s1.1.ref44" rid="niceng226er7.s1.1.ref44"><sup>44</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng226er7.s1.1.ref58" rid="niceng226er7.s1.1.ref58"><sup>58</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng226er7.s1.1.ref64" rid="niceng226er7.s1.1.ref64"><sup>64</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng226er7.s1.1.ref66" rid="niceng226er7.s1.1.ref66"><sup>66</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng226er7.s1.1.ref69" rid="niceng226er7.s1.1.ref69"><sup>69</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng226er7.s1.1.ref71" rid="niceng226er7.s1.1.ref71"><sup>71</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng226er7.s1.1.ref74" rid="niceng226er7.s1.1.ref74"><sup>74</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng226er7.s1.1.ref76" rid="niceng226er7.s1.1.ref76"><sup>76</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng226er7.s1.1.ref79" rid="niceng226er7.s1.1.ref79"><sup>79</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng226er7.s1.1.ref80" rid="niceng226er7.s1.1.ref80"><sup>80</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng226er7.s1.1.ref83" rid="niceng226er7.s1.1.ref83"><sup>83</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng226er7.s1.1.ref84" rid="niceng226er7.s1.1.ref84"><sup>84</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng226er7.s1.1.ref86" rid="niceng226er7.s1.1.ref86"><sup>86</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng226er7.s1.1.ref90" rid="niceng226er7.s1.1.ref90"><sup>90</sup></a><sup>–</sup><a class="bibr" href="#niceng226er7.s1.1.ref93" rid="niceng226er7.s1.1.ref93"><sup>93</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng226er7.s1.1.ref96" rid="niceng226er7.s1.1.ref96"><sup>96</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng226er7.s1.1.ref97" rid="niceng226er7.s1.1.ref97"><sup>97</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng226er7.s1.1.ref100" rid="niceng226er7.s1.1.ref100"><sup>100</sup></a><sup>–</sup><a class="bibr" href="#niceng226er7.s1.1.ref102" rid="niceng226er7.s1.1.ref102"><sup>102</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng226er7.s1.1.ref107" rid="niceng226er7.s1.1.ref107"><sup>107</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng226er7.s1.1.ref115" rid="niceng226er7.s1.1.ref115"><sup>115</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng226er7.s1.1.ref118" rid="niceng226er7.s1.1.ref118"><sup>118</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng226er7.s1.1.ref120" rid="niceng226er7.s1.1.ref120"><sup>120</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng226er7.s1.1.ref121" rid="niceng226er7.s1.1.ref121"><sup>121</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng226er7.s1.1.ref124" rid="niceng226er7.s1.1.ref124"><sup>124</sup></a><sup>,</sup>
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|
<a class="bibr" href="#niceng226er7.s1.1.ref126" rid="niceng226er7.s1.1.ref126"><sup>126</sup></a><sup>,</sup>
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|
<a class="bibr" href="#niceng226er7.s1.1.ref131" rid="niceng226er7.s1.1.ref131"><sup>131</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng226er7.s1.1.ref132" rid="niceng226er7.s1.1.ref132"><sup>132</sup></a><sup>,</sup>
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|
<a class="bibr" href="#niceng226er7.s1.1.ref142" rid="niceng226er7.s1.1.ref142"><sup>142</sup></a><sup>,</sup>
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|
<a class="bibr" href="#niceng226er7.s1.1.ref146" rid="niceng226er7.s1.1.ref146"><sup>146</sup></a><sup>,</sup>
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|
<a class="bibr" href="#niceng226er7.s1.1.ref148" rid="niceng226er7.s1.1.ref148"><sup>148</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng226er7.s1.1.ref150" rid="niceng226er7.s1.1.ref150"><sup>150</sup></a><sup>–</sup><a class="bibr" href="#niceng226er7.s1.1.ref155" rid="niceng226er7.s1.1.ref155"><sup>155</sup></a><sup>,</sup>
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|
<a class="bibr" href="#niceng226er7.s1.1.ref160" rid="niceng226er7.s1.1.ref160"><sup>160</sup></a><sup>,</sup>
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|
<a class="bibr" href="#niceng226er7.s1.1.ref166" rid="niceng226er7.s1.1.ref166"><sup>166</sup></a><sup>–</sup><a class="bibr" href="#niceng226er7.s1.1.ref170" rid="niceng226er7.s1.1.ref170"><sup>170</sup></a><sup>,</sup>
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|
<a class="bibr" href="#niceng226er7.s1.1.ref175" rid="niceng226er7.s1.1.ref175"><sup>175</sup></a><sup>,</sup>
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|
<a class="bibr" href="#niceng226er7.s1.1.ref178" rid="niceng226er7.s1.1.ref178"><sup>178</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref179" rid="niceng226er7.s1.1.ref179"><sup>179</sup></a><sup>,</sup>
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|
<a class="bibr" href="#niceng226er7.s1.1.ref190" rid="niceng226er7.s1.1.ref190"><sup>190</sup></a><sup>,</sup>
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|
<a class="bibr" href="#niceng226er7.s1.1.ref193" rid="niceng226er7.s1.1.ref193"><sup>193</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref205" rid="niceng226er7.s1.1.ref205"><sup>205</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref208" rid="niceng226er7.s1.1.ref208"><sup>208</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref211" rid="niceng226er7.s1.1.ref211"><sup>211</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref213" rid="niceng226er7.s1.1.ref213"><sup>213</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng226er7.s1.1.ref217" rid="niceng226er7.s1.1.ref217"><sup>217</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref220" rid="niceng226er7.s1.1.ref220"><sup>220</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng226er7.s1.1.ref224" rid="niceng226er7.s1.1.ref224"><sup>224</sup></a><sup>,</sup>
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|
<a class="bibr" href="#niceng226er7.s1.1.ref225" rid="niceng226er7.s1.1.ref225"><sup>225</sup></a><sup>,</sup>
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|
<a class="bibr" href="#niceng226er7.s1.1.ref229" rid="niceng226er7.s1.1.ref229"><sup>229</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng226er7.s1.1.ref236" rid="niceng226er7.s1.1.ref236"><sup>236</sup></a><sup>–</sup><a class="bibr" href="#niceng226er7.s1.1.ref238" rid="niceng226er7.s1.1.ref238"><sup>238</sup></a><sup>,</sup>
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|
<a class="bibr" href="#niceng226er7.s1.1.ref240" rid="niceng226er7.s1.1.ref240"><sup>240</sup></a> these are summarised in <a class="figpopup" href="/books/NBK589223/table/niceng226er7.tab2/?report=objectonly" target="object" rid-figpopup="figniceng226er7tab2" rid-ob="figobniceng226er7tab2">Table 2</a> below. Evidence from these studies is summarised in the clinical evidence summary below (<a class="figpopup" href="/books/NBK589223/table/niceng226er7.tab3/?report=objectonly" target="object" rid-figpopup="figniceng226er7tab3" rid-ob="figobniceng226er7tab3">Table 3</a>).</p><p>The clinical studies identified included the following comparisons:
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<ul><li class="half_rhythm"><div>Pulsed short-wave therapy compared to sham electrotherapy<a class="bibr" href="#niceng226er7.s1.1.ref22" rid="niceng226er7.s1.1.ref22"><sup>22</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref27" rid="niceng226er7.s1.1.ref27"><sup>27</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref41" rid="niceng226er7.s1.1.ref41"><sup>41</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref66" rid="niceng226er7.s1.1.ref66"><sup>66</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref79" rid="niceng226er7.s1.1.ref79"><sup>79</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref83" rid="niceng226er7.s1.1.ref83"><sup>83</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref86" rid="niceng226er7.s1.1.ref86"><sup>86</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref155" rid="niceng226er7.s1.1.ref155"><sup>155</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref160" rid="niceng226er7.s1.1.ref160"><sup>160</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref168" rid="niceng226er7.s1.1.ref168"><sup>168</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref179" rid="niceng226er7.s1.1.ref179"><sup>179</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref208" rid="niceng226er7.s1.1.ref208"><sup>208</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref211" rid="niceng226er7.s1.1.ref211"><sup>211</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref220" rid="niceng226er7.s1.1.ref220"><sup>220</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref240" rid="niceng226er7.s1.1.ref240"><sup>240</sup></a></div></li><li class="half_rhythm"><div>Pulsed short-wave therapy compared to no treatment<a class="bibr" href="#niceng226er7.s1.1.ref6" rid="niceng226er7.s1.1.ref6"><sup>6</sup></a><sup>,</sup>
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|
<a class="bibr" href="#niceng226er7.s1.1.ref44" rid="niceng226er7.s1.1.ref44"><sup>44</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref66" rid="niceng226er7.s1.1.ref66"><sup>66</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref83" rid="niceng226er7.s1.1.ref83"><sup>83</sup></a><sup>,</sup>
|
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<a class="bibr" href="#niceng226er7.s1.1.ref155" rid="niceng226er7.s1.1.ref155"><sup>155</sup></a></div></li><li class="half_rhythm"><div>Pulsed short-wave therapy compared to laser therapy<a class="bibr" href="#niceng226er7.s1.1.ref66" rid="niceng226er7.s1.1.ref66"><sup>66</sup></a></div></li><li class="half_rhythm"><div>Interferential therapy compared to pulsed short-wave therapy<a class="bibr" href="#niceng226er7.s1.1.ref22" rid="niceng226er7.s1.1.ref22"><sup>22</sup></a><sup>,</sup>
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|
<a class="bibr" href="#niceng226er7.s1.1.ref66" rid="niceng226er7.s1.1.ref66"><sup>66</sup></a></div></li><li class="half_rhythm"><div>Interferential compared to laser therapy<a class="bibr" href="#niceng226er7.s1.1.ref15" rid="niceng226er7.s1.1.ref15"><sup>15</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng226er7.s1.1.ref66" rid="niceng226er7.s1.1.ref66"><sup>66</sup></a></div></li><li class="half_rhythm"><div>Interferential therapy compared to sham electrotherapy<a class="bibr" href="#niceng226er7.s1.1.ref15" rid="niceng226er7.s1.1.ref15"><sup>15</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref22" rid="niceng226er7.s1.1.ref22"><sup>22</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref66" rid="niceng226er7.s1.1.ref66"><sup>66</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng226er7.s1.1.ref91" rid="niceng226er7.s1.1.ref91"><sup>91</sup></a></div></li><li class="half_rhythm"><div>Interferential therapy compared to no treatment<a class="bibr" href="#niceng226er7.s1.1.ref66" rid="niceng226er7.s1.1.ref66"><sup>66</sup></a></div></li><li class="half_rhythm"><div>Neuromuscular electrical stimulation compared to no treatment<a class="bibr" href="#niceng226er7.s1.1.ref21" rid="niceng226er7.s1.1.ref21"><sup>21</sup></a><sup>,</sup>
|
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<a class="bibr" href="#niceng226er7.s1.1.ref36" rid="niceng226er7.s1.1.ref36"><sup>36</sup></a><sup>,</sup>
|
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<a class="bibr" href="#niceng226er7.s1.1.ref76" rid="niceng226er7.s1.1.ref76"><sup>76</sup></a><sup>,</sup>
|
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<a class="bibr" href="#niceng226er7.s1.1.ref131" rid="niceng226er7.s1.1.ref131"><sup>131</sup></a><sup>,</sup>
|
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<a class="bibr" href="#niceng226er7.s1.1.ref154" rid="niceng226er7.s1.1.ref154"><sup>154</sup></a><sup>,</sup>
|
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<a class="bibr" href="#niceng226er7.s1.1.ref170" rid="niceng226er7.s1.1.ref170"><sup>170</sup></a></div></li><li class="half_rhythm"><div>Extracorporeal shockwave therapy compared to sham electrotherapy<a class="bibr" href="#niceng226er7.s1.1.ref58" rid="niceng226er7.s1.1.ref58"><sup>58</sup></a><sup>,</sup>
|
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<a class="bibr" href="#niceng226er7.s1.1.ref217" rid="niceng226er7.s1.1.ref217"><sup>217</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng226er7.s1.1.ref236" rid="niceng226er7.s1.1.ref236"><sup>236</sup></a><sup>–</sup><a class="bibr" href="#niceng226er7.s1.1.ref238" rid="niceng226er7.s1.1.ref238"><sup>238</sup></a></div></li><li class="half_rhythm"><div>Extracorporeal therapy compared to no treatment<a class="bibr" href="#niceng226er7.s1.1.ref74" rid="niceng226er7.s1.1.ref74"><sup>74</sup></a><sup>,</sup>
|
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<a class="bibr" href="#niceng226er7.s1.1.ref90" rid="niceng226er7.s1.1.ref90"><sup>90</sup></a></div></li><li class="half_rhythm"><div>Laser therapy compared to neuromuscular electrical stimulation<a class="bibr" href="#niceng226er7.s1.1.ref152" rid="niceng226er7.s1.1.ref152"><sup>152</sup></a></div></li><li class="half_rhythm"><div>Laser therapy compared to sham electrotherapy<a class="bibr" href="#niceng226er7.s1.1.ref10" rid="niceng226er7.s1.1.ref10"><sup>10</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref13" rid="niceng226er7.s1.1.ref13"><sup>13</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng226er7.s1.1.ref15" rid="niceng226er7.s1.1.ref15"><sup>15</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng226er7.s1.1.ref29" rid="niceng226er7.s1.1.ref29"><sup>29</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng226er7.s1.1.ref35" rid="niceng226er7.s1.1.ref35"><sup>35</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng226er7.s1.1.ref37" rid="niceng226er7.s1.1.ref37"><sup>37</sup></a><sup>,</sup>
|
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<a class="bibr" href="#niceng226er7.s1.1.ref42" rid="niceng226er7.s1.1.ref42"><sup>42</sup></a><sup>,</sup>
|
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<a class="bibr" href="#niceng226er7.s1.1.ref66" rid="niceng226er7.s1.1.ref66"><sup>66</sup></a><sup>,</sup>
|
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<a class="bibr" href="#niceng226er7.s1.1.ref84" rid="niceng226er7.s1.1.ref84"><sup>84</sup></a><sup>,</sup>
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|
<a class="bibr" href="#niceng226er7.s1.1.ref92" rid="niceng226er7.s1.1.ref92"><sup>92</sup></a><sup>,</sup>
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|
<a class="bibr" href="#niceng226er7.s1.1.ref93" rid="niceng226er7.s1.1.ref93"><sup>93</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng226er7.s1.1.ref96" rid="niceng226er7.s1.1.ref96"><sup>96</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng226er7.s1.1.ref97" rid="niceng226er7.s1.1.ref97"><sup>97</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref100" rid="niceng226er7.s1.1.ref100"><sup>100</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref120" rid="niceng226er7.s1.1.ref120"><sup>120</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref146" rid="niceng226er7.s1.1.ref146"><sup>146</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref148" rid="niceng226er7.s1.1.ref148"><sup>148</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref150" rid="niceng226er7.s1.1.ref150"><sup>150</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref193" rid="niceng226er7.s1.1.ref193"><sup>193</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref229" rid="niceng226er7.s1.1.ref229"><sup>229</sup></a></div></li><li class="half_rhythm"><div>Laser therapy compared to no treatment<a class="bibr" href="#niceng226er7.s1.1.ref8" rid="niceng226er7.s1.1.ref8"><sup>8</sup></a><sup>,</sup>
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|
<a class="bibr" href="#niceng226er7.s1.1.ref64" rid="niceng226er7.s1.1.ref64"><sup>64</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref66" rid="niceng226er7.s1.1.ref66"><sup>66</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref97" rid="niceng226er7.s1.1.ref97"><sup>97</sup></a></div></li><li class="half_rhythm"><div>Transcutaneous electrical nerve stimulation compared to pulsed short-wave therapy<a class="bibr" href="#niceng226er7.s1.1.ref22" rid="niceng226er7.s1.1.ref22"><sup>22</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref44" rid="niceng226er7.s1.1.ref44"><sup>44</sup></a></div></li><li class="half_rhythm"><div>Transcutaneous electrical nerve stimulation compared to interferential therapy<a class="bibr" href="#niceng226er7.s1.1.ref22" rid="niceng226er7.s1.1.ref22"><sup>22</sup></a><sup>,</sup>
|
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<a class="bibr" href="#niceng226er7.s1.1.ref38" rid="niceng226er7.s1.1.ref38"><sup>38</sup></a></div></li><li class="half_rhythm"><div>Transcutaneous electrical nerve stimulation compared to sham electrotherapy<a class="bibr" href="#niceng226er7.s1.1.ref17" rid="niceng226er7.s1.1.ref17"><sup>17</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref22" rid="niceng226er7.s1.1.ref22"><sup>22</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref107" rid="niceng226er7.s1.1.ref107"><sup>107</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref132" rid="niceng226er7.s1.1.ref132"><sup>132</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref169" rid="niceng226er7.s1.1.ref169"><sup>169</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref175" rid="niceng226er7.s1.1.ref175"><sup>175</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref178" rid="niceng226er7.s1.1.ref178"><sup>178</sup></a></div></li><li class="half_rhythm"><div>Transcutaneous electrical nerve stimulation compared to no treatment<a class="bibr" href="#niceng226er7.s1.1.ref44" rid="niceng226er7.s1.1.ref44"><sup>44</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref151" rid="niceng226er7.s1.1.ref151"><sup>151</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref175" rid="niceng226er7.s1.1.ref175"><sup>175</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref178" rid="niceng226er7.s1.1.ref178"><sup>178</sup></a></div></li><li class="half_rhythm"><div>Ultrasound compared to pulsed short-wave therapy<a class="bibr" href="#niceng226er7.s1.1.ref44" rid="niceng226er7.s1.1.ref44"><sup>44</sup></a></div></li><li class="half_rhythm"><div>Ultrasound compared to neuromuscular electrical stimulation<a class="bibr" href="#niceng226er7.s1.1.ref69" rid="niceng226er7.s1.1.ref69"><sup>69</sup></a></div></li><li class="half_rhythm"><div>Ultrasound compared to transcutaneous electrical nerve stimulation<a class="bibr" href="#niceng226er7.s1.1.ref44" rid="niceng226er7.s1.1.ref44"><sup>44</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref151" rid="niceng226er7.s1.1.ref151"><sup>151</sup></a></div></li><li class="half_rhythm"><div>Ultrasound compared to sham electrotherapy<a class="bibr" href="#niceng226er7.s1.1.ref40" rid="niceng226er7.s1.1.ref40"><sup>40</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref71" rid="niceng226er7.s1.1.ref71"><sup>71</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref115" rid="niceng226er7.s1.1.ref115"><sup>115</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref118" rid="niceng226er7.s1.1.ref118"><sup>118</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref124" rid="niceng226er7.s1.1.ref124"><sup>124</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref126" rid="niceng226er7.s1.1.ref126"><sup>126</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref142" rid="niceng226er7.s1.1.ref142"><sup>142</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref166" rid="niceng226er7.s1.1.ref166"><sup>166</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref167" rid="niceng226er7.s1.1.ref167"><sup>167</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref205" rid="niceng226er7.s1.1.ref205"><sup>205</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref213" rid="niceng226er7.s1.1.ref213"><sup>213</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref224" rid="niceng226er7.s1.1.ref224"><sup>224</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref225" rid="niceng226er7.s1.1.ref225"><sup>225</sup></a></div></li><li class="half_rhythm"><div>Ultrasound compared to no treatment<a class="bibr" href="#niceng226er7.s1.1.ref12" rid="niceng226er7.s1.1.ref12"><sup>12</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref44" rid="niceng226er7.s1.1.ref44"><sup>44</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref101" rid="niceng226er7.s1.1.ref101"><sup>101</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref102" rid="niceng226er7.s1.1.ref102"><sup>102</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref151" rid="niceng226er7.s1.1.ref151"><sup>151</sup></a></div></li><li class="half_rhythm"><div>Combination therapy compared to neuromuscular electrical stimulation<a class="bibr" href="#niceng226er7.s1.1.ref152" rid="niceng226er7.s1.1.ref152"><sup>152</sup></a></div></li><li class="half_rhythm"><div>Combination therapy compared to laser therapy<a class="bibr" href="#niceng226er7.s1.1.ref15" rid="niceng226er7.s1.1.ref15"><sup>15</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref152" rid="niceng226er7.s1.1.ref152"><sup>152</sup></a></div></li><li class="half_rhythm"><div>Combination therapy compared to ultrasound<a class="bibr" href="#niceng226er7.s1.1.ref124" rid="niceng226er7.s1.1.ref124"><sup>124</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref190" rid="niceng226er7.s1.1.ref190"><sup>190</sup></a></div></li><li class="half_rhythm"><div>Combination compared to interferential therapy<a class="bibr" href="#niceng226er7.s1.1.ref15" rid="niceng226er7.s1.1.ref15"><sup>15</sup></a></div></li><li class="half_rhythm"><div>Combination therapy compared to sham electrotherapy<a class="bibr" href="#niceng226er7.s1.1.ref15" rid="niceng226er7.s1.1.ref15"><sup>15</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref124" rid="niceng226er7.s1.1.ref124"><sup>124</sup></a></div></li><li class="half_rhythm"><div>Combination therapy compared to transcutaneous electrical nerve stimulation<a class="bibr" href="#niceng226er7.s1.1.ref121" rid="niceng226er7.s1.1.ref121"><sup>121</sup></a></div></li><li class="half_rhythm"><div>Combination therapy compared to no treatment<a class="bibr" href="#niceng226er7.s1.1.ref16" rid="niceng226er7.s1.1.ref16"><sup>16</sup></a><sup>,</sup>
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|
<a class="bibr" href="#niceng226er7.s1.1.ref74" rid="niceng226er7.s1.1.ref74"><sup>74</sup></a></div></li></ul></p><p>Evidence was available for each intervention stated in the protocol. However, there was no evidence for the following comparison to sham electrotherapy:
|
|
<ul><li class="half_rhythm"><div>Neuromuscular electrical stimulation</div></li></ul></p><p>See also the study selection flow chart in <a href="#niceng226er7.appc">Appendix C</a>, study evidence tables in <a href="#niceng226er7.appd">Appendix D</a>, forest plots in <a href="#niceng226er7.appe">Appendix E</a> and GRADE tables in <a href="#niceng226er7.appf">Appendix F</a>.</p><p>A network meta-analysis was not conducted for this review. This was due to the heterogeneity identified in the studies and outcomes, including heterogeneity in the types of interventions (including the intensity of therapy delivered) and in comparisons (different types of sham therapy devices, some studies delivering different levels of concomitant care being combined in the no treatment group). Given this, the committee agreed it would be difficult to draw conclusions from the results of a network meta-analysis and so used the evidence from pairwise meta-analysis instead.</p><div id="niceng226er7.s1.1.4.1.1"><h5>1.1.4.1.1. Combination therapy</h5><p>The combinations of therapy reported in the studies included:
|
|
<ul><li class="half_rhythm"><div>Laser therapy combined with neuromuscular electrical stimulation<a class="bibr" href="#niceng226er7.s1.1.ref152" rid="niceng226er7.s1.1.ref152"><sup>152</sup></a></div></li><li class="half_rhythm"><div>Ultrasound combined with transcutaneous electrical nerve stimulation<a class="bibr" href="#niceng226er7.s1.1.ref16" rid="niceng226er7.s1.1.ref16"><sup>16</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref74" rid="niceng226er7.s1.1.ref74"><sup>74</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref121" rid="niceng226er7.s1.1.ref121"><sup>121</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref124" rid="niceng226er7.s1.1.ref124"><sup>124</sup></a><sup>,</sup>
|
|
<a class="bibr" href="#niceng226er7.s1.1.ref190" rid="niceng226er7.s1.1.ref190"><sup>190</sup></a>,</div></li><li class="half_rhythm"><div>Interferential combined with laser therapy<a class="bibr" href="#niceng226er7.s1.1.ref15" rid="niceng226er7.s1.1.ref15"><sup>15</sup></a></div></li></ul></p><p>No other combinations were reported.</p></div><div id="niceng226er7.s1.1.4.1.2"><h5>1.1.4.1.2. Inconsistency</h5><p>Heterogeneity was seen in outcomes in the following comparisons:
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|
<ul><li class="half_rhythm"><div>Pulsed short-wave therapy compared to sham electrotherapy (quality of life, pain and physical function)</div></li><li class="half_rhythm"><div>Interferential therapy compared to sham electrotherapy (pain and physical function)</div></li><li class="half_rhythm"><div>Neuromuscular electrical stimulation compared to no treatment (physical function)</div></li><li class="half_rhythm"><div>Laser therapy compared to sham electrotherapy (pain and physical function)</div></li><li class="half_rhythm"><div>Laser therapy compared to no treatment (quality of life, pain and physical function)</div></li><li class="half_rhythm"><div>Transcutaneous electrical nerve stimulation compared to interferential therapy (pain and physical function)</div></li><li class="half_rhythm"><div>Transcutaneous electrical nerve stimulation compared to sham electrotherapy (pain and physical function)</div></li><li class="half_rhythm"><div>Transcutaneous electrical nerve stimulation compared to no treatment (pain and physical function)</div></li></ul></p><p>In these scenarios, there was either an insufficient number of studies to form valid subgroups or subgroup analysis did not resolve the heterogeneity, therefore outcomes were downgraded for inconsistency and analysed using a random effects model.</p></div><div id="niceng226er7.s1.1.4.1.3"><h5>1.1.4.1.3. Indirectness</h5><p>The majority of evidence was direct in most cases and therefore only one outcome was downgraded for indirectness. However, some outcomes included indirect components.</p><ul><li class="half_rhythm"><div>Cho 2016<a class="bibr" href="#niceng226er7.s1.1.ref58" rid="niceng226er7.s1.1.ref58"><sup>58</sup></a> included people with osteoarthritis who had also had a stroke and so was noted as having serious population indirectness.</div></li><li class="half_rhythm"><div>Marquina 2012<a class="bibr" href="#niceng226er7.s1.1.ref150" rid="niceng226er7.s1.1.ref150"><sup>150</sup></a> did not define the population as having knee osteoarthritis, but included people with chronic knee pain so was noted as having serious population indirectness.</div></li><li class="half_rhythm"><div>Thamsborg 2005<a class="bibr" href="#niceng226er7.s1.1.ref208" rid="niceng226er7.s1.1.ref208"><sup>208</sup></a> included a sham intervention that sounded like it could have an active effect (a device applying a magnetic field with a DC current rather than a pulse generating therapy) and so was noted as having serious intervention indirectness.</div></li></ul></div></div><div id="niceng226er7.s1.1.4.2"><h5>1.1.4.2. Excluded studies</h5><p>Cochrane reviews were identified but could not be included due to using interventions not stated in the protocol (Rutjes 2010<a class="bibr" href="#niceng226er7.s1.1.ref188" rid="niceng226er7.s1.1.ref188"><sup>188</sup></a>, Zammit 2010<a class="bibr" href="#niceng226er7.s1.1.ref231" rid="niceng226er7.s1.1.ref231"><sup>231</sup></a>), using comparisons not stated in the protocol and different outcome measures being used (Li 2013<a class="bibr" href="#niceng226er7.s1.1.ref138" rid="niceng226er7.s1.1.ref138"><sup>138</sup></a>, Osiri 2000<a class="bibr" href="#niceng226er7.s1.1.ref164" rid="niceng226er7.s1.1.ref164"><sup>164</sup></a>). The references were checked any studies that fulfilled the inclusion criteria were included.</p><p>See the excluded studies list in <a href="#niceng226er7.appj">Appendix J</a>.</p></div></div><div id="niceng226er7.s1.1.5"><h4>1.1.5. Summary of studies included in the effectiveness evidence</h4><div id="niceng226er7.s1.1.5.1"><h5>1.1.5.1. Pulsed short-wave therapy compared to sham electrotherapy</h5><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab2"><a href="/books/NBK589223/table/niceng226er7.tab2/?report=objectonly" target="object" title="Table 2" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab2" rid-ob="figobniceng226er7tab2"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab2/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab2/?report=previmg" alt="Table 2. Summary of studies included in the pulsed short-wave therapy compared to sham electrotherapy comparison." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab2"><a href="/books/NBK589223/table/niceng226er7.tab2/?report=objectonly" target="object" rid-ob="figobniceng226er7tab2">Table 2</a></h4><p class="float-caption no_bottom_margin">Summary of studies included in the pulsed short-wave therapy compared to sham electrotherapy comparison. </p></div></div></div><div id="niceng226er7.s1.1.5.2"><h5>1.1.5.2. Pulsed short-wave therapy compared to no treatment</h5><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab3"><a href="/books/NBK589223/table/niceng226er7.tab3/?report=objectonly" target="object" title="Table 3" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab3" rid-ob="figobniceng226er7tab3"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab3/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab3/?report=previmg" alt="Table 3. Summary of studies included in the pulsed short-wave therapy compared to no treatment comparison." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab3"><a href="/books/NBK589223/table/niceng226er7.tab3/?report=objectonly" target="object" rid-ob="figobniceng226er7tab3">Table 3</a></h4><p class="float-caption no_bottom_margin">Summary of studies included in the pulsed short-wave therapy compared to no treatment comparison. </p></div></div></div><div id="niceng226er7.s1.1.5.3"><h5>1.1.5.3. Interferential therapy compared to pulsed short-wave therapy</h5><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab4"><a href="/books/NBK589223/table/niceng226er7.tab4/?report=objectonly" target="object" title="Table 4" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab4" rid-ob="figobniceng226er7tab4"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab4/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab4/?report=previmg" alt="Table 4. Summary of studies included in the interferential therapy compared to pulsed short-wave therapy comparison." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab4"><a href="/books/NBK589223/table/niceng226er7.tab4/?report=objectonly" target="object" rid-ob="figobniceng226er7tab4">Table 4</a></h4><p class="float-caption no_bottom_margin">Summary of studies included in the interferential therapy compared to pulsed short-wave therapy comparison. </p></div></div></div><div id="niceng226er7.s1.1.5.4"><h5>1.1.5.4. Interferential therapy compared to laser therapy</h5><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab5"><a href="/books/NBK589223/table/niceng226er7.tab5/?report=objectonly" target="object" title="Table 5" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab5" rid-ob="figobniceng226er7tab5"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab5/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab5/?report=previmg" alt="Table 5. Summary of studies included in the interferential therapy compared to laser therapy comparison." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab5"><a href="/books/NBK589223/table/niceng226er7.tab5/?report=objectonly" target="object" rid-ob="figobniceng226er7tab5">Table 5</a></h4><p class="float-caption no_bottom_margin">Summary of studies included in the interferential therapy compared to laser therapy comparison. </p></div></div></div><div id="niceng226er7.s1.1.5.5"><h5>1.1.5.5. Interferential therapy compared to sham electrotherapy</h5><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab6"><a href="/books/NBK589223/table/niceng226er7.tab6/?report=objectonly" target="object" title="Table 6" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab6" rid-ob="figobniceng226er7tab6"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab6/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab6/?report=previmg" alt="Table 6. Summary of studies included in the interferential therapy compared to sham electrotherapy comparison." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab6"><a href="/books/NBK589223/table/niceng226er7.tab6/?report=objectonly" target="object" rid-ob="figobniceng226er7tab6">Table 6</a></h4><p class="float-caption no_bottom_margin">Summary of studies included in the interferential therapy compared to sham electrotherapy comparison. </p></div></div></div><div id="niceng226er7.s1.1.5.6"><h5>1.1.5.6. Interferential therapy compared to no treatment</h5><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab7"><a href="/books/NBK589223/table/niceng226er7.tab7/?report=objectonly" target="object" title="Table 7" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab7" rid-ob="figobniceng226er7tab7"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab7/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab7/?report=previmg" alt="Table 7. Summary of studies included in the interferential therapy compared to no treatment comparison." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab7"><a href="/books/NBK589223/table/niceng226er7.tab7/?report=objectonly" target="object" rid-ob="figobniceng226er7tab7">Table 7</a></h4><p class="float-caption no_bottom_margin">Summary of studies included in the interferential therapy compared to no treatment comparison. </p></div></div></div><div id="niceng226er7.s1.1.5.7"><h5>1.1.5.7. Neuromuscular electrical stimulation compared to no treatment</h5><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab8"><a href="/books/NBK589223/table/niceng226er7.tab8/?report=objectonly" target="object" title="Table 8" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab8" rid-ob="figobniceng226er7tab8"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab8/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab8/?report=previmg" alt="Table 8. Summary of studies included in the neuromuscular electrical stimulation compared to no treatment comparison." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab8"><a href="/books/NBK589223/table/niceng226er7.tab8/?report=objectonly" target="object" rid-ob="figobniceng226er7tab8">Table 8</a></h4><p class="float-caption no_bottom_margin">Summary of studies included in the neuromuscular electrical stimulation compared to no treatment comparison. </p></div></div></div><div id="niceng226er7.s1.1.5.8"><h5>1.1.5.8. Extracorporeal shockwave therapy compared to sham electrotherapy</h5><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab9"><a href="/books/NBK589223/table/niceng226er7.tab9/?report=objectonly" target="object" title="Table 9" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab9" rid-ob="figobniceng226er7tab9"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab9/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab9/?report=previmg" alt="Table 9. Summary of studies included in the extracorporeal shockwave therapy compared to sham electrotherapy comparison." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab9"><a href="/books/NBK589223/table/niceng226er7.tab9/?report=objectonly" target="object" rid-ob="figobniceng226er7tab9">Table 9</a></h4><p class="float-caption no_bottom_margin">Summary of studies included in the extracorporeal shockwave therapy compared to sham electrotherapy comparison. </p></div></div></div><div id="niceng226er7.s1.1.5.9"><h5>1.1.5.9. Extracorporeal shockwave therapy compared to no treatment</h5><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab10"><a href="/books/NBK589223/table/niceng226er7.tab10/?report=objectonly" target="object" title="Table 10" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab10" rid-ob="figobniceng226er7tab10"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab10/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab10/?report=previmg" alt="Table 10. Summary of studies included in the extracorporeal shockwave therapy compared to no treatment comparison." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab10"><a href="/books/NBK589223/table/niceng226er7.tab10/?report=objectonly" target="object" rid-ob="figobniceng226er7tab10">Table 10</a></h4><p class="float-caption no_bottom_margin">Summary of studies included in the extracorporeal shockwave therapy compared to no treatment comparison. </p></div></div></div><div id="niceng226er7.s1.1.5.10"><h5>1.1.5.10. Laser therapy compared to pulsed short-wave therapy</h5><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab11"><a href="/books/NBK589223/table/niceng226er7.tab11/?report=objectonly" target="object" title="Table 11" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab11" rid-ob="figobniceng226er7tab11"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab11/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab11/?report=previmg" alt="Table 11. Summary of studies included in the pulsed short-wave therapy compared to laser therapy comparison." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab11"><a href="/books/NBK589223/table/niceng226er7.tab11/?report=objectonly" target="object" rid-ob="figobniceng226er7tab11">Table 11</a></h4><p class="float-caption no_bottom_margin">Summary of studies included in the pulsed short-wave therapy compared to laser therapy comparison. </p></div></div></div><div id="niceng226er7.s1.1.5.11"><h5>1.1.5.11. Laser therapy compared to neuromuscular electrical stimulation</h5><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab12"><a href="/books/NBK589223/table/niceng226er7.tab12/?report=objectonly" target="object" title="Table 12" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab12" rid-ob="figobniceng226er7tab12"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab12/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab12/?report=previmg" alt="Table 12. Summary of studies included in the laser therapy compared to neuromuscular electrical stimulation comparison." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab12"><a href="/books/NBK589223/table/niceng226er7.tab12/?report=objectonly" target="object" rid-ob="figobniceng226er7tab12">Table 12</a></h4><p class="float-caption no_bottom_margin">Summary of studies included in the laser therapy compared to neuromuscular electrical stimulation comparison. </p></div></div></div><div id="niceng226er7.s1.1.5.12"><h5>1.1.5.12. Laser therapy compared to sham electrotherapy</h5><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab13"><a href="/books/NBK589223/table/niceng226er7.tab13/?report=objectonly" target="object" title="Table 13" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab13" rid-ob="figobniceng226er7tab13"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab13/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab13/?report=previmg" alt="Table 13. Summary of studies included in the laser therapy compared to sham electrotherapy comparison." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab13"><a href="/books/NBK589223/table/niceng226er7.tab13/?report=objectonly" target="object" rid-ob="figobniceng226er7tab13">Table 13</a></h4><p class="float-caption no_bottom_margin">Summary of studies included in the laser therapy compared to sham electrotherapy comparison. </p></div></div></div><div id="niceng226er7.s1.1.5.13"><h5>1.1.5.13. Laser therapy compared to no treatment</h5><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab14"><a href="/books/NBK589223/table/niceng226er7.tab14/?report=objectonly" target="object" title="Table 14" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab14" rid-ob="figobniceng226er7tab14"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab14/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab14/?report=previmg" alt="Table 14. Summary of studies included in the laser therapy compared to no treatment comparison." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab14"><a href="/books/NBK589223/table/niceng226er7.tab14/?report=objectonly" target="object" rid-ob="figobniceng226er7tab14">Table 14</a></h4><p class="float-caption no_bottom_margin">Summary of studies included in the laser therapy compared to no treatment comparison. </p></div></div></div><div id="niceng226er7.s1.1.5.14"><h5>1.1.5.14. Transcutaneous electrical nerve stimulation compared to pulsed short-wave therapy</h5><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab15"><a href="/books/NBK589223/table/niceng226er7.tab15/?report=objectonly" target="object" title="Table 15" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab15" rid-ob="figobniceng226er7tab15"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab15/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab15/?report=previmg" alt="Table 15. Summary of studies included in the transcutaneous electrical nerve stimulation compared to pulsed short-wave therapy comparison." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab15"><a href="/books/NBK589223/table/niceng226er7.tab15/?report=objectonly" target="object" rid-ob="figobniceng226er7tab15">Table 15</a></h4><p class="float-caption no_bottom_margin">Summary of studies included in the transcutaneous electrical nerve stimulation compared to pulsed short-wave therapy comparison. </p></div></div></div><div id="niceng226er7.s1.1.5.15"><h5>1.1.5.15. Transcutaneous electrical nerve stimulation compared to interferential therapy</h5><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab16"><a href="/books/NBK589223/table/niceng226er7.tab16/?report=objectonly" target="object" title="Table 16" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab16" rid-ob="figobniceng226er7tab16"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab16/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab16/?report=previmg" alt="Table 16. Summary of studies included in the transcutaneous electrical nerve stimulation compared to interferential therapy comparison." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab16"><a href="/books/NBK589223/table/niceng226er7.tab16/?report=objectonly" target="object" rid-ob="figobniceng226er7tab16">Table 16</a></h4><p class="float-caption no_bottom_margin">Summary of studies included in the transcutaneous electrical nerve stimulation compared to interferential therapy comparison. </p></div></div></div><div id="niceng226er7.s1.1.5.16"><h5>1.1.5.16. Transcutaneous electrical nerve stimulation compared to sham electrotherapy</h5><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab17"><a href="/books/NBK589223/table/niceng226er7.tab17/?report=objectonly" target="object" title="Table 17" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab17" rid-ob="figobniceng226er7tab17"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab17/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab17/?report=previmg" alt="Table 17. Summary of studies included in transcutaneous electrical nerve stimulation compared to sham electrotherapy comparison." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab17"><a href="/books/NBK589223/table/niceng226er7.tab17/?report=objectonly" target="object" rid-ob="figobniceng226er7tab17">Table 17</a></h4><p class="float-caption no_bottom_margin">Summary of studies included in transcutaneous electrical nerve stimulation compared to sham electrotherapy comparison. </p></div></div></div><div id="niceng226er7.s1.1.5.17"><h5>1.1.5.17. Transcutaneous electrical nerve stimulation compared to no treatment</h5><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab18"><a href="/books/NBK589223/table/niceng226er7.tab18/?report=objectonly" target="object" title="Table 18" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab18" rid-ob="figobniceng226er7tab18"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab18/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab18/?report=previmg" alt="Table 18. Summary of studies included in the transcutaneous electrical nerve stimulation compared to no treatment comparison." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab18"><a href="/books/NBK589223/table/niceng226er7.tab18/?report=objectonly" target="object" rid-ob="figobniceng226er7tab18">Table 18</a></h4><p class="float-caption no_bottom_margin">Summary of studies included in the transcutaneous electrical nerve stimulation compared to no treatment comparison. </p></div></div></div><div id="niceng226er7.s1.1.5.18"><h5>1.1.5.18. Ultrasound compared to pulsed short-wave therapy</h5><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab19"><a href="/books/NBK589223/table/niceng226er7.tab19/?report=objectonly" target="object" title="Table 19" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab19" rid-ob="figobniceng226er7tab19"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab19/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab19/?report=previmg" alt="Table 19. Summary of studies included in the ultrasound compared to pulsed short-wave therapy comparison." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab19"><a href="/books/NBK589223/table/niceng226er7.tab19/?report=objectonly" target="object" rid-ob="figobniceng226er7tab19">Table 19</a></h4><p class="float-caption no_bottom_margin">Summary of studies included in the ultrasound compared to pulsed short-wave therapy comparison. </p></div></div></div><div id="niceng226er7.s1.1.5.19"><h5>1.1.5.19. Ultrasound compared to neuromuscular electrical stimulation</h5><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab20"><a href="/books/NBK589223/table/niceng226er7.tab20/?report=objectonly" target="object" title="Table 20" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab20" rid-ob="figobniceng226er7tab20"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab20/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab20/?report=previmg" alt="Table 20. Summary of studies included in the ultrasound compared to neuromuscular electrical stimulation." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab20"><a href="/books/NBK589223/table/niceng226er7.tab20/?report=objectonly" target="object" rid-ob="figobniceng226er7tab20">Table 20</a></h4><p class="float-caption no_bottom_margin">Summary of studies included in the ultrasound compared to neuromuscular electrical stimulation. </p></div></div></div><div id="niceng226er7.s1.1.5.20"><h5>1.1.5.20. Ultrasound compared to transcutaneous electrical nerve stimulation</h5><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab21"><a href="/books/NBK589223/table/niceng226er7.tab21/?report=objectonly" target="object" title="Table 21" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab21" rid-ob="figobniceng226er7tab21"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab21/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab21/?report=previmg" alt="Table 21. Summary of studies included in the ultrasound compared to transcutaneous electrical nerve stimulation." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab21"><a href="/books/NBK589223/table/niceng226er7.tab21/?report=objectonly" target="object" rid-ob="figobniceng226er7tab21">Table 21</a></h4><p class="float-caption no_bottom_margin">Summary of studies included in the ultrasound compared to transcutaneous electrical nerve stimulation. </p></div></div></div><div id="niceng226er7.s1.1.5.21"><h5>1.1.5.21. Ultrasound compared to sham electrotherapy</h5><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab22"><a href="/books/NBK589223/table/niceng226er7.tab22/?report=objectonly" target="object" title="Table 22" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab22" rid-ob="figobniceng226er7tab22"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab22/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab22/?report=previmg" alt="Table 22. Summary of studies included in the ultrasound compared to sham electrotherapy comparison." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab22"><a href="/books/NBK589223/table/niceng226er7.tab22/?report=objectonly" target="object" rid-ob="figobniceng226er7tab22">Table 22</a></h4><p class="float-caption no_bottom_margin">Summary of studies included in the ultrasound compared to sham electrotherapy comparison. </p></div></div></div><div id="niceng226er7.s1.1.5.22"><h5>1.1.5.22. Ultrasound compared to no treatment</h5><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab23"><a href="/books/NBK589223/table/niceng226er7.tab23/?report=objectonly" target="object" title="Table 23" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab23" rid-ob="figobniceng226er7tab23"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab23/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab23/?report=previmg" alt="Table 23. Summary of studies included in the ultrasound compared to no treatment comparison." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab23"><a href="/books/NBK589223/table/niceng226er7.tab23/?report=objectonly" target="object" rid-ob="figobniceng226er7tab23">Table 23</a></h4><p class="float-caption no_bottom_margin">Summary of studies included in the ultrasound compared to no treatment comparison. </p></div></div></div><div id="niceng226er7.s1.1.5.23"><h5>1.1.5.23. Combination therapy compared to interferential therapy</h5><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab24"><a href="/books/NBK589223/table/niceng226er7.tab24/?report=objectonly" target="object" title="Table 24" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab24" rid-ob="figobniceng226er7tab24"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab24/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab24/?report=previmg" alt="Table 24. Summary of studies included in the combination therapy compared to interferential therapy comparison." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab24"><a href="/books/NBK589223/table/niceng226er7.tab24/?report=objectonly" target="object" rid-ob="figobniceng226er7tab24">Table 24</a></h4><p class="float-caption no_bottom_margin">Summary of studies included in the combination therapy compared to interferential therapy comparison. </p></div></div></div><div id="niceng226er7.s1.1.5.24"><h5>1.1.5.24. Combination therapy compared to neuromuscular electrical stimulation</h5><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab25"><a href="/books/NBK589223/table/niceng226er7.tab25/?report=objectonly" target="object" title="Table 25" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab25" rid-ob="figobniceng226er7tab25"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab25/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab25/?report=previmg" alt="Table 25. Summary of studies included in the combination therapy compared to neuromuscular electrical stimulation comparison." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab25"><a href="/books/NBK589223/table/niceng226er7.tab25/?report=objectonly" target="object" rid-ob="figobniceng226er7tab25">Table 25</a></h4><p class="float-caption no_bottom_margin">Summary of studies included in the combination therapy compared to neuromuscular electrical stimulation comparison. </p></div></div></div><div id="niceng226er7.s1.1.5.25"><h5>1.1.5.25. Combination therapy compared to laser therapy</h5><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab26"><a href="/books/NBK589223/table/niceng226er7.tab26/?report=objectonly" target="object" title="Table 26" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab26" rid-ob="figobniceng226er7tab26"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab26/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab26/?report=previmg" alt="Table 26. Summary of studies included in the combination therapy compared to laser therapy comparison." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab26"><a href="/books/NBK589223/table/niceng226er7.tab26/?report=objectonly" target="object" rid-ob="figobniceng226er7tab26">Table 26</a></h4><p class="float-caption no_bottom_margin">Summary of studies included in the combination therapy compared to laser therapy comparison. </p></div></div></div><div id="niceng226er7.s1.1.5.26"><h5>1.1.5.26. Combination therapy compared to transcutaneous electrical nerve stimulation</h5><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab27"><a href="/books/NBK589223/table/niceng226er7.tab27/?report=objectonly" target="object" title="Table 27" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab27" rid-ob="figobniceng226er7tab27"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab27/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab27/?report=previmg" alt="Table 27. Summary of studies included in the combination therapy compared to transcutaneous electrical nerve stimulation comparison." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab27"><a href="/books/NBK589223/table/niceng226er7.tab27/?report=objectonly" target="object" rid-ob="figobniceng226er7tab27">Table 27</a></h4><p class="float-caption no_bottom_margin">Summary of studies included in the combination therapy compared to transcutaneous electrical nerve stimulation comparison. </p></div></div></div><div id="niceng226er7.s1.1.5.27"><h5>1.1.5.27. Combination therapy compared to ultrasound</h5><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab28"><a href="/books/NBK589223/table/niceng226er7.tab28/?report=objectonly" target="object" title="Table 28" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab28" rid-ob="figobniceng226er7tab28"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab28/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab28/?report=previmg" alt="Table 28. Summary of studies included in the combination therapy compared to ultrasound comparison." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab28"><a href="/books/NBK589223/table/niceng226er7.tab28/?report=objectonly" target="object" rid-ob="figobniceng226er7tab28">Table 28</a></h4><p class="float-caption no_bottom_margin">Summary of studies included in the combination therapy compared to ultrasound comparison. </p></div></div></div><div id="niceng226er7.s1.1.5.28"><h5>1.1.5.28. Combination therapy compared to sham treatment</h5><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab29"><a href="/books/NBK589223/table/niceng226er7.tab29/?report=objectonly" target="object" title="Table 29" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab29" rid-ob="figobniceng226er7tab29"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab29/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab29/?report=previmg" alt="Table 29. Summary of studies included in the combination therapy compared to sham treatment comparison." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab29"><a href="/books/NBK589223/table/niceng226er7.tab29/?report=objectonly" target="object" rid-ob="figobniceng226er7tab29">Table 29</a></h4><p class="float-caption no_bottom_margin">Summary of studies included in the combination therapy compared to sham treatment comparison. </p></div></div></div><div id="niceng226er7.s1.1.5.29"><h5>1.1.5.29. Combination therapy compared to no treatment</h5><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab30"><a href="/books/NBK589223/table/niceng226er7.tab30/?report=objectonly" target="object" title="Table 30" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab30" rid-ob="figobniceng226er7tab30"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab30/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab30/?report=previmg" alt="Table 30. Summary of studies included in the combination therapy compared to no treatment comparison." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab30"><a href="/books/NBK589223/table/niceng226er7.tab30/?report=objectonly" target="object" rid-ob="figobniceng226er7tab30">Table 30</a></h4><p class="float-caption no_bottom_margin">Summary of studies included in the combination therapy compared to no treatment comparison. </p></div></div></div><div id="niceng226er7.s1.1.5.30"><h5>1.1.5.30. Matrices</h5><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab31"><a href="/books/NBK589223/table/niceng226er7.tab31/?report=objectonly" target="object" title="Table 31" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab31" rid-ob="figobniceng226er7tab31"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab31/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab31/?report=previmg" alt="Table 31. Summary matrix for all interventions at ≤3 months." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab31"><a href="/books/NBK589223/table/niceng226er7.tab31/?report=objectonly" target="object" rid-ob="figobniceng226er7tab31">Table 31</a></h4><p class="float-caption no_bottom_margin">Summary matrix for all interventions at ≤3 months. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab32"><a href="/books/NBK589223/table/niceng226er7.tab32/?report=objectonly" target="object" title="Table 32" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab32" rid-ob="figobniceng226er7tab32"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab32/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab32/?report=previmg" alt="Table 32. Summary matrix for all interventions at >3 months." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab32"><a href="/books/NBK589223/table/niceng226er7.tab32/?report=objectonly" target="object" rid-ob="figobniceng226er7tab32">Table 32</a></h4><p class="float-caption no_bottom_margin">Summary matrix for all interventions at >3 months. </p></div></div></div></div><div id="niceng226er7.s1.1.6"><h4>1.1.6. Summary of the effectiveness evidence</h4><div id="niceng226er7.s1.1.6.1"><h5>1.1.6.1. Pulsed short-wave therapy compared to sham electrotherapy and no treatment</h5><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab33"><a href="/books/NBK589223/table/niceng226er7.tab33/?report=objectonly" target="object" title="Table 33" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab33" rid-ob="figobniceng226er7tab33"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab33/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab33/?report=previmg" alt="Table 33. Clinical evidence summary: pulsed short-wave therapy compared to sham electrotherapy." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab33"><a href="/books/NBK589223/table/niceng226er7.tab33/?report=objectonly" target="object" rid-ob="figobniceng226er7tab33">Table 33</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: pulsed short-wave therapy compared to sham electrotherapy. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab34"><a href="/books/NBK589223/table/niceng226er7.tab34/?report=objectonly" target="object" title="Table 34" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab34" rid-ob="figobniceng226er7tab34"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab34/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab34/?report=previmg" alt="Table 34. Clinical evidence summary: pulsed short-wave therapy compared to no treatment." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab34"><a href="/books/NBK589223/table/niceng226er7.tab34/?report=objectonly" target="object" rid-ob="figobniceng226er7tab34">Table 34</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: pulsed short-wave therapy compared to no treatment. </p></div></div></div><div id="niceng226er7.s1.1.6.2"><h5>1.1.6.2. Interferential therapy compared to pulsed short-wave therapy, laser therapy, sham electrotherapy and no treatment</h5><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab35"><a href="/books/NBK589223/table/niceng226er7.tab35/?report=objectonly" target="object" title="Table 35" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab35" rid-ob="figobniceng226er7tab35"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab35/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab35/?report=previmg" alt="Table 35. Clinical evidence summary: interferential therapy compared to pulsed short-wave therapy." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab35"><a href="/books/NBK589223/table/niceng226er7.tab35/?report=objectonly" target="object" rid-ob="figobniceng226er7tab35">Table 35</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: interferential therapy compared to pulsed short-wave therapy. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab36"><a href="/books/NBK589223/table/niceng226er7.tab36/?report=objectonly" target="object" title="Table 36" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab36" rid-ob="figobniceng226er7tab36"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab36/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab36/?report=previmg" alt="Table 36. Clinical evidence summary: interferential therapy compared to laser therapy." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab36"><a href="/books/NBK589223/table/niceng226er7.tab36/?report=objectonly" target="object" rid-ob="figobniceng226er7tab36">Table 36</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: interferential therapy compared to laser therapy. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab37"><a href="/books/NBK589223/table/niceng226er7.tab37/?report=objectonly" target="object" title="Table 37" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab37" rid-ob="figobniceng226er7tab37"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab37/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab37/?report=previmg" alt="Table 37. Clinical evidence summary: interferential therapy compared to sham electrotherapy." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab37"><a href="/books/NBK589223/table/niceng226er7.tab37/?report=objectonly" target="object" rid-ob="figobniceng226er7tab37">Table 37</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: interferential therapy compared to sham electrotherapy. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab38"><a href="/books/NBK589223/table/niceng226er7.tab38/?report=objectonly" target="object" title="Table 38" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab38" rid-ob="figobniceng226er7tab38"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab38/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab38/?report=previmg" alt="Table 38. Clinical evidence summary: interferential therapy compared to no treatment." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab38"><a href="/books/NBK589223/table/niceng226er7.tab38/?report=objectonly" target="object" rid-ob="figobniceng226er7tab38">Table 38</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: interferential therapy compared to no treatment. </p></div></div></div><div id="niceng226er7.s1.1.6.3"><h5>1.1.6.3. Neuromuscular electrical stimulation compared to no treatment</h5><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab39"><a href="/books/NBK589223/table/niceng226er7.tab39/?report=objectonly" target="object" title="Table 39" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab39" rid-ob="figobniceng226er7tab39"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab39/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab39/?report=previmg" alt="Table 39. Clinical evidence summary: neuromuscular electrical stimulation compared to no treatment." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab39"><a href="/books/NBK589223/table/niceng226er7.tab39/?report=objectonly" target="object" rid-ob="figobniceng226er7tab39">Table 39</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: neuromuscular electrical stimulation compared to no treatment. </p></div></div></div><div id="niceng226er7.s1.1.6.4"><h5>1.1.6.4. Extracorporeal shockwave therapy compared to sham electrotherapy and no treatment</h5><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab40"><a href="/books/NBK589223/table/niceng226er7.tab40/?report=objectonly" target="object" title="Table 40" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab40" rid-ob="figobniceng226er7tab40"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab40/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab40/?report=previmg" alt="Table 40. Clinical evidence summary: extracorporeal shockwave therapy compared to sham electrotherapy." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab40"><a href="/books/NBK589223/table/niceng226er7.tab40/?report=objectonly" target="object" rid-ob="figobniceng226er7tab40">Table 40</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: extracorporeal shockwave therapy compared to sham electrotherapy. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab41"><a href="/books/NBK589223/table/niceng226er7.tab41/?report=objectonly" target="object" title="Table 41" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab41" rid-ob="figobniceng226er7tab41"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab41/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab41/?report=previmg" alt="Table 41. Clinical evidence summary: extracorporeal shockwave therapy compared to no treatment." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab41"><a href="/books/NBK589223/table/niceng226er7.tab41/?report=objectonly" target="object" rid-ob="figobniceng226er7tab41">Table 41</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: extracorporeal shockwave therapy compared to no treatment. </p></div></div></div><div id="niceng226er7.s1.1.6.5"><h5>1.1.6.5. Laser therapy compared to pulsed short-wave therapy, neuromuscular electrical stimulation, sham electrotherapy and no treatment</h5><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab42"><a href="/books/NBK589223/table/niceng226er7.tab42/?report=objectonly" target="object" title="Table 42" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab42" rid-ob="figobniceng226er7tab42"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab42/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab42/?report=previmg" alt="Table 42. Clinical evidence summary: laser therapy compared to pulsed short-wave therapy." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab42"><a href="/books/NBK589223/table/niceng226er7.tab42/?report=objectonly" target="object" rid-ob="figobniceng226er7tab42">Table 42</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: laser therapy compared to pulsed short-wave therapy. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab43"><a href="/books/NBK589223/table/niceng226er7.tab43/?report=objectonly" target="object" title="Table 43" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab43" rid-ob="figobniceng226er7tab43"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab43/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab43/?report=previmg" alt="Table 43. Clinical evidence summary: laser therapy compared to neuromuscular electrical stimulation." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab43"><a href="/books/NBK589223/table/niceng226er7.tab43/?report=objectonly" target="object" rid-ob="figobniceng226er7tab43">Table 43</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: laser therapy compared to neuromuscular electrical stimulation. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab44"><a href="/books/NBK589223/table/niceng226er7.tab44/?report=objectonly" target="object" title="Table 44" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab44" rid-ob="figobniceng226er7tab44"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab44/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab44/?report=previmg" alt="Table 44. Clinical evidence summary: laser therapy compared to sham electrotherapy." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab44"><a href="/books/NBK589223/table/niceng226er7.tab44/?report=objectonly" target="object" rid-ob="figobniceng226er7tab44">Table 44</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: laser therapy compared to sham electrotherapy. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab45"><a href="/books/NBK589223/table/niceng226er7.tab45/?report=objectonly" target="object" title="Table 45" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab45" rid-ob="figobniceng226er7tab45"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab45/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab45/?report=previmg" alt="Table 45. Clinical evidence summary: laser therapy compared to no treatment." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab45"><a href="/books/NBK589223/table/niceng226er7.tab45/?report=objectonly" target="object" rid-ob="figobniceng226er7tab45">Table 45</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: laser therapy compared to no treatment. </p></div></div></div><div id="niceng226er7.s1.1.6.6"><h5>1.1.6.6. Transcutaneous electrical nerve stimulation compared to pulsed short-wave therapy, interferential therapy, sham electrotherapy and no treatment</h5><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab46"><a href="/books/NBK589223/table/niceng226er7.tab46/?report=objectonly" target="object" title="Table 46" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab46" rid-ob="figobniceng226er7tab46"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab46/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab46/?report=previmg" alt="Table 46. Clinical evidence summary: transcutaneous electrical nerve stimulation compared to pulsed short-wave therapy." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab46"><a href="/books/NBK589223/table/niceng226er7.tab46/?report=objectonly" target="object" rid-ob="figobniceng226er7tab46">Table 46</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: transcutaneous electrical nerve stimulation compared to pulsed short-wave therapy. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab47"><a href="/books/NBK589223/table/niceng226er7.tab47/?report=objectonly" target="object" title="Table 47" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab47" rid-ob="figobniceng226er7tab47"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab47/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab47/?report=previmg" alt="Table 47. Clinical evidence summary: transcutaneous electrical nerve stimulation compared to interferential therapy." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab47"><a href="/books/NBK589223/table/niceng226er7.tab47/?report=objectonly" target="object" rid-ob="figobniceng226er7tab47">Table 47</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: transcutaneous electrical nerve stimulation compared to interferential therapy. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab48"><a href="/books/NBK589223/table/niceng226er7.tab48/?report=objectonly" target="object" title="Table 48" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab48" rid-ob="figobniceng226er7tab48"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab48/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab48/?report=previmg" alt="Table 48. Clinical evidence summary: transcutaneous electrical nerve stimulation compared to sham electrotherapy." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab48"><a href="/books/NBK589223/table/niceng226er7.tab48/?report=objectonly" target="object" rid-ob="figobniceng226er7tab48">Table 48</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: transcutaneous electrical nerve stimulation compared to sham electrotherapy. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab49"><a href="/books/NBK589223/table/niceng226er7.tab49/?report=objectonly" target="object" title="Table 49" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab49" rid-ob="figobniceng226er7tab49"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab49/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab49/?report=previmg" alt="Table 49. Clinical evidence summary: transcutaneous electrical nerve stimulation compared to no treatment." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab49"><a href="/books/NBK589223/table/niceng226er7.tab49/?report=objectonly" target="object" rid-ob="figobniceng226er7tab49">Table 49</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: transcutaneous electrical nerve stimulation compared to no treatment. </p></div></div></div><div id="niceng226er7.s1.1.6.7"><h5>1.1.6.7. Ultrasound compared to pulsed short-wave therapy, neuromuscular electrical stimulation, transcutaneous electrical nerve stimulation, sham ultrasound and no treatment</h5><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab50"><a href="/books/NBK589223/table/niceng226er7.tab50/?report=objectonly" target="object" title="Table 50" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab50" rid-ob="figobniceng226er7tab50"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab50/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab50/?report=previmg" alt="Table 50. Clinical evidence summary: ultrasound compared to pulsed short-wave therapy." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab50"><a href="/books/NBK589223/table/niceng226er7.tab50/?report=objectonly" target="object" rid-ob="figobniceng226er7tab50">Table 50</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: ultrasound compared to pulsed short-wave therapy. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab51"><a href="/books/NBK589223/table/niceng226er7.tab51/?report=objectonly" target="object" title="Table 51" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab51" rid-ob="figobniceng226er7tab51"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab51/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab51/?report=previmg" alt="Table 51. Clinical evidence summary: ultrasound compared to neuromuscular electrical stimulation." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab51"><a href="/books/NBK589223/table/niceng226er7.tab51/?report=objectonly" target="object" rid-ob="figobniceng226er7tab51">Table 51</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: ultrasound compared to neuromuscular electrical stimulation. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab52"><a href="/books/NBK589223/table/niceng226er7.tab52/?report=objectonly" target="object" title="Table 52" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab52" rid-ob="figobniceng226er7tab52"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab52/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab52/?report=previmg" alt="Table 52. Clinical evidence summary: ultrasound compared to transcutaneous electrical nerve stimulation." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab52"><a href="/books/NBK589223/table/niceng226er7.tab52/?report=objectonly" target="object" rid-ob="figobniceng226er7tab52">Table 52</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: ultrasound compared to transcutaneous electrical nerve stimulation. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab53"><a href="/books/NBK589223/table/niceng226er7.tab53/?report=objectonly" target="object" title="Table 53" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab53" rid-ob="figobniceng226er7tab53"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab53/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab53/?report=previmg" alt="Table 53. Clinical evidence summary: ultrasound compared to sham electrotherapy." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab53"><a href="/books/NBK589223/table/niceng226er7.tab53/?report=objectonly" target="object" rid-ob="figobniceng226er7tab53">Table 53</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: ultrasound compared to sham electrotherapy. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab54"><a href="/books/NBK589223/table/niceng226er7.tab54/?report=objectonly" target="object" title="Table 54" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab54" rid-ob="figobniceng226er7tab54"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab54/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab54/?report=previmg" alt="Table 54. Clinical evidence summary: ultrasound compared to no treatment." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab54"><a href="/books/NBK589223/table/niceng226er7.tab54/?report=objectonly" target="object" rid-ob="figobniceng226er7tab54">Table 54</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: ultrasound compared to no treatment. </p></div></div></div><div id="niceng226er7.s1.1.6.8"><h5>1.1.6.8. Combination therapy compared to interferential therapy, neuromuscular electrical stimulation, laser therapy, transcutaneous electrical nerve stimulation, ultrasound, sham electrotherapy and no treatment</h5><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab55"><a href="/books/NBK589223/table/niceng226er7.tab55/?report=objectonly" target="object" title="Table 55" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab55" rid-ob="figobniceng226er7tab55"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab55/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab55/?report=previmg" alt="Table 55. Clinical evidence summary: combination therapy compared to interferential therapy." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab55"><a href="/books/NBK589223/table/niceng226er7.tab55/?report=objectonly" target="object" rid-ob="figobniceng226er7tab55">Table 55</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: combination therapy compared to interferential therapy. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab56"><a href="/books/NBK589223/table/niceng226er7.tab56/?report=objectonly" target="object" title="Table 56" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab56" rid-ob="figobniceng226er7tab56"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab56/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab56/?report=previmg" alt="Table 56. Clinical evidence summary: combination therapy compared to neuromuscular electrical stimulation." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab56"><a href="/books/NBK589223/table/niceng226er7.tab56/?report=objectonly" target="object" rid-ob="figobniceng226er7tab56">Table 56</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: combination therapy compared to neuromuscular electrical stimulation. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab57"><a href="/books/NBK589223/table/niceng226er7.tab57/?report=objectonly" target="object" title="Table 57" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab57" rid-ob="figobniceng226er7tab57"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab57/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab57/?report=previmg" alt="Table 57. Clinical evidence summary: combination therapy compared to laser therapy." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab57"><a href="/books/NBK589223/table/niceng226er7.tab57/?report=objectonly" target="object" rid-ob="figobniceng226er7tab57">Table 57</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: combination therapy compared to laser therapy. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab58"><a href="/books/NBK589223/table/niceng226er7.tab58/?report=objectonly" target="object" title="Table 58" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab58" rid-ob="figobniceng226er7tab58"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab58/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab58/?report=previmg" alt="Table 58. Clinical evidence summary: combination therapy compared to transcutaneous electrical nerve stimulation." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab58"><a href="/books/NBK589223/table/niceng226er7.tab58/?report=objectonly" target="object" rid-ob="figobniceng226er7tab58">Table 58</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: combination therapy compared to transcutaneous electrical nerve stimulation. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab59"><a href="/books/NBK589223/table/niceng226er7.tab59/?report=objectonly" target="object" title="Table 59" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab59" rid-ob="figobniceng226er7tab59"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab59/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab59/?report=previmg" alt="Table 59. Clinical evidence summary: combination therapy compared to ultrasound." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab59"><a href="/books/NBK589223/table/niceng226er7.tab59/?report=objectonly" target="object" rid-ob="figobniceng226er7tab59">Table 59</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: combination therapy compared to ultrasound. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab60"><a href="/books/NBK589223/table/niceng226er7.tab60/?report=objectonly" target="object" title="Table 60" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab60" rid-ob="figobniceng226er7tab60"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab60/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab60/?report=previmg" alt="Table 60. Clinical evidence summary: combination therapy compared to sham electrotherapy." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab60"><a href="/books/NBK589223/table/niceng226er7.tab60/?report=objectonly" target="object" rid-ob="figobniceng226er7tab60">Table 60</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: combination therapy compared to sham electrotherapy. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab61"><a href="/books/NBK589223/table/niceng226er7.tab61/?report=objectonly" target="object" title="Table 61" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab61" rid-ob="figobniceng226er7tab61"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab61/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab61/?report=previmg" alt="Table 61. Clinical evidence summary: combination therapy compared to no treatment." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab61"><a href="/books/NBK589223/table/niceng226er7.tab61/?report=objectonly" target="object" rid-ob="figobniceng226er7tab61">Table 61</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: combination therapy compared to no treatment. </p></div></div><p>See <a href="#niceng226er7.appf">Appendix F</a> for full GRADE tables.</p></div></div><div id="niceng226er7.s1.1.7"><h4>1.1.7. Economic evidence</h4><div id="niceng226er7.s1.1.7.1"><h5>1.1.7.1. Included studies</h5><p>One health economic study with the relevant comparison was included in this review.<a class="bibr" href="#niceng226er7.s1.1.ref145" rid="niceng226er7.s1.1.ref145"><sup>145</sup></a> This is summarised in the health economic evidence profile below (<a class="figpopup" href="/books/NBK589223/table/niceng226er7.tab62/?report=objectonly" target="object" rid-figpopup="figniceng226er7tab62" rid-ob="figobniceng226er7tab62">62</a>) and the health economic evidence table in <a href="#niceng226er7.apph">Appendix H</a>.</p></div><div id="niceng226er7.s1.1.7.2"><h5>1.1.7.2. Excluded studies</h5><p>No relevant health economic studies were excluded due to limited applicability or methodological limitations.</p><p>See also the health economic study selection flow chart in <a href="#niceng226er7.appg">Appendix G</a>.</p></div></div><div id="niceng226er7.s1.1.8"><h4>1.1.8. Summary of included economic evidence</h4><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab62"><a href="/books/NBK589223/table/niceng226er7.tab62/?report=objectonly" target="object" title="Table 62" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab62" rid-ob="figobniceng226er7tab62"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab62/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab62/?report=previmg" alt="Table 62. Health economic evidence profile: Electrotherapy versus usual care." /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab62"><a href="/books/NBK589223/table/niceng226er7.tab62/?report=objectonly" target="object" rid-ob="figobniceng226er7tab62">Table 62</a></h4><p class="float-caption no_bottom_margin">Health economic evidence profile: Electrotherapy versus usual care. </p></div></div></div><div id="niceng226er7.s1.1.9"><h4>1.1.9. Economic model</h4><p>This area was not prioritised for new cost-effectiveness analysis.</p></div><div id="niceng226er7.s1.1.10"><h4>1.1.10. Unit costs</h4><p>Relevant unit costs are provided below to aid consideration of cost effectiveness.</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng226er7tab63"><a href="/books/NBK589223/table/niceng226er7.tab63/?report=objectonly" target="object" title="Table" class="img_link icnblk_img figpopup" rid-figpopup="figniceng226er7tab63" rid-ob="figobniceng226er7tab63"><img class="small-thumb" src="/books/NBK589223/table/niceng226er7.tab63/?report=thumb" src-large="/books/NBK589223/table/niceng226er7.tab63/?report=previmg" alt="Image " /></a><div class="icnblk_cntnt"><h4 id="niceng226er7.tab63"><a href="/books/NBK589223/table/niceng226er7.tab63/?report=objectonly" target="object" rid-ob="figobniceng226er7tab63">Table</a></h4></div></div></div><div id="niceng226er7.s1.1.11"><h4>1.1.11. Economic evidence statements</h4><ul><li class="half_rhythm"><div>One cost-utility analysis compared usual care to a multitude of electrotherapy options; interferential therapy, laser light therapy, neuromuscular electrical stimulation (NMES), pulsed electromagnetic field (PEMF), pulsed electrical stimulation (PES) and transcutaneous electrical nerve stimulation (TENS) as well as non-electrotherapy options; acupuncture, braces, heat treatment insoles and static magnets. TENS was the only electrotherapy option that was cost effective compared with usual care with a cost per QALY gained of £2,690. This analysis was assessed as directly applicable with potentially serious limitations.</div></li></ul></div><div id="niceng226er7.s1.1.12"><h4>1.1.12. The committee’s discussion and interpretation of the evidence</h4><div id="niceng226er7.s1.1.12.1"><h5>1.1.12.1. The outcomes that matter most</h5><p>The critical outcomes were quality of life, pain and physical function. These were considered critical due to their importance to people with osteoarthritis. The Osteoarthritis Research Society International (OARSI) consider that pain and physical function were the most important outcomes for evaluating interventions. Quality of life gives a broader perspective on the person’s wellbeing, allowing for examination of the biopsychosocial impact of interventions. Psychological distress, osteoarthritis flare, mild adverse events and moderate/major adverse events were included as important outcomes.</p><p>The committee considered osteoarthritis flares to be important in the lived experience and management of osteoarthritis. However, these were also considered difficult to measure with no clear consensus on their definition. The Flares in OA OMERACT working group have proposed an initial definition and domains of OA flares through a consensus exercise; “it is a transient state, different from the usual state of the condition, with a duration of a few days, characterized by onset, worsening of pain, swelling, stiffness, impact on sleep, activity, functioning, and psychological aspects that can resolve spontaneously or lead to a need to adjust therapy”. However, this has been considered to have limitations and has not been widely adopted. Therefore, the committee included the outcome accepting any reasonable definition provided by any studies discussing the event.</p><p>Mortality was included as a treatment adverse event rather than as a discreet outcome and categorised as an important outcome. Osteoarthritis as a disease process is not considered to cause mortality by itself and mortality is an uncommon outcome from osteoarthritis interventions.</p><p>There was evidence available for all outcomes apart from osteoarthritis flares. However, there was only limited evidence available regarding psychological distress and adverse events.</p></div><div id="niceng226er7.s1.1.12.2"><h5>1.1.12.2. The quality of the evidence</h5><p>Sixty-six randomised controlled trial studies were included in the review. The comparisons where evidence was present included:
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<ul><li class="half_rhythm"><div>Pulsed short-wave therapy compared to sham electrotherapy</div></li><li class="half_rhythm"><div>Pulsed short-wave therapy compared to no treatment</div></li><li class="half_rhythm"><div>Interferential therapy compared to pulsed short-wave therapy</div></li><li class="half_rhythm"><div>Interferential therapy compared to laser therapy</div></li><li class="half_rhythm"><div>Interferential therapy compared to sham electrotherapy</div></li><li class="half_rhythm"><div>Interferential therapy compared to no treatment</div></li><li class="half_rhythm"><div>Neuromuscular electrical stimulation compared to no treatment</div></li><li class="half_rhythm"><div>Extracorporeal shockwave therapy compared to sham electrotherapy</div></li><li class="half_rhythm"><div>Extracorporeal shockwave therapy compared to no treatment</div></li><li class="half_rhythm"><div>Laser therapy compared to pulsed short-wave therapy</div></li><li class="half_rhythm"><div>Laser therapy compared to neuromuscular electrical stimulation</div></li><li class="half_rhythm"><div>Laser therapy compared to sham electrotherapy</div></li><li class="half_rhythm"><div>Laser therapy compared to no treatment</div></li><li class="half_rhythm"><div>Transcutaneous electrical nerve stimulation compared to pulsed short-wave therapy</div></li><li class="half_rhythm"><div>Transcutaneous electrical nerve stimulation compared to interferential therapy</div></li><li class="half_rhythm"><div>Transcutaneous electrical nerve stimulation compared to sham electrotherapy</div></li><li class="half_rhythm"><div>Transcutaneous electrical nerve stimulation compared to no treatment</div></li><li class="half_rhythm"><div>Ultrasound compared to pulsed short-wave therapy</div></li><li class="half_rhythm"><div>Ultrasound compared to neuromuscular electrical stimulation</div></li><li class="half_rhythm"><div>Ultrasound compared to transcutaneous electrical nerve stimulation</div></li><li class="half_rhythm"><div>Ultrasound compared to sham electrotherapy</div></li><li class="half_rhythm"><div>Ultrasound compared to no treatment</div></li><li class="half_rhythm"><div>Combination therapy compared to interferential therapy</div></li><li class="half_rhythm"><div>Combination therapy compared to neuromuscular electrical stimulation</div></li><li class="half_rhythm"><div>Combination therapy compared to laser therapy</div></li><li class="half_rhythm"><div>Combination therapy compared to transcutaneous electrical nerve stimulation</div></li><li class="half_rhythm"><div>Combination therapy compared to ultrasound</div></li><li class="half_rhythm"><div>Combination therapy compared to sham electrotherapy</div></li><li class="half_rhythm"><div>Combination therapy compared to no treatment</div></li></ul></p><p>The evidence varied from high to very low quality, with the majority being of low quality. Outcomes were commonly downgraded for risk of bias, in particular for selection bias and performance bias (apart from where the comparator was sham therapy), and imprecision. Some outcomes were downgraded for inconsistency. When present, inconsistent results were not explained by subgroup analysis. The majority of comparisons consisted of studies with a small number of participants (less than 50) with a few studies that included a larger number of participants.</p><p>The committee agreed that there was some evidence comparing the majority of different forms of electrotherapy to sham or no treatment (with the exception of neuromuscular electrical stimulation that was not compared to sham electrotherapy). However, findings were often mixed and there is insufficient evidence to compare different types of electrotherapy to each other.</p><div id="niceng226er7.s1.1.12.2.1"><h5>Pulsed short-wave therapy</h5><p>Pulsed short-wave therapy was compared to interferential therapy, laser therapy, transcutaneous electrical nerve stimulation, ultrasound, sham electrotherapy and no treatment. Comparisons were available at less than and greater than 3 months.</p><ul><li class="half_rhythm"><div>When compared to interferential therapy, the evidence was based on 2 studies and was of moderate to low quality due to risk of bias and imprecision.</div></li><li class="half_rhythm"><div>When compared to laser therapy, the evidence was based on 1 small study (N=40 for this comparison) reporting 2 outcomes that were of moderate and low quality respectively due to risk of bias and imprecision.</div></li><li class="half_rhythm"><div>When compared to transcutaneous electrical nerve stimulation, the evidence was based on 2 studies and was of low quality due to risk of bias and imprecision.</div></li><li class="half_rhythm"><div>When compared to ultrasound, the evidence was based on 1 small study (N=40) reporting 1 outcome that was of very low quality, due to risk of bias and imprecision.</div></li><li class="half_rhythm"><div>When compared to sham electrotherapy, the evidence was based on 15 studies and the quality of the outcomes was between high and very low quality, with the majority of evidence being of moderate-low quality. Outcomes were often downgraded due to risk of bias and imprecision. However, some outcomes were downgraded due to inconsistency (including some pain and physical function outcomes).</div></li><li class="half_rhythm"><div>When compared to no treatment, the evidence was based on 5 studies. Most outcomes included only 1 small study and were of moderate-very low quality, with the majority being of very low quality. Outcomes were often downgraded due to risk of bias and imprecision.</div></li></ul></div><div id="niceng226er7.s1.1.12.2.2"><h5>Interferential therapy</h5><p>Interferential therapy was compared to pulsed short-wave therapy, laser therapy, transcutaneous electrical nerve stimulation, combination therapy, sham electrotherapy and no treatment. Comparisons were available at less than and greater than 3 months.</p><ul><li class="half_rhythm"><div>When compared to interferential therapy, the evidence was based on 2 studies and the outcomes were of moderate to low quality due to risk of bias and imprecision.</div></li><li class="half_rhythm"><div>When compared to laser therapy, the evidence was based on 2 studies and the quality of the outcomes was between moderate and low quality. Outcomes were often downgraded for risk of bias and imprecision.</div></li><li class="half_rhythm"><div>When compared to transcutaneous electrical nerve stimulation, the evidence was based on 2 studies with only 1 study reporting each outcome and was of low quality due to risk of bias and imprecision.</div></li><li class="half_rhythm"><div>When compared to combination therapy (interferential therapy and laser therapy), the evidence was based on 1 small study (N=84 for this comparison) with the outcomes being of moderate quality due to imprecision.</div></li><li class="half_rhythm"><div>When compared to sham electrotherapy, the evidence was based on 4 studies where outcomes ranged from moderate to very low quality. Outcomes were often downgraded for risk of bias and imprecision. However, some outcomes were downgraded for inconsistency, with heterogeneity that could not be resolved by subgroup analysis.</div></li><li class="half_rhythm"><div>When compared to no treatment, the evidence was based on 1 small study (N=40) with outcomes ranging from moderate to low quality, due to concerns risk of bias and both risk of bias and imprecision respectively.</div></li></ul></div><div id="niceng226er7.s1.1.12.2.3"><h5>Neuromuscular electrical stimulation</h5><p>Neuromuscular electrical stimulation was compared to laser therapy, ultrasound, combination therapy and no treatment. The majority of comparisons only had data reported at less than 3 months. The comparison to no treatment had data available at less than and more than 3 months.</p><ul><li class="half_rhythm"><div>When compared to laser therapy, 1 outcome was reported in 1 small study (N=30) that was of low quality due to risk of bias and imprecision.</div></li><li class="half_rhythm"><div>When compared to ultrasound, outcomes were reported in 1 small study (N=60) that was of low quality due to risk of bias and imprecision.</div></li><li class="half_rhythm"><div>When compared to combination therapy (laser therapy and neuromuscular electrical stimulation), 1 outcome was reported in 1 small study (N=29) that was of low quality due to risk of bias and imprecision.</div></li><li class="half_rhythm"><div>When compared to no treatment, the evidence was based on 6 studies. The quality ranged from moderate to very low quality, with the majority being of very low quality. Studies were commonly downgraded due to risk of bias and imprecision. 1 outcome was downgraded due to inconsistency.</div></li></ul></div><div id="niceng226er7.s1.1.12.2.4"><h5>Extracorporeal shockwave therapy</h5><p>Extracorporeal shockwave therapy was compared to sham electrotherapy and no treatment at ≤3 months only.</p><ul><li class="half_rhythm"><div>When compared to sham electrotherapy, the evidence was based on 5 studies. The outcomes ranged from moderate to very low quality due to risk of bias, imprecision and in some cases, inconsistency with heterogeneity that could not be resolved by subgroup analysis.</div></li><li class="half_rhythm"><div>When compared to no treatment, the evidence was based on 2 studies. The outcomes were of low quality due to risk of bias and imprecision.</div></li></ul></div><div id="niceng226er7.s1.1.12.2.5"><h5>Laser therapy</h5><p>Laser therapy was compared to pulsed short-wave therapy, interferential therapy, neuromuscular electrical stimulation, combination therapy, sham electrotherapy and no treatment. Sham electrotherapy and no treatment comparisons were available before and after 3 months.</p><ul><li class="half_rhythm"><div>When compared to pulsed short-wave therapy, the evidence was based on 1 small study (N=40 for this comparison) reporting 2 outcomes that were of moderate and low quality respectively due to risk of bias and imprecision.</div></li><li class="half_rhythm"><div>When compared to interferential therapy, the evidence was based on 2 studies and the quality of the outcomes was between moderate and low quality. Outcomes were often downgraded for risk of bias and imprecision.</div></li><li class="half_rhythm"><div>When compared to neuromuscular electrical stimulation, 1 outcome was reported in 1 small study (N=30) that was of low quality due to risk of bias and imprecision.</div></li><li class="half_rhythm"><div>When compared to combination therapy (laser therapy and interferential therapy or laser therapy and neuromuscular electrical stimulation), 2 outcomes was reported in 2 studies that were of moderate and low quality due to risk of bias and imprecision respectively.</div></li><li class="half_rhythm"><div>When compared to sham electrotherapy, the evidence was based on 20 studies. The quality ranged between high and very low quality, with the majority being of moderate to low quality. Studies were often downgraded due to risk of bias, inconsistency or imprecision. 6 outcomes were downgraded due to inconsistency.</div></li><li class="half_rhythm"><div>When compared to no treatment, the evidence was based on 3 studies. The quality was of low or very low quality. Studies were often downgraded due to risk of bias and imprecision. 3 outcomes were downgraded due to inconsistency.</div></li></ul></div><div id="niceng226er7.s1.1.12.2.6"><h5>Transcutaneous electrical nerve stimulation</h5><p>Transcutaneous electrical nerve stimulation was compared to pulsed short-wave therapy, interferential therapy, ultrasound, combination therapy, sham electrotherapy and no treatment. Evidence was available for most comparisons at both before and after 3 months.</p><ul><li class="half_rhythm"><div>When compared to pulsed short-wave therapy, the evidence was based on 2 studies and was of low quality due to risk of bias and imprecision.</div></li><li class="half_rhythm"><div>When compared to interferential therapy, the evidence was based on 2 studies with only 1 study reporting each outcome and was of low quality due to risk of bias and imprecision.</div></li><li class="half_rhythm"><div>When compared to ultrasound, the evidence was based on 2 small studies with only 1 study reporting each outcome and was of very low quality due to risk of bias and imprecision.</div></li><li class="half_rhythm"><div>When compared to combination therapy (transcutaneous electrical nerve stimulation and ultrasound), the evidence was based on 1 small study (N=40 for this comparison) with outcomes ranging between moderate and very low quality due to indirectness (using the global score of SF-36 for quality of life rather than the relevant subscales) and imprecision.</div></li><li class="half_rhythm"><div>When compared to sham electrotherapy, the evidence was based on 6 studies. The quality of evidence ranged from moderate to very low quality, with the majority being of very low quality. Studies were often downgraded due to risk of bias and imprecision. 2 outcomes were downgraded due to inconsistency.</div></li><li class="half_rhythm"><div>When compared to no treatment, the evidence was based on 4 studies. The evidence ranged between low and very low quality. Studies were often downgraded for risk of bias, inconsistency and imprecision. 2 outcomes were downgraded due to inconsistency.</div></li></ul></div><div id="niceng226er7.s1.1.12.2.7"><h5>Ultrasound</h5><p>Ultrasound was compared to pulsed short-wave therapy, neuromuscular electrical stimulation, transcutaneous electrical nerve stimulation, combination therapy, sham electrotherapy and no treatment. Evidence was available for all comparisons at ≤3 months but only limited evidence was available at >3 months when compared to sham electrotherapy and no treatment.</p><ul><li class="half_rhythm"><div>When compared to pulsed short-wave therapy, the evidence was based on 1 small study (N=40) reporting 1 outcome that was of very low quality, due to risk of bias and imprecision.</div></li><li class="half_rhythm"><div>When compared to neuromuscular electrical stimulation, outcomes were reported in 1 small study (N=60) that was of low quality due to risk of bias and imprecision.</div></li><li class="half_rhythm"><div>When compared to transcutaneous electrical nerve stimulation, the evidence was based on 2 small studies with only 1 study reporting each outcome and was of very low quality due to risk of bias and imprecision.</div></li><li class="half_rhythm"><div>When compared to combination therapy (transcutaneous electrical nerve stimulation and ultrasound), the evidence was based on 2 studies with the outcomes being of low to very low quality due to risk of bias, imprecision and inconsistency, due to some studies reporting mild adverse events including zero events while others report events in all study arms.</div></li><li class="half_rhythm"><div>When compared to sham electrotherapy, the evidence was based on 11 studies. The quality of evidence ranged from high to very low quality, with the majority being of moderate to low quality. Studies were often downgraded for risk of bias and imprecision. 2 outcomes were downgraded due to inconsistency.</div></li><li class="half_rhythm"><div>When compared to no treatment, the evidence was based on 4 studies. The quality of evidence ranged from low to very low quality, with the majority being of very low quality. Studies were often downgraded for risk of bias and imprecision. 3 outcomes were downgraded due to inconsistency.</div></li></ul></div><div id="niceng226er7.s1.1.12.2.8"><h5>Combination therapy</h5><p>Combination therapy was compared to interferential therapy, neuromuscular electrical stimulation, laser therapy, transcutaneous electrical nerve stimulation, ultrasound, sham electrotherapy and no treatment.</p><ul><li class="half_rhythm"><div>When compared to interferential therapy, the evidence was based on 1 small study (N=84 for this comparison) with the outcomes being of moderate quality due to imprecision.</div></li><li class="half_rhythm"><div>When compared to neuromuscular electrical stimulation, 1 outcome was reported in 1 small study (N=29) that was of low quality due to risk of bias and imprecision.</div></li><li class="half_rhythm"><div>When compared to laser therapy, 2 outcomes was reported in 2 studies that were of moderate and low quality due to risk of bias and imprecision respectively.</div></li><li class="half_rhythm"><div>When compared to transcutaneous electrical nerve stimulation, the evidence was based on 1 small study (N=40 for this comparison) with outcomes ranging between moderate and very low quality due to indirectness (using the global score of SF-36 for quality of life rather than the relevant subscales) and imprecision.</div></li><li class="half_rhythm"><div>When compared to ultrasound, the evidence was based on 2 studies with the outcomes being of low to very low quality due to risk of bias, imprecision and inconsistency, due to some studies reporting mild adverse events including zero events while others report events in all study arms.</div></li><li class="half_rhythm"><div>When compared to sham electrotherapy, the evidence was based on 2 studies and ranged from high to low quality due to imprecision.</div></li><li class="half_rhythm"><div>When compared to no treatment, the evidence was based on 2 studies and ranged from low to very low quality due to risk of bias, imprecision and inconsistency with heterogeneity that could be not resolved by subgroup analysis.</div></li></ul></div></div><div id="niceng226er7.s1.1.12.3"><h5>1.1.12.3. Benefits and harms</h5><div id="niceng226er7.s1.1.12.3.1"><h5>Key uncertainties</h5><p>The committee discussed that generally the adverse events data for these trials was limited as this was generally found in small studies with a short follow up time and so it is unclear whether this is representative of the events expected to be seen in real life practice. Given this, the committee considered the evidence for mild, moderate and severe adverse events to be unclear throughout the review reflecting this in their weighting of findings while making recommendations. The committee noted throughout the evidence that the number of adverse events was often low and where events were reported they were transient in nature (such as increased pain). Given this, while the committee acknowledged where clinically important differences were highlighted in the evidence, but also considered the nature and true number of these events.</p><p>On examining the evidence, the committee agreed that there was significant heterogeneity in the interventions being offered between studies investigating the same class, which made it difficult to draw conclusions regarding the interventions. This variation was also present in the use of sham comparisons, where the techniques used to achieve this varied from using the device but having no power entering the machine, to using devices made to simulate the effect. In some cases, these shams seemed like they may not effectively blind the participant due to the vigorous nature of the intervention (such as for extracorporeal shockwave therapy). The committee acknowledge the challenges in examining these interventions using these methods and considered this when making recommendations.</p></div><div id="niceng226er7.s1.1.12.3.2"><h5>Pulsed short-wave therapy</h5><p>Pulsed short-wave therapy was compared to interferential therapy, laser therapy, transcutaneous electrical nerve stimulation, ultrasound, sham electrotherapy and no treatment. When compared to sham electrotherapy, unclear effects were seen in quality of life and pain at ≤3 months, where 1 outcome including 1 and9 studies respectively showed a clinically important benefit, while 2 outcomes including 4 studies for quality of life and 1 outcome including 4 studies for pain showed no clinically important difference. The clinically important benefit for pain was seen in an analysis where the result was inconsistent, with some studies showing clinically important benefits while others showed no difference. These unclear effects for pain were also seen at >3 months. Clinically important benefits were seen in physical function (based on low to very low quality evidence). No clinically important differences were seen in psychological distress, mild and moderate/major adverse events. When compared to no treatment, unclear effects were seen for quality of life (present at less than and more than 3 months), pain and physical function where some outcomes showed clinically important benefits while others showed no clinically important differences. When compared to other interventions, pulsed short-wave therapy had an unclear effect when compared to laser therapy (where laser therapy led to clinically important benefits in pain, while pulsed short-wave therapy led to clinically important benefits in physical function). Otherwise, there did not appear to be a clinically important difference between pulsed-short wave therapy and the other therapies mentioned above.</p></div><div id="niceng226er7.s1.1.12.3.3"><h5>Interferential therapy</h5><p>Interferential therapy was compared to pulsed short-wave therapy, laser therapy, transcutaneous electrical nerve stimulation, combination therapy, sham electrotherapy and no treatment. When compared to sham electrotherapy at ≤3 months, an unclear effect was seen for pain, with 1 outcome including 3 studies indicating a clinically important benefit based on very low quality evidence, while 1 outcome including 1 study indicated no clinically important difference based on moderate quality evidence. Clinically important benefits were seen for physical function based on two studies. When compared to other interventions, interferential therapy appeared to cause a clinically important benefit in mild adverse events when compared to transcutaneous electrical nerve stimulation. A clinically important difference in physical function was seen when compared to laser therapy based on evidence from 1 small study (N=40). No effects were sustained at >3 months.</p></div><div id="niceng226er7.s1.1.12.3.4"><h5>Neuromuscular electrical stimulation</h5><p>Neuromuscular electrical stimulation was compared to laser therapy, ultrasound, combination therapy and no treatment. When compared to no treatment at ≤3 months, unclear effects were seen in pain where 1 outcome showed a clinically important benefit with 1 outcome showed no clinically important difference. An unclear effect was seen in quality of life. However, in this case 6 outcomes indicated no clinically important difference while 2 outcomes indicated a clinically important harm. Otherwise, there was no clinically important difference seen in physical function and mild adverse events. However, at >3 months clinically important benefits were seen in pain and physical function. When compared to other interventions neuromuscular electrical stimulation appeared inferior. When compared to laser therapy there was a clinically important harm in pain based on 1 small study (N=30), and when compared to ultrasound there were clinically important harms in pain and physical function based on 1 small study (N=60). When compared to combination therapy there was no clinically important difference in pain based on 1 small study (N=29).</p></div><div id="niceng226er7.s1.1.12.3.5"><h5>Extracorporeal shockwave therapy</h5><p>Extracorporeal shockwave therapy was compared to sham electrotherapy and no treatment at ≤3 months only. When compared to sham electrotherapy clinically important benefits were seen in pain, physical function and mild adverse events, while no clinically important difference was seen in moderate/major adverse events. However, when compared to no treatment no clinically important difference was seen in pain while a clinically important harm was seen in physical function. The committee considered the studies and agreed that, while a sham comparison was used, it was unlikely to be sufficiently blinded due to the sensation that a person receiving extracorporeal shockwave therapy being of a likely greater amplitude to that received with sham. This meant that people may have known if they received the real or sham treatment, creating uncertainty in the effect. They also agreed that, while the overall number of participants in the meta-analysis was larger (N=307 and N=200 for pain and physical function respectively) the individual studies were still small. Given these factors and the uncertainty seen between the sham and no treatment comparisons, the committee agreed that there was currently insufficient evidence to support the use of extracorporeal shockwave therapy.</p></div><div id="niceng226er7.s1.1.12.3.6"><h5>Laser therapy</h5><p>Laser therapy was compared to pulsed short-wave therapy, interferential therapy, neuromuscular electrical stimulation, combination therapy, sham electrotherapy and no treatment. When compared to sham electrotherapy, a clinically important benefit was seen in moderate/major adverse events based on 1 small study (N=55). Unclear effects were seen in quality of life and pain with some outcomes showing a clinically important benefit while others showed no difference. For pain, 4 studies were included in the outcome showing a clinically important benefit while 14 were included in the outcome showing no clinically important difference. However, the outcomes showing a benefit were affected by inconsistency. No clinically important difference was seen in physical function and mild adverse events. When compared to no treatment, there was a clinically important benefit in physical function but no clinically important difference in quality of life and pain. For both comparisons, no effects were retained at >3 months.</p><p>When compared to other interventions, laser therapy had an unclear effect when compared to pulsed short-wave therapy (where laser therapy led to clinically important benefits in pain, while pulsed short-wave therapy led to clinically important benefits in physical function). Interferential therapy had a clinically important benefit in physical function when compared to laser therapy. Laser therapy had a clinically important benefit on pain when compared to neuromuscular electrical stimulation based on 1 small study (N=30). However, when compared to combination therapy, there was no clinically important difference in pain.</p></div><div id="niceng226er7.s1.1.12.3.7"><h5>Transcutaneous electrical nerve stimulation</h5><p>Transcutaneous electrical nerve stimulation was compared to pulsed short-wave therapy, interferential therapy, ultrasound, combination therapy, sham electrotherapy and no treatment. When compared to sham electrotherapy, there was an unclear effect on quality of life with 2 outcomes showing a clinically important benefit while 3 showed no clinically important difference. There was no clinically important difference in pain, physical function and mild adverse events. The effects on pain and physical function were both seen at less than and more than 3 months. When compared to no treatment there was no clinically important difference in pain, physical function and mild adverse events. When compared to other treatments, there was no clinically important difference in pain and physical function seen when compared to pulsed short-wave therapy and interferential therapy though there appeared to be a clinically important harm in mild adverse events when compared to interferential therapy. When compared to ultrasound, there was a mixed effect with 1 outcome including 1 small study (N=24) showing a clinically important benefit while 1 outcome including another 1 small study (N=40) showed no clinically important difference.</p></div><div id="niceng226er7.s1.1.12.3.8"><h5>Ultrasound</h5><p>Ultrasound was compared to pulsed short-wave therapy, neuromuscular electrical stimulation, transcutaneous electrical nerve stimulation, combination therapy, sham electrotherapy and no treatment. When compared to sham electrotherapy there was a clinically important benefit in pain (seen in 2 outcomes including 13 studies). This effect was not seen at greater than 3 months. However, these outcomes were affected by inconsistency. There was an unclear effect on quality of life with 5 outcomes showing a clinically important benefit and 5 outcomes showing no clinically important difference. There was no clinically important difference seen in physical function, psychological distress and mild adverse event. When compared to no treatment, there was no clinically important difference in quality of life and pain, but a clinically important harm seen in physical function based on 2 studies. When compared to other treatments, there were clinically important benefits in pain and physical function seen compared to neuromuscular electrical stimulation based on 1 small study (N=60). There was no clinically important difference in pain seen when compared to pulsed short-wave therapy, and no difference in pain and mild adverse events when compared to combination therapy. There was an unclear effect with no clinically important difference in pain in 1 outcome including 1 small study (N=40), and a clinically important harm in 1 outcome including 1 small study (N=24).</p></div><div id="niceng226er7.s1.1.12.3.9"><h5>Combination therapy</h5><p>Combination therapy was compared to interferential therapy, neuromuscular electrical stimulation, laser therapy, transcutaneous electrical nerve stimulation, ultrasound, sham electrotherapy and no treatment. When compared to sham electrotherapy, clinically important benefits were seen in pain at less than and equal to 3 months. An unclear effect was seen for quality of life, with 1 outcome indicating a clinically important benefit while another indicated no clinically important difference. Otherwise, there was no clinically important difference seen in mild and moderate/major adverse events. When compared to no treatment, clinically important benefits were seen in quality of life, pain and psychological distress, with no clinically important difference in physical function. The outcomes were of low-very low quality and based on small studies. For each comparison to other interventions the majority of outcomes indicated no clinically important difference. However, a clinically important harm was seen in physical function when compared to transcutaneous electrical nerve stimulation based on 1 small study (N=38). An unclear effect was seen in quality of life when compared to ultrasound, with 1 outcome indicating a clinically important benefit while another indicated no clinically important difference based on 1 small study (N=53).</p><p>The committee took these results into consideration when evaluating the individual therapies. As they concluded that there was insufficient evidence of consistent benefit with any individual treatments, they agreed that while there was some evidence of benefit for the combination the effect was at times unclear and based on low quality evidence. Overall, they concluded that there was no indication from the available evidence that a combination of electrotherapy procedures would have more benefit than the individual therapies.</p></div><div id="niceng226er7.s1.1.12.3.10"><h5>Weighing up the clinical benefits and harms</h5><p>The committee noted that despite there being a large number of trials, the vast majority had very small sample sizes (with <50 participants in each study arm) and there was inconsistency in the findings which reduced their confidence in the evidence. This taken into consideration led them to conclude that there was insufficient evidence of high quality to form recommendations for this topic. Due to this being present throughout the evidence in this review, they recommended not offering the following electrotherapy treatments: transcutaneous electrical nerve stimulation (TENS), ultrasound, interferential therapy, laser therapy, pulsed short-wave therapy, neuromuscular electrical stimulation (NMES) because of the insufficient evidence of benefit.</p><p>On weighing up the effects seen from the treatments investigated in this review, the committee agreed that extracorporeal shockwave therapy showed potential evidence of benefit. However, the quality of the evidence was insufficient to conclude that this was evidence was accurate. Therefore, the committee agreed the research recommendation should investigate the effect of this treatment specifically.</p></div></div><div id="niceng226er7.s1.1.12.4"><h5>1.1.12.4. Cost effectiveness and resource use</h5><p>One economic evaluation was identified for inclusion in this review. This was based on a network meta-analysis of randomised controlled trials (RCTs) and took a UK perspective. QALYs were calculated by mapping various measures to the EQ-5D, which were then pooled to give an overall estimate. The study was deemed to be directly applicable to the review question.</p><p>The time horizon of the model was relatively short at 8 weeks. Unit costs were also taken from 2011/12 and were therefore unlikely to be representative of current NHS practice. The analysis was therefore graded as having potentially serious limitations.</p><p>There were three different meta-analyses used in the study, differentiating trials according to their level of grading and time frame within which outcomes were reported:
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<ol><li class="half_rhythm"><div>All trials</div></li><li class="half_rhythm"><div>Subset of trials that were graded as having a low risk of bias for allocation concealment</div></li><li class="half_rhythm"><div>Same as point 2 but further restricting trials to those that reported outcomes between 3 and 13 weeks.</div></li></ol></p><p>The analysis compared usual care to a multitude of electrotherapy options; interferential therapy, laser light therapy, neuromuscular electrical stimulation (NMES), pulsed electromagnetic field (PEMF), pulsed electrical stimulation (PES) and transcutaneous electrical nerve stimulation (TENS) as well as non-electrotherapy options; acupuncture, braces, heat treatment insoles and static magnets. TENS was the only electrotherapy option that was cost effective compared with usual care with a cost per QALY gained of £2,690.</p><p>It should be noted that interventions such as laser therapy and ultrasound are commonly a shared resource across the NHS and would not be limited to osteoarthritis as they could feasibly be used for a range of conditions. They would be found in most physiotherapy departments and therefore the physiotherapists time is likely the main cost associated with these treatments. The cost of physiotherapist time was presented to the committee as the main cost associated with these treatments.</p><p>Due to the lack of quality evidence in the clinical review, the committee decided that a research recommendation evaluating the clinical and cost-effectiveness of electrotherapy in patients with osteoarthritis was warranted.</p><p>The previous osteoarthritis guideline recommended that healthcare professionals consider TENS as an adjunct to core treatments for pain relief. TENS machines can be loaned to an individual for a short period, and if effective, the person is advised to purchase their own. The committee’s decision to not routinely offer electrotherapy to people with osteoarthritis may result in a cost saving, since if TENS machines were purchased directly by a person, the cost will not be incurred by the NHS.</p></div><div id="niceng226er7.s1.1.12.5"><h5>1.1.12.5. Other factors the committee took into account</h5><p>The committee reflected that electrotherapy is not commonly provided by healthcare professionals in the NHS (when provided it would be more commonly administered by physiotherapists). Laser therapy is the more common modality used, though some people are using extracorporeal shockwave therapy.</p><p>The committee noted that electrotherapy was more commonly used by people with osteoarthritis outside of formal medical care. Devices can be purchased and used by patients independent of health care professional involvement. These devices can be expensive for the individual. A lay committee member reported that the advertisement for these devices can be confusing, as there are lots of devices that advertise themselves as better than others, but it is difficult to know which to use and whether using them will lead to any improvements.</p><p>The committee noted that the research identified does not appear to represent the diverse population of people with osteoarthritis. They agreed that any further research should be representative of the population, including people from different family backgrounds, and socioeconomic backgrounds, disabled people, and people of different ages and genders. Future work should be done to consider the different experiences of people from diverse communities to ensure that the approach taken can be made equitable for everyone. With this in mind the committee subgrouped their research recommendation by these protected characteristics where appropriate while suggesting that people from each group should be included in the research to ensure that it is applicable to the entire population</p></div></div><div id="niceng226er7.s1.1.13"><h4>1.1.13. Recommendations supported by this evidence review</h4><p>This evidence review supports recommendation 1.3.9 and the research recommendation on electrotherapy. Other evidence supporting these recommendations can be found in evidence review G.</p></div><div id="niceng226er7.s1.1.rl.r1"><h4>1.1.14. References</h4><dl class="temp-labeled-list"><dl class="bkr_refwrap"><dt>1.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref1">Abdel-Aziem
|
|
AA, Draz
|
|
AH, Battecha
|
|
KH, Mosaad
|
|
DM. Effect of ultrasound combined with conventional therapy on neck pain, function, and disability in patients with cervical spondylosis: A randomized placebo-controlled trial. Journal of Musculoskeletal Pain. 2014; 22(2):199–205</div></dd></dl><dl class="bkr_refwrap"><dt>2.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref2">Adedoyin
|
|
RA, Olaogun
|
|
MO, Fagbeja
|
|
OO. Effect of interferential current stimulation in management of osteo-arthritic knee pain. Physiotherapy. 2002; 88(8):493–499</div></dd></dl><dl class="bkr_refwrap"><dt>3.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref3">Adedoyin
|
|
RA, Olaogun
|
|
MOB, Oyeyemi
|
|
AL. Transcutaneous electrical nerve stimulation and interferential current combined with exercise for the treatment of knee osteoarthritis: a randomised controlled trial. Hong kong physiotherapy journal. 2005; 23:13–19</div></dd></dl><dl class="bkr_refwrap"><dt>4.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref4">Ahn
|
|
H, Woods
|
|
AJ, Kunik
|
|
ME, Bhattacharjee
|
|
A, Chen
|
|
Z, Choi
|
|
E
|
|
et al. Efficacy of transcranial direct current stimulation over primary motor cortex (anode) and contralateral supraorbital area (cathode) on clinical pain severity and mobility performance in persons with knee osteoarthritis: An experimenter- and participant-blinded, randomized, sham-controlled pilot clinical study. Brain Stimulation. 2017; 10(5):902–909 [<a href="/pmc/articles/PMC5568498/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5568498</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/28566193" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28566193</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>5.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref5">Akaltun
|
|
MS, Altindag
|
|
O, Turan
|
|
N, Gursoy
|
|
S, Gur
|
|
A. Efficacy of high intensity laser therapy in knee osteoarthritis: a double-blind controlled randomized study. Clinical Rheumatology. 2021; 40(5):1989–1995 [<a href="https://pubmed.ncbi.nlm.nih.gov/33074393" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 33074393</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>6.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref6">Akyol
|
|
Y, Durmus
|
|
D, Alayli
|
|
G, Tander
|
|
B, Bek
|
|
Y, Canturk
|
|
F
|
|
et al. Does short-wave diathermy increase the effectiveness of isokinetic exercise on pain, function, knee muscle strength, quality of life, and depression in the patients with knee osteoarthritis? A randomized controlled clinical study. European journal of physical & rehabilitation medicine. 2010; 46(3):325–336 [<a href="https://pubmed.ncbi.nlm.nih.gov/20926998" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20926998</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>7.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref7">Al Rashoud
|
|
AS, Abboud
|
|
RJ, Wang
|
|
W, Wigderowitz
|
|
C. Efficacy of low-level laser therapy applied at acupuncture points in knee osteoarthritis: a randomised double-blind comparative trial. Physiotherapy. 2014; 100(3):242–248 [<a href="https://pubmed.ncbi.nlm.nih.gov/24418801" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24418801</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>8.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref8">Alayat
|
|
MS, Aly
|
|
TH, Elsayed
|
|
AE, Fadil
|
|
AS. Efficacy of pulsed Nd:YAG laser in the treatment of patients with knee osteoarthritis: a randomized controlled trial. Lasers in Medical Science. 2017; 32(3):503–511 [<a href="https://pubmed.ncbi.nlm.nih.gov/28078503" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28078503</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>9.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref9">Alcidi
|
|
L, Beneforti
|
|
E, Maresca
|
|
M, Santosuosso
|
|
U, Zoppi
|
|
M. Low power radiofrequency electromagnetic radiation for the treatment of pain due to osteoarthritis of the knee. Reumatismo. 2007; 59(2):140–145 [<a href="https://pubmed.ncbi.nlm.nih.gov/17603694" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 17603694</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>10.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref10">Alfredo
|
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PP, Bjordal
|
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JM, Dreyer
|
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SH, Meneses
|
|
SR, Zaguetti
|
|
G, Ovanessian
|
|
V
|
|
et al. Efficacy of low level laser therapy associated with exercises in knee osteoarthritis: a randomized double-blind study. Clinical Rehabilitation. 2012; 26(6):523–533 [<a href="https://pubmed.ncbi.nlm.nih.gov/22169831" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22169831</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>11.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref11">Alfredo
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PP, Bjordal
|
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JM, Junior
|
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WS, Lopes-Martins
|
|
RAB, Stausholm
|
|
MB, Casarotto
|
|
RA
|
|
et al. Long-term results of a randomized, controlled, double-blind study of low-level laser therapy before exercises in knee osteoarthritis: laser and exercises in knee osteoarthritis. Clinical Rehabilitation. 2018; 32(2):173–178 [<a href="https://pubmed.ncbi.nlm.nih.gov/28776408" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28776408</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>12.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref12">Alfredo
|
|
PP, Junior
|
|
WS, Casarotto
|
|
RA. Efficacy of continuous and pulsed therapeutic ultrasound combined with exercises for knee osteoarthritis: a randomized controlled trial. Clinical Rehabilitation. 2020; 34(4):480–490 [<a href="https://pubmed.ncbi.nlm.nih.gov/32063035" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32063035</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>13.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref13">Alghadir
|
|
A, Omar
|
|
MT, Al-Askar
|
|
AB, Al-Muteri
|
|
NK. Effect of low-level laser therapy in patients with chronic knee osteoarthritis: a single-blinded randomized clinical study. Lasers in Medical Science. 2014; 29(2):749–755 [<a href="https://pubmed.ncbi.nlm.nih.gov/23912778" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23912778</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>14.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref14">Ali
|
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SS, Ahmed
|
|
SI, Khan
|
|
M, Soomro
|
|
RR. Comparing the effects of manual therapy versus electrophysical agents in the management of knee osteoarthritis. Pakistan Journal of Pharmaceutical Sciences. 2014; 27(Suppl 4):1103–1106 [<a href="https://pubmed.ncbi.nlm.nih.gov/25016274" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25016274</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>15.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref15">Alqualo-Costa
|
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R, Rampazo
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EP, Thome
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GR, Perracini
|
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MR, Liebano
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RE. Interferential current and photobiomodulation in knee osteoarthritis: A randomized, placebo-controlled, double-blind clinical trial. Clinical Rehabilitation. 2021; 35(10):1413–1427 [<a href="https://pubmed.ncbi.nlm.nih.gov/33896234" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 33896234</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>16.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref16">Altas
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EU, Demirdal
|
|
U. The effect of physical therapy and rehabilitation modalities on sleep quality in patients with primary knee osteoarthritis: A single-blind, prospective, randomized-controlled study. Turkish journal of physical medicine and rehabilitation. 2020; 66(1):73–83 [<a href="/pmc/articles/PMC7171892/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7171892</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/32318678" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32318678</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>17.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref17">Altay
|
|
F, Durmus
|
|
D, Canturk
|
|
F. Effects of TENS on pain, disabiliy, quality of life and depression in patients with knee osteoarthritis. Turkish journal of rheumatology. 2010; 25(3):116–121</div></dd></dl><dl class="bkr_refwrap"><dt>18.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref18">Ammar
|
|
TA. Monochromatic infrared photo energy versus low level laser therapy in patients with knee osteoarthritis. Journal of Lasers in Medical Sciences. 2014; 5(4):176–182 [<a href="/pmc/articles/PMC4281991/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4281991</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/25653818" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25653818</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>19.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref19">Ananias
|
|
J, Ubilla
|
|
D, Irarrazaval
|
|
S, Ortiz-Munoz
|
|
L. Is pulsed ultrasound an alternative for osteoarthritis?
|
|
Medwave. 2017; 17(9):e7109 [<a href="https://pubmed.ncbi.nlm.nih.gov/29286351" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29286351</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>20.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref20">Angelova
|
|
A, Ilieva
|
|
EM. Effectiveness of high intensity laser therapy for reduction of pain in knee osteoarthritis. Pain Research & Management. 2016; 2016:9163618 [<a href="/pmc/articles/PMC5206453/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5206453</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/28096711" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28096711</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>21.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref21">Arslan
|
|
SA, Demirguc
|
|
A, Kocaman
|
|
AA, Keskin
|
|
ED. The effect of short-term neuromuscular electrical stimulation on pain, physical performance, kinesiophobia, and quality of life in patients with knee osteoarthritis. Physiotherapy Quarterly. 2020; 28(2):31–37</div></dd></dl><dl class="bkr_refwrap"><dt>22.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref22">Atamaz
|
|
FC, Durmaz
|
|
B, Baydar
|
|
M, Demircioglu
|
|
OY, Iyiyapici
|
|
A, Kuran
|
|
B
|
|
et al. Comparison of the efficacy of transcutaneous electrical nerve stimulation, interferential currents, and shortwave diathermy in knee osteoarthritis: a double-blind, randomized, controlled, multicenter study. Archives of Physical Medicine and Rehabilitation. 2012; 93(5):748–756 [<a href="https://pubmed.ncbi.nlm.nih.gov/22459699" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22459699</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>23.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref23">Avendano-Coy
|
|
J, Comino-Suarez
|
|
N, Grande-Munoz
|
|
J, Avendano-Lopez
|
|
C, Gomez-Soriano
|
|
J. Extracorporeal shockwave therapy improves pain and function in subjects with knee osteoarthritis: A systematic review and meta-analysis of randomized clinical trials. International Journal Of Surgery. 2020; 82:64–75 [<a href="https://pubmed.ncbi.nlm.nih.gov/32798759" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32798759</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>24.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref24">Ay
|
|
S, Evcik
|
|
D. The effects of pulsed electromagnetic fields in the treatment of knee osteoarthritis: a randomized, placebo-controlled trial. Rheumatology International. 2009; 29(6):663–666 [<a href="https://pubmed.ncbi.nlm.nih.gov/19015858" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19015858</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>25.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref25">Azizi
|
|
S, Rezasoltani
|
|
Z, Najafi
|
|
S, Mohebi
|
|
B, Tabatabaee
|
|
SM, Dadarkhah
|
|
A. Transcranial direct current stimulation for knee osteoarthritis: a single-blind randomized sham-controlled trial. Neurophysiologie Clinique. 2021; 51(4):329–338 [<a href="https://pubmed.ncbi.nlm.nih.gov/33323306" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 33323306</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>26.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref26">Bagheri
|
|
SR, Fatemi
|
|
E, Fazeli
|
|
SH, Ghorbani
|
|
R, Lashkari
|
|
F. Efficacy of low level laser on knee osteoarthritis treatment. Koomesh. 2011; 12(3):285–292</div></dd></dl><dl class="bkr_refwrap"><dt>27.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref27">Bagnato
|
|
GL, Miceli
|
|
G, Marino
|
|
N, Sciortino
|
|
D, Bagnato
|
|
GF. Pulsed electromagnetic fields in knee osteoarthritis: a double blind, placebo-controlled, randomized clinical trial. Rheumatology. 2016; 55(4):755–762 [<a href="/pmc/articles/PMC4795538/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4795538</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/26705327" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26705327</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>28.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref28">Bal
|
|
S, Turan
|
|
Y, Gurgan
|
|
A. The effectiveness of transcutaneous electrical nerve stimulation in patients with knee osteoarthritis. Journal of rheumatology and medical rehabilitation. 2007; 18(1):1–5</div></dd></dl><dl class="bkr_refwrap"><dt>29.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref29">Basford
|
|
JR, Sheffield
|
|
CG, Mair
|
|
SD, Ilstrup
|
|
DM. Low-energy helium neon laser treatment of thumb osteoarthritis. Archives of Physical Medicine and Rehabilitation. 1987; 68(11):794–797 [<a href="https://pubmed.ncbi.nlm.nih.gov/3314790" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 3314790</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>30.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref30">Battisti
|
|
E, Piazza
|
|
E, Rigato
|
|
M, Nuti
|
|
R, Bianciardi
|
|
L, Scribano
|
|
A
|
|
et al. Efficacy and safety of a musically modulated electromagnetic field (TAMMEF) in patients affected by knee osteoarthritis. Clinical and Experimental Rheumatology. 2004; 22(5):568–572 [<a href="https://pubmed.ncbi.nlm.nih.gov/15485009" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 15485009</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>31.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref31">Beasley
|
|
J, Ward
|
|
L, Knipper-Fisher
|
|
K, Hughes
|
|
K, Lunsford
|
|
D, Leiras
|
|
C. Conservative therapeutic interventions for osteoarthritic finger joints: A systematic review. Journal of Hand Therapy. 2019; 32(2):153–164 e152 [<a href="https://pubmed.ncbi.nlm.nih.gov/30017415" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30017415</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>32.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref32">Bertolucci
|
|
LE, Grey
|
|
T. Clinical analysis of mid-laser versus placebo treatment of arthralgic TMJ degenerative joints. Cranio. 1995; 13(1):26–29 [<a href="https://pubmed.ncbi.nlm.nih.gov/7585998" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 7585998</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>33.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref33">Bertolucci
|
|
LE, Grey
|
|
T. Clinical comparative study of microcurrent electrical stimulation to mid-laser and placebo treatment in degenerative joint disease of the temporomandibular joint. Cranio. 1995; 13(2):116–120 [<a href="https://pubmed.ncbi.nlm.nih.gov/8697497" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8697497</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>34.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref34">Brosseau
|
|
L, Welch
|
|
V, Wells
|
|
G, de
|
|
BR, Gam
|
|
A, Harman
|
|
K et al. Low level laser therapy (Classes III) for treating osteoarthritis. Cochrane Database of Systematic Reviews
|
|
2007, Issue 1. Art. No.: CD002046. DOI: 10.1002/14651858.CD002046.pub3. [<a href="https://pubmed.ncbi.nlm.nih.gov/17636694" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 17636694</span></a>] [<a href="http://dx.crossref.org/10.1002/14651858.CD002046.pub3" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl><dl class="bkr_refwrap"><dt>35.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref35">Brosseau
|
|
L, Wells
|
|
G, Marchand
|
|
S, Gaboury
|
|
I, Stokes
|
|
B, Morin
|
|
M
|
|
et al. Randomized controlled trial on low level laser therapy (LLLT) in the treatment of osteoarthritis (OA) of the hand. Lasers in Surgery and Medicine. 2005; 36(3):210–219 [<a href="https://pubmed.ncbi.nlm.nih.gov/15704096" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 15704096</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>36.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref36">Bruce-Brand
|
|
RA, Walls
|
|
RJ, Ong
|
|
JC, Emerson
|
|
BS, O’Byrne
|
|
JM, Moyna
|
|
NM. Effects of home-based resistance training and neuromuscular electrical stimulation in knee osteoarthritis: a randomized controlled trial. BMC Musculoskeletal Disorders. 2012; 13:118 [<a href="/pmc/articles/PMC3493368/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3493368</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/22759883" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22759883</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>37.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref37">Bulow
|
|
PM, Jensen
|
|
H, Danneskiold-Samsoe
|
|
B. Low power Ga-Al-As laser treatment of painful osteoarthritis of the knee. A double-blind placebo-controlled study. Scandinavian Journal of Rehabilitation Medicine. 1994; 26(3):155–159 [<a href="https://pubmed.ncbi.nlm.nih.gov/7801065" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 7801065</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>38.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref38">Burch
|
|
FX, Tarro
|
|
JN, Greenberg
|
|
JJ, Carroll
|
|
WJ. Evaluating the benefits of patterned stimulation in the treatment of osteoarthritis of the knee: a multi-center, randomized, single-blind, controlled study with an independent masked evaluator. Osteoarthritis and Cartilage. 2008; 16(8):865–872 [<a href="https://pubmed.ncbi.nlm.nih.gov/18262443" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 18262443</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>39.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref39">Burgess
|
|
LC, Taylor
|
|
P, Wainwright
|
|
TW, Bahadori
|
|
S, Swain
|
|
ID. Adherence to neuromuscular electrical stimulation interventions for muscle impairment in hip and knee osteoarthritis: A systematic review. Clinical medicine insights Arthritis and musculoskeletal disorders. 2021; 14:11795441211028746 [<a href="/pmc/articles/PMC8243113/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC8243113</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/34262384" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 34262384</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>40.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref40">Cakir
|
|
S, Hepguler
|
|
S, Ozturk
|
|
C, Korkmaz
|
|
M, Isleten
|
|
B, Atamaz
|
|
FC. Efficacy of therapeutic ultrasound for the management of knee osteoarthritis: a randomized, controlled, and double-blind study. American Journal of Physical Medicine and Rehabilitation. 2014; 93(5):405–412 [<a href="https://pubmed.ncbi.nlm.nih.gov/24322433" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24322433</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>41.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref41">Callaghan
|
|
MJ, Whittaker
|
|
PE, Grimes
|
|
S, Smith
|
|
L. An evaluation of pulsed shortwave on knee osteoarthritis using radioleucoscintigraphy: a randomised, double blind, controlled trial. Joint, Bone, Spine: Revue du Rhumatisme. 2005; 72(2):150–155 [<a href="https://pubmed.ncbi.nlm.nih.gov/15797496" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 15797496</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>42.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref42">Cantero-Tellez
|
|
R, Villafane
|
|
JH, Valdes
|
|
K, Garcia-Orza
|
|
S, Bishop
|
|
MD, Medina-Porqueres
|
|
I. Effects of high-intensity laser therapy on pain sensitivity and motor performance in patients with thumb carpometacarpal joint osteoarthritis: A randomized controlled trial. Pain Medicine. 2020; 21(10):2357–2365 [<a href="https://pubmed.ncbi.nlm.nih.gov/31807782" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31807782</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>43.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref43">Carlos
|
|
KP, Belli
|
|
BS, Alfredo
|
|
PP. Effect of pulsed ultrasound and continuous ultrasound linked to exercise in patients with knee osteoarthritis: pilot study. Fisioterapia e pesquisa. 2012; 19(3):275–281</div></dd></dl><dl class="bkr_refwrap"><dt>44.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref44">Cetin
|
|
N, Aytar
|
|
A, Atalay
|
|
A, Akman
|
|
MN. Comparing hot pack, short-wave diathermy, ultrasound, and TENS on isokinetic strength, pain, and functional status of women with osteoarthritic knees: a single-blind, randomized, controlled trial. American Journal of Physical Medicine and Rehabilitation. 2008; 87(6):443–451 [<a href="https://pubmed.ncbi.nlm.nih.gov/18496246" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 18496246</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>45.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref45">Chang
|
|
WJ, Bennell
|
|
KL, Hodges
|
|
PW, Hinman
|
|
RS, Young
|
|
CL, Buscemi
|
|
V
|
|
et al. Addition of transcranial direct current stimulation to quadriceps strengthening exercise in knee osteoarthritis: A pilot randomised controlled trial. PLoS ONE [Electronic Resource]. 2017; 12(6):e0180328 [<a href="/pmc/articles/PMC5493377/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5493377</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/28665989" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28665989</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>46.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref46">Chaturvedi
|
|
R, Kulandaivelan
|
|
S. The combination of transcranial direct current stimulation (tDCS) and TENS - its effectiveness on pain and functional outcomes in knee OA patients: A pilot study. Indian journal of public health research and development. 2020; 11(3):300–303</div></dd></dl><dl class="bkr_refwrap"><dt>47.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref47">Cheing
|
|
GL, Hui-Chan
|
|
CW. Would the addition of TENS to exercise training produce better physical performance outcomes in people with knee osteoarthritis than either intervention alone?
|
|
Clinical Rehabilitation. 2004; 18(5):487–497 [<a href="https://pubmed.ncbi.nlm.nih.gov/15293483" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 15293483</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>48.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref48">Cheing
|
|
GL, Hui-Chan
|
|
CW, Chan
|
|
KM. Does four weeks of TENS and/or isometric exercise produce cumulative reduction of osteoarthritic knee pain?
|
|
Clinical Rehabilitation. 2002; 16(7):749–760 [<a href="https://pubmed.ncbi.nlm.nih.gov/12428824" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 12428824</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>49.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref49">Cheing
|
|
GL, Tsui
|
|
AY, Lo
|
|
SK, Hui-Chan
|
|
CW. Optimal stimulation duration of tens in the management of osteoarthritic knee pain. Journal of Rehabilitation Medicine. 2003; 35(2):62–68 [<a href="https://pubmed.ncbi.nlm.nih.gov/12691335" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 12691335</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>50.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref50">Chen
|
|
L, Duan
|
|
X, Xing
|
|
F, Liu
|
|
G, Gong
|
|
M, Li
|
|
L
|
|
et al. Effects of pulsed electromagnetic field therapy on pain, stiffness and physical function in patients with knee osteoarthritis: A systematic review and meta-analysis of randomized controlled trials. Journal of Rehabilitation Medicine. 2019; 51(11):821–827 [<a href="https://pubmed.ncbi.nlm.nih.gov/31583420" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31583420</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>51.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref51">Chen
|
|
LX, Zhou
|
|
ZR, Li
|
|
YL, Ning
|
|
GZ, Li
|
|
Y, Wang
|
|
XB
|
|
et al. Transcutaneous electrical nerve stimulation in patients with knee osteoarthritis: Evidence from randomized-controlled trials. Clinical Journal of Pain. 2016; 32(2):146–154 [<a href="https://pubmed.ncbi.nlm.nih.gov/25803757" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25803757</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>52.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref52">Chen
|
|
TW, Lin
|
|
CW, Lee
|
|
CL, Chen
|
|
CH, Chen
|
|
YJ, Lin
|
|
TY
|
|
et al. The efficacy of shock wave therapy in patients with knee osteoarthritis and popliteal cyamella. Kaohsiung Journal of Medical Sciences. 2014; 30(7):362–370 [<a href="https://pubmed.ncbi.nlm.nih.gov/24924842" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24924842</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>53.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref53">Chen
|
|
Z, Ma
|
|
C, Xu
|
|
L, Wu
|
|
Z, He
|
|
Y, Xu
|
|
K
|
|
et al. Laser acupuncture for patients with knee osteoarthritis: A systematic review and meta-analysis of randomized placebo-controlled trials. Evidence-Based Complementary & Alternative Medicine: eCAM. 2019; 2019:6703828</div></dd></dl><dl class="bkr_refwrap"><dt>54.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref54">Cherian
|
|
JJ, Harrison
|
|
PE, Benjamin
|
|
SA, Bhave
|
|
A, Harwin
|
|
SF, Mont
|
|
MA. Do the effects of transcutaneous electrical nerve stimulation on knee osteoarthritis pain and function last?
|
|
The Journal of Knee Surgery. 2016; 29(6):497–501 [<a href="https://pubmed.ncbi.nlm.nih.gov/26540652" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26540652</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>55.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref55">Cherian
|
|
JJ, Jauregui
|
|
JJ, Leichliter
|
|
AK, Elmallah
|
|
RK, Bhave
|
|
A, Mont
|
|
MA. The effects of various physical non-operative modalities on the pain in osteoarthritis of the knee. Bone & Joint Journal. 2016; 98-B(1 Suppl A):89–94 [<a href="https://pubmed.ncbi.nlm.nih.gov/26733650" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26733650</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>56.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref56">Cherian
|
|
JJ, Kapadia
|
|
BH, Bhave
|
|
A, McElroy
|
|
MJ, Cherian
|
|
C, Harwin
|
|
SF
|
|
et al. Use of transcutaneous electrical nerve stimulation device in early osteoarthritis of the knee. The Journal of Knee Surgery. 2015; 28(4):321–327 [<a href="https://pubmed.ncbi.nlm.nih.gov/25162407" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25162407</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>57.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref57">Cherian
|
|
JJ, Kapadia
|
|
BH, McElroy
|
|
MJ, Johnson
|
|
AJ, Bhave
|
|
A, Harwin
|
|
SF
|
|
et al. Knee osteoarthritis: Does transcutaneous electrical nerve stimulation work?
|
|
Orthopedics. 2016; 39(1):e180–186 [<a href="https://pubmed.ncbi.nlm.nih.gov/26726986" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26726986</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>58.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref58">Cho
|
|
SJ, Yang
|
|
JR, Yang
|
|
HS, Yang
|
|
HE. Effects of extracorporeal shockwave therapy in chronic stroke patients with knee osteoarthritis: A pilot study. Annals of Rehabilitation Medicine. 2016; 40(5):862–870 [<a href="/pmc/articles/PMC5108713/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5108713</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/27847716" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27847716</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>59.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref59">Cottingham
|
|
B, Phillips
|
|
PD, Davies
|
|
GK, Getty
|
|
CJ. The effect of subcutaneous nerve stimulation (SCNS) on pain associated with osteoarthritis of the hip. Pain. 1985; 22(3):243–248 [<a href="https://pubmed.ncbi.nlm.nih.gov/3875827" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 3875827</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>60.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref60">Cottingham
|
|
B, Phillips
|
|
PD, Davies
|
|
GK, Getty
|
|
CJM. The effects of peripheral electrical nerve stimulation on pain associated with osteoarthritis of the hip. American Journal of Surgery. 1985; 67-B:152 [<a href="https://pubmed.ncbi.nlm.nih.gov/3875827" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 3875827</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>61.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref61">Curtis
|
|
L, Burns
|
|
A. Unit costs of health and social care 2020. Canterbury. University of Kent, 2020. Available from: <a href="https://www.pssru.ac.uk/project-pages/unit-costs/unit-costs-2020/" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.pssru.ac<wbr style="display:inline-block"></wbr>​.uk/project-pages/unit-costs<wbr style="display:inline-block"></wbr>​/unit-costs-2020/</a></div></dd></dl><dl class="bkr_refwrap"><dt>62.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref62">da Graca-Tarrago
|
|
M, Deitos
|
|
A, Patricia Brietzke
|
|
A, Torres
|
|
IL, Cadore Stefani
|
|
L, Fregni
|
|
F
|
|
et al. Electrical intramuscular stimulation in osteoarthritis enhances the inhibitory systems in pain processing at cortical and cortical spinal system. Pain Medicine. 2016; 17(5):877–891 [<a href="https://pubmed.ncbi.nlm.nih.gov/26398594" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26398594</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>63.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref63">Dantas
|
|
LO, Osani
|
|
MC, Bannuru
|
|
RR. Therapeutic ultrasound for knee osteoarthritis: A systematic review and meta-analysis with grade quality assessment. Brazilian journal of physical therapy. 2021; 09 [<a href="/pmc/articles/PMC8721076/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC8721076</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/34535411" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 34535411</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>64.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref64">de Matos Brunelli Braghin
|
|
R, Libardi
|
|
EC, Junqueira
|
|
C, Rodrigues
|
|
NC, Nogueira-Barbosa
|
|
MH, Renno
|
|
ACM
|
|
et al. The effect of low-level laser therapy and physical exercise on pain, stiffness, function, and spatiotemporal gait variables in subjects with bilateral knee osteoarthritis: a blind randomized clinical trial. Disability and Rehabilitation. 2019; 41(26):3165–3172 [<a href="https://pubmed.ncbi.nlm.nih.gov/30324827" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30324827</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>65.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref65">de Oliveira Melo
|
|
M, Pompeo
|
|
KD, Baroni
|
|
BM, Vaz
|
|
MA. Effects of neuromuscular electrical stimulation and low-level laser therapy on neuromuscular parameters and health status in elderly women with knee osteoarthritis: A randomized trial. Journal of Rehabilitation Medicine. 2016; 48(3):293–299 [<a href="https://pubmed.ncbi.nlm.nih.gov/26871692" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26871692</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>66.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref66">de Paula Gomes
|
|
CAF, Politti
|
|
F, de Souza Bacelar Pereira
|
|
C, da Silva
|
|
ACB, Dibai-Filho
|
|
AV, de Oliveira
|
|
AR
|
|
et al. Exercise program combined with electrophysical modalities in subjects with knee osteoarthritis: a randomised, placebo-controlled clinical trial. BMC Musculoskeletal Disorders. 2020; 21(1):258 [<a href="/pmc/articles/PMC7171730/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7171730</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/32312265" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32312265</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>67.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref67">Defrin
|
|
R, Ariel
|
|
E, Peretz
|
|
C. Segmental noxious versus innocuous electrical stimulation for chronic pain relief and the effect of fading sensation during treatment. Pain. 2005; 115(1–2):152–160 [<a href="https://pubmed.ncbi.nlm.nih.gov/15836978" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 15836978</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>68.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref68">Delkhosh
|
|
CT, Fatemy
|
|
E, Ghorbani
|
|
R, Mohammadi
|
|
R. Comparing the immediate and long-term effects of low and high power laser on the symptoms of knee osteoarthritis. Journal of mazandaran university of medical sciences. 2018; 28(165):69–77</div></dd></dl><dl class="bkr_refwrap"><dt>69.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref69">Devrimsel
|
|
G, Metin
|
|
Y, Serdaroglu Beyazal
|
|
M. Short-term effects of neuromuscular electrical stimulation and ultrasound therapies on muscle architecture and functional capacity in knee osteoarthritis: a randomized study. Clinical Rehabilitation. 2019; 33(3):418–427 [<a href="https://pubmed.ncbi.nlm.nih.gov/30514113" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30514113</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>70.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref70">Dincer
|
|
U, Cakar
|
|
E, Ozdemir
|
|
B, Kiralp
|
|
MZ, Dursun
|
|
H. Comparison of effects of combined physical therapy program and exercise on corrupted balance functions in patient with knee bilateral osteoarthritis. Romatizma. 2008; 23(1):9–13</div></dd></dl><dl class="bkr_refwrap"><dt>71.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref71">Draper
|
|
DO, Klyve
|
|
D, Ortiz
|
|
R, Best
|
|
TM. Effect of low-intensity long-duration ultrasound on the symptomatic relief of knee osteoarthritis: a randomized, placebo-controlled double-blind study. Journal of Orthopaedic Surgery. 2018; 13(1):257 [<a href="/pmc/articles/PMC6192104/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6192104</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/30326947" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30326947</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>72.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref72">Dundar
|
|
U, Asik
|
|
G, Ulasli
|
|
AM, Sinici
|
|
S, Yaman
|
|
F, Solak
|
|
O
|
|
et al. Assessment of pulsed electromagnetic field therapy with Serum YKL-40 and ultrasonography in patients with knee osteoarthritis. International Journal of Rheumatic Diseases. 2016; 19(3):287–293 [<a href="https://pubmed.ncbi.nlm.nih.gov/25955771" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25955771</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>73.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref73">Durmus
|
|
D, Alayli
|
|
G, Canturk
|
|
F. Effects of quadriceps electrical stimulation program on clinical parameters in the patients with knee osteoarthritis. Clinical Rheumatology. 2007; 26(5):674–678 [<a href="https://pubmed.ncbi.nlm.nih.gov/16897119" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 16897119</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>74.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref74">Eftekharsadat
|
|
B, Jahanjoo
|
|
F, Toopchizadeh
|
|
V, Heidari
|
|
F, Ahmadi
|
|
R, Babaei-Ghazani
|
|
A. Extracorporeal shockwave therapy and physiotherapy in patients with moderate knee osteoarthritis. Crescent Journal of Medical and Biological Sciences. 2020; 7(4):518–526</div></dd></dl><dl class="bkr_refwrap"><dt>75.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref75">Elbadawy
|
|
MA. Effectiveness of periosteal stimulation therapy and home exercise program in the rehabilitation of patients with advanced knee osteoarthritis. Clinical Journal of Pain. 2017; 33(3):254–263 [<a href="https://pubmed.ncbi.nlm.nih.gov/27513639" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27513639</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>76.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref76">Elboim-Gabyzon
|
|
M, Rozen
|
|
N, Laufer
|
|
Y. Does neuromuscular electrical stimulation enhance the effectiveness of an exercise programme in subjects with knee osteoarthritis? A randomized controlled trial. Clinical Rehabilitation. 2013; 27(3):246–257 [<a href="https://pubmed.ncbi.nlm.nih.gov/22952305" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22952305</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>77.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref77">Falconer
|
|
J, Hayes
|
|
KW, Chang
|
|
RW. Effect of ultrasound on mobility in osteoarthritis of the knee. A randomized clinical trial. Arthritis Care and Research. 1992; 5(1):29–35 [<a href="https://pubmed.ncbi.nlm.nih.gov/1581369" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 1581369</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>78.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref78">Fargas-Babjak
|
|
A, Rooney
|
|
P, Gerecz
|
|
E. Randomized trial of Codetron for pain control in osteoarthritis of the hip/knee. Clinical Journal of Pain. 1989; 5(2):137–141 [<a href="https://pubmed.ncbi.nlm.nih.gov/2520394" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 2520394</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>79.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref79">Fary
|
|
RE, Carroll
|
|
GJ, Briffa
|
|
TG, Briffa
|
|
NK. The effectiveness of pulsed electrical stimulation in the management of osteoarthritis of the knee: results of a double-blind, randomized, placebo-controlled, repeated-measures trial. Arthritis and Rheumatism. 2011; 63(5):1333–1342 [<a href="https://pubmed.ncbi.nlm.nih.gov/21312188" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21312188</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>80.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref80">Fary
|
|
RE, Carroll
|
|
GJ, Briffa
|
|
TG, Gupta
|
|
R, Briffa
|
|
NK. The effectiveness of pulsed electrical stimulation (E-PES) in the management of osteoarthritis of the knee: a protocol for a randomised controlled trial. BMC Musculoskeletal Disorders. 2008; 9:18 [<a href="/pmc/articles/PMC2275728/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC2275728</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/18241355" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 18241355</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>81.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref81">Fischer
|
|
G, Pelka
|
|
RB, Barovic
|
|
J. Adjuvant treatment of knee osteoarthritis with weak pulsing magnetic fields. Results of a placebo-controlled trial prospective clinical trial. Zeitschrift für Orthopädie und Ihre Grenzgebiete. 2005; 143(5):544–550 [<a href="https://pubmed.ncbi.nlm.nih.gov/16224674" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 16224674</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>82.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref82">Fischer
|
|
G, Pelka
|
|
RB, Barovic
|
|
J. Adjuvant treatment of osteo arthritis of the knee with weak pulsing magnetic fields - Results of a prospective, placebo controlled trial. Aktuelle rheumatologie. 2006; 31(4):226–233</div></dd></dl><dl class="bkr_refwrap"><dt>83.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref83">Fukuda
|
|
TY, Alves da Cunha
|
|
R, Fukuda
|
|
VO, Rienzo
|
|
FA, Cazarini
|
|
C, Jr., Carvalho Nde
|
|
A
|
|
et al. Pulsed shortwave treatment in women with knee osteoarthritis: a multicenter, randomized, placebo-controlled clinical trial. Physical Therapy. 2011; 91(7):1009–1017 [<a href="https://pubmed.ncbi.nlm.nih.gov/21642511" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21642511</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>84.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref84">Fukuda
|
|
VO, Fukuda
|
|
TY, Guimaraes
|
|
M, Shiwa
|
|
S, de Lima Bdel
|
|
C, Martins
|
|
RA
|
|
et al. Short-term efficacy of low-level laser therapy in patients with knee osteoarthritis: A randomized placebo-controlled, double-blind clinical trial. Revista Brasileira de Ortopedia. 2011; 46(5):526–533 [<a href="/pmc/articles/PMC4799277/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4799277</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/27027049" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27027049</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>85.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref85">Gaines
|
|
JM, Metter
|
|
EJ, Talbot
|
|
LA. The effect of neuromuscular electrical stimulation on arthritis knee pain in older adults with osteoarthritis of the knee. Applied Nursing Research. 2004; 17(3):201–206 [<a href="https://pubmed.ncbi.nlm.nih.gov/15343554" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 15343554</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>86.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref86">Garland
|
|
D, Holt
|
|
P, Harrington
|
|
JT, Caldwell
|
|
J, Zizic
|
|
T, Cholewczynski
|
|
J. A 3-month, randomized, double-blind, placebo-controlled study to evaluate the safety and efficacy of a highly optimized, capacitively coupled, pulsed electrical stimulator in patients with osteoarthritis of the knee. Osteoarthritis and Cartilage. 2007; 15(6):630–637 [<a href="https://pubmed.ncbi.nlm.nih.gov/17303443" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 17303443</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>87.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref87">Geler Kulcu
|
|
D, Yanik
|
|
B, Gulsen
|
|
G, Gokmen
|
|
D. Effect of neuromuscular electrical stimulation on pain and functional parameters in knee osteoarthritis. Turkiye Fiziksel Tip ve Rehabilitasyon Dergisi. 2009; 55(3):111–115</div></dd></dl><dl class="bkr_refwrap"><dt>88.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref88">Goksen
|
|
N, Calis
|
|
M, Dogan
|
|
S, Calis
|
|
HT, Ozgocmen
|
|
S. Magnetic resonance therapy for knee osteoarthritis: a randomized, double blind placebo controlled trial. European journal of physical & rehabilitation medicine. 2016; 52(4):431–439 [<a href="https://pubmed.ncbi.nlm.nih.gov/26799573" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26799573</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>89.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref89">Grimmer
|
|
K. A controlled double blind study comparing the effects of strong burst mode TENS and High Rate TENS on painful osteoarthritic knees. Australian Journal of Physiotherapy. 1992; 38(1):49–56 [<a href="https://pubmed.ncbi.nlm.nih.gov/25025517" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25025517</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>90.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref90">Gunaydin
|
|
OE, Bayrakci Tunay
|
|
V. Comparison of the added effects of kinesio taping and extracorporeal shockwave therapy to exercise alone in knee osteoarthritis. Physiotherapy Theory & Practice. 2020:1–9 [<a href="https://pubmed.ncbi.nlm.nih.gov/32574094" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32574094</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>91.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref91">Gundog
|
|
M, Atamaz
|
|
F, Kanyilmaz
|
|
S, Kirazli
|
|
Y, Celepoglu
|
|
G. Interferential current therapy in patients with knee osteoarthritis: comparison of the effectiveness of different amplitude-modulated frequencies. American Journal of Physical Medicine and Rehabilitation. 2012; 91(2):107–113 [<a href="https://pubmed.ncbi.nlm.nih.gov/22019968" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22019968</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>92.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref92">Gur
|
|
A, Cosut
|
|
A, Sarac
|
|
AJ, Cevik
|
|
R, Nas
|
|
K, Uyar
|
|
A. Efficacy of different therapy regimes of low-power laser in painful osteoarthritis of the knee: a double-blind and randomized-controlled trial. Lasers in Surgery and Medicine. 2003; 33(5):330–338 [<a href="https://pubmed.ncbi.nlm.nih.gov/14677160" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 14677160</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>93.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref93">Gworys
|
|
K, Gasztych
|
|
J, Puzder
|
|
A, Gworys
|
|
P, Kujawa
|
|
J. Influence of various laser therapy methods on knee joint pain and function in patients with knee osteoarthritis. Ortopedia Traumatologia Rehabilitacja. 2012; 14(3):269–277 [<a href="https://pubmed.ncbi.nlm.nih.gov/22764339" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22764339</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>94.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref94">He
|
|
DP, Zhang
|
|
J, Bai
|
|
ZF. Percutaneous electrical nerve stimulation for chronic knee pain: A randomized, sham-controlled trial. Alternative Therapies in Health and Medicine. 2019; 25(2):30–34 [<a href="https://pubmed.ncbi.nlm.nih.gov/29101777" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29101777</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>95.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref95">Hegedus
|
|
B, Viharos
|
|
L, Gervain
|
|
M, Galfi
|
|
M. The effect of low-level laser in knee osteoarthritis: a double-blind, randomized, placebo-controlled trial. Photomedicine and Laser Surgery. 2009; 27(4):577–584 [<a href="/pmc/articles/PMC2957068/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC2957068</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/19530911" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19530911</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>96.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref96">Helianthi
|
|
DR, Simadibrata
|
|
C, Srilestari
|
|
A, Wahyudi
|
|
ER, Hidayat
|
|
R. Pain reduction after laser acupuncture treatment in geriatric patients with knee osteoarthritis: A randomized controlled trial. Acta Medica Indonesiana. 2016; 48(2):114–121 [<a href="https://pubmed.ncbi.nlm.nih.gov/27550880" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27550880</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>97.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref97">Hinman
|
|
RS, McCrory
|
|
P, Pirotta
|
|
M, Relf
|
|
I, Forbes
|
|
A, Crossley
|
|
KM
|
|
et al. Acupuncture for chronic knee pain: a randomized clinical trial. JAMA. 2014; 312(13):1313–1322 [<a href="https://pubmed.ncbi.nlm.nih.gov/25268438" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25268438</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>98.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref98">Hsieh
|
|
CK, Chang
|
|
CJ, Liu
|
|
ZW, Tai
|
|
TW. Extracorporeal shockwave therapy for the treatment of knee osteoarthritis: a meta-analysis. International Orthopaedics. 2020; 44(5):877–884 [<a href="https://pubmed.ncbi.nlm.nih.gov/31993710" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31993710</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>99.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref99">Hsieh
|
|
RL, Liao
|
|
WC, Lee
|
|
WC. Local and systemic cardiovascular effects from monochromatic infrared therapy in patients with knee osteoarthritis: a double-blind, randomized, placebo-controlled study. Evidence-Based Complementary & Alternative Medicine: eCAM. 2012; 2012:583016 [<a href="/pmc/articles/PMC3391934/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3391934</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/22792125" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22792125</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>100.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref100">Hsieh
|
|
RL, Lo
|
|
MT, Lee
|
|
WC, Liao
|
|
WC. Therapeutic effects of short-term monochromatic infrared energy therapy on patients with knee osteoarthritis: a double-blind, randomized, placebo-controlled study. Journal of Orthopaedic and Sports Physical Therapy. 2012; 42(11):947–956 [<a href="https://pubmed.ncbi.nlm.nih.gov/22960644" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22960644</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>101.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref101">Huang
|
|
MH, Lin
|
|
YS, Lee
|
|
CL, Yang
|
|
RC. Use of ultrasound to increase effectiveness of isokinetic exercise for knee osteoarthritis. Archives of Physical Medicine and Rehabilitation. 2005; 86(8):1545–1551 [<a href="https://pubmed.ncbi.nlm.nih.gov/16084806" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 16084806</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>102.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref102">Huang
|
|
MH, Yang
|
|
RC, Lee
|
|
CL, Chen
|
|
TW, Wang
|
|
MC. Preliminary results of integrated therapy for patients with knee osteoarthritis. Arthritis and Rheumatism. 2005; 53(6):812–820 [<a href="https://pubmed.ncbi.nlm.nih.gov/16342083" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 16342083</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>103.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref103">Huang
|
|
Z, Chen
|
|
J, Ma
|
|
J, Shen
|
|
B, Pei
|
|
F, Kraus
|
|
VB. Effectiveness of low-level laser therapy in patients with knee osteoarthritis: a systematic review and meta-analysis. Osteoarthritis and Cartilage. 2015; 23(9):1437–1444 [<a href="/pmc/articles/PMC4814167/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4814167</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/25914044" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25914044</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>104.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref104">Iijima
|
|
H, Eguchi
|
|
R, Shimoura
|
|
K, Yamada
|
|
K, Aoyama
|
|
T, Takahashi
|
|
M. Transcutaneous Electrical Nerve Stimulation Improves Stair Climbing Capacity in People with Knee Osteoarthritis. Scientific Reports. 2020; 10(1):7294 [<a href="/pmc/articles/PMC7190707/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7190707</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/32350320" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32350320</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>105.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref105">Imamura
|
|
M, Alamino
|
|
S, Hsing
|
|
WT, Alfieri
|
|
FM, Schmitz
|
|
C, Battistella
|
|
LR. Radial extracorporeal shock wave therapy for disabling pain due to severe primary knee osteoarthritis. Journal of Rehabilitation Medicine. 2017; 49(1):54–62 [<a href="https://pubmed.ncbi.nlm.nih.gov/27904912" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27904912</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>106.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref106">Imoto
|
|
AM, Peccin
|
|
MS, Teixeira
|
|
LE, Silva
|
|
KN, Abrahao
|
|
M, Trevisani
|
|
VF. Is neuromuscular electrical stimulation effective for improving pain, function and activities of daily living of knee osteoarthritis patients? A randomized clinical trial. Sao Paulo Medical Journal = Revista Paulista de Medicina. 2013; 131(2):80–87 [<a href="https://pubmed.ncbi.nlm.nih.gov/23657509" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23657509</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>107.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref107">Inal
|
|
EE, Eroglu
|
|
P, Yucel
|
|
SH, Orhan
|
|
H. Which is the appropriate frequency of TENS in managing knee osteoarthritis: high or low frequency?
|
|
Journal of clinical and analytical medicine. 2016; 7(3)</div></dd></dl><dl class="bkr_refwrap"><dt>108.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref108">Ip
|
|
D. Does addition of low-level laser therapy (LLLT) in conservative care of knee arthritis successfully postpone the need for joint replacement?
|
|
Lasers in Medical Science. 2015; 30(9):2335–2339 [<a href="https://pubmed.ncbi.nlm.nih.gov/26420240" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26420240</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>109.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref109">Isik
|
|
R, Karapolat
|
|
H, Bayram
|
|
KB, Usan
|
|
H, Tanigor
|
|
G, Atamaz Calis
|
|
F. Effects of short wave diathermy added on dextrose prolotherapy injections in osteoarthritis of the knee. Journal of Alternative and Complementary Medicine. 2020; 26(4):316–322 [<a href="https://pubmed.ncbi.nlm.nih.gov/32017856" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32017856</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>110.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref110">Itoh
|
|
K, Hirota
|
|
S, Katsumi
|
|
Y, Ochi
|
|
H, Kitakoji
|
|
H. A pilot study on using acupuncture and transcutaneous electrical nerve stimulation (TENS) to treat knee osteoarthritis (OA). Chinesische Medizin. 2008; 3:2 [<a href="/pmc/articles/PMC2268695/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC2268695</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/18312661" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 18312661</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>111.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref111">Jacobson
|
|
JI, Gorman
|
|
R, Yamanashi
|
|
WS, Saxena
|
|
BB, Clayton
|
|
L. Low-amplitude, extremely low frequency magnetic fields for the treatment of osteoarthritic knees: a double-blind clinical study. Alternative Therapies in Health and Medicine. 2001; 7(5):54–64, 66–59 [<a href="https://pubmed.ncbi.nlm.nih.gov/11565402" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 11565402</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>112.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref112">Jensen
|
|
H, Zesler
|
|
R, Christensen
|
|
T. Transcutaneous electrical nerve stimulation (tens) for painful osteoarthrosis of the knee. International journal rehabilitation research. 1991; 14(4):356–358 [<a href="https://pubmed.ncbi.nlm.nih.gov/1783484" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 1783484</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>113.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref113">Ji
|
|
QH, Qiao
|
|
XF, Wang
|
|
SF, Zhao
|
|
P, Liu
|
|
SC, Xue
|
|
Y
|
|
et al. Effectiveness of neuromuscular electrical stimulation and ibuprofen for pain caused by necrosis of the femoral head: A retrospective study. Medicine. 2019; 98(11):e14812 [<a href="/pmc/articles/PMC6426472/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6426472</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/30882660" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30882660</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>114.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref114">Jia
|
|
L, Tan
|
|
BT, Chen
|
|
JY. Safety and efficacy of focused low-intensity pulsed ultrasound therapy for the treatment of knee osteoarthritis. [Chinese]. Journal of Shanghai Jiaotong University (Medical Science). 2020; 40(5):633–638</div></dd></dl><dl class="bkr_refwrap"><dt>115.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref115">Jia
|
|
L, Wang
|
|
Y, Chen
|
|
J, Chen
|
|
W. Efficacy of focused low-intensity pulsed ultrasound therapy for the management of knee osteoarthritis: a randomized, double blind, placebo-controlled trial. Scientific Reports. 2016; 6:35453 [<a href="/pmc/articles/PMC5066246/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5066246</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/27748432" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27748432</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>116.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref116">Kamalakannan
|
|
M, Karthik. Efficacy of proprioception training for tibiofemoral arthritis in relation with pain and functional disability. Research journal of pharmacy and technology. 2019; 12(3):995–998</div></dd></dl><dl class="bkr_refwrap"><dt>117.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref117">Kapidzic
|
|
S. Measurement of therapeutic effect of ultrasound on knee osteoarthritis; double blind study. Annals of Physical and Rehabilitation Medicine. 2011; 1:e183</div></dd></dl><dl class="bkr_refwrap"><dt>118.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref118">Karakas
|
|
A, Dilek
|
|
B, Sahin
|
|
MA, Ellidokuz
|
|
H, Senocak
|
|
O. The effectiveness of pulsed ultrasound treatment on pain, function, synovial sac thickness and femoral cartilage thickness in patients with knee osteoarthritis: a randomized, double-blind clinical, controlled study. Clinical Rehabilitation. 2020; 34(12):1474–1484 [<a href="https://pubmed.ncbi.nlm.nih.gov/32715744" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32715744</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>119.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref119">Katsnelson
|
|
Y, Khokhlov
|
|
A, Tsvetkov
|
|
V, Bartoo
|
|
G, Bartoo
|
|
M. Temporary pain relief using transcranial electrotherapy stimulation: results of a randomized, double-blind pilot study. Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine & Biology Society. 2004; 6:4087–4090 [<a href="https://pubmed.ncbi.nlm.nih.gov/17271198" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 17271198</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>120.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref120">Kheshie
|
|
AR, Alayat
|
|
MS, Ali
|
|
MM. High-intensity versus low-level laser therapy in the treatment of patients with knee osteoarthritis: a randomized controlled trial. Lasers in Medical Science. 2014; 29(4):1371–1376 [<a href="https://pubmed.ncbi.nlm.nih.gov/24487957" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24487957</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>121.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref121">Kim
|
|
ED, Won
|
|
YH, Park
|
|
SH, Seo
|
|
JH, Kim
|
|
DS, Ko
|
|
MH
|
|
et al. Efficacy and safety of a stimulator using low-intensity pulsed ultrasound combined with transcutaneous electrical nerve stimulation in patients with painful knee osteoarthritis. Pain Research & Management. 2019; 2019:7964897 [<a href="/pmc/articles/PMC6604342/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6604342</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/31316682" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31316682</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>122.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref122">Kim
|
|
JH, Kim
|
|
JY, Choi
|
|
CM, Lee
|
|
JK, Kee
|
|
HS, Jung
|
|
KI
|
|
et al. The dose-related effects of extracorporeal shock wave therapy for knee osteoarthritis. Annals of Rehabilitation Medicine. 2015; 39(4):616–623 [<a href="/pmc/articles/PMC4564710/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4564710</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/26361599" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26361599</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>123.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref123">Kim
|
|
JH, Lee
|
|
S, Kim
|
|
JH, Kim
|
|
KS, Yoo
|
|
CW, Chun
|
|
TH. Efficacy of high intensity laser therapy in the mild osteoarthritis of the knee: A randomized double-blind controlled trial. Journal of korean orthopaedic research society. 2009; 12(2):53–59</div></dd></dl><dl class="bkr_refwrap"><dt>124.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref124">Kiraly
|
|
M, Gomori
|
|
E, Kiss
|
|
R, Nogradi
|
|
N, Nusser
|
|
N, Hodosi
|
|
K et al. Effects of various types of ultrasound therapy in hip osteoarthritis - a double-blind, randomized, controlled, follow-up study. Physiotherapy Theory & Practice. 2021:1–11 [<a href="https://pubmed.ncbi.nlm.nih.gov/33715574" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 33715574</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>125.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref125">Kolen
|
|
AF, de Nijs
|
|
RN, Wagemakers
|
|
FM, Meier
|
|
AJ, Johnson
|
|
MI. Effects of spatially targeted transcutaneous electrical nerve stimulation using an electrode array that measures skin resistance on pain and mobility in patients with osteoarthritis in the knee: a randomized controlled trial. Pain. 2012; 153(2):373–381 [<a href="https://pubmed.ncbi.nlm.nih.gov/22119338" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22119338</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>126.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref126">Koybasi
|
|
M, Borman
|
|
P, Kocaoglu
|
|
S, Ceceli
|
|
E. The effect of additional therapeutic ultrasound in patients with primary hip osteoarthritis: a randomized placebo-controlled study. Clinical Rheumatology. 2010; 29(12):1387–1394 [<a href="https://pubmed.ncbi.nlm.nih.gov/20499122" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20499122</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>127.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref127">Krauss
|
|
I, Steinhilber
|
|
B, Haupt
|
|
G, Miller
|
|
R, Grau
|
|
S, Janssen
|
|
P. Efficacy of conservative treatment regimes for hip osteoarthritis--evaluation of the therapeutic exercise regime “Hip School”: a protocol for a randomised, controlled trial. BMC Musculoskeletal Disorders. 2011; 12:270 [<a href="/pmc/articles/PMC3252289/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3252289</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/22114973" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22114973</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>128.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref128">Kul’chitskaya
|
|
DB, Konchugova
|
|
TV, Luk’yanova
|
|
TV, Gushchina
|
|
NV. The substantiation for the application of high-intensity laser therapy for the treatment of the patients presenting with gonarthrosis. Voprosy kurortologii, fizioterapii, i lechebnoi fizicheskoi kultury. 2015; 92(1):23–26 [<a href="https://pubmed.ncbi.nlm.nih.gov/25876430" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25876430</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>129.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref129">Kulcu
|
|
DG, Gulsen
|
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G, Altunok
|
|
EC. Short-term efficacy of pulsed electromagnetic field therapy on pain and functional level in knee osteoarthritis: a randomized controlled study. Turkish journal of rheumatology. 2009; 24(3):144–148</div></dd></dl><dl class="bkr_refwrap"><dt>130.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref130">Kumaran
|
|
B, Watson
|
|
T. Treatment using 448kHz capacitive resistive monopolar radiofrequency improves pain and function in patients with osteoarthritis of the knee joint: a randomised controlled trial. Physiotherapy. 2019; 105(1):98–107 [<a href="https://pubmed.ncbi.nlm.nih.gov/30269963" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30269963</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>131.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref131">Laufer
|
|
Y, Shtraker
|
|
H, Elboim Gabyzon
|
|
M. The effects of exercise and neuromuscular electrical stimulation in subjects with knee osteoarthritis: a 3-month follow-up study. Clinical Interventions in Aging. 2014; 9:1153–1161 [<a href="/pmc/articles/PMC4108455/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4108455</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/25083133" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25083133</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>132.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref132">Law
|
|
PP, Cheing
|
|
GL. Optimal stimulation frequency of transcutaneous electrical nerve stimulation on people with knee osteoarthritis. Journal of Rehabilitation Medicine. 2004; 36(5):220–225 [<a href="https://pubmed.ncbi.nlm.nih.gov/15626162" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 15626162</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>133.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref133">Law
|
|
PP, Cheing
|
|
GL, Tsui
|
|
AY. Does transcutaneous electrical nerve stimulation improve the physical performance of people with knee osteoarthritis?
|
|
JCR: Journal of Clinical Rheumatology. 2004; 10(6):295–299 [<a href="https://pubmed.ncbi.nlm.nih.gov/17043536" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 17043536</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>134.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref134">Lee
|
|
JC, Park
|
|
JJ, Sheen
|
|
DH, Choi
|
|
YM, Park
|
|
NG, Kim
|
|
WK. Effect of pulsed electromagnetic fields in the treatment of knee osteoarthritis. Report of double-blind, placebo-controlled, randomized trial. The journal of the korean rheumatism association. 2004; 11(2):143–150</div></dd></dl><dl class="bkr_refwrap"><dt>135.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref135">Lewis
|
|
B, Lewis
|
|
D, Cumming
|
|
G. The comparative analgesic efficacy of transcutaneous electrical nerve stimulation and a non-steroidal anti-inflammatory drug for painful osteoarthritis. British Journal of Rheumatology. 1994; 33(5):455–460 [<a href="https://pubmed.ncbi.nlm.nih.gov/8173850" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8173850</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>136.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref136">Lewis
|
|
D, Lewis
|
|
B, Sturrock
|
|
RD. Transcutaneous electrical nerve stimulation in osteoarthrosis: a therapeutic alternative?
|
|
Annals of the Rheumatic Diseases. 1984; 43(1):47–49 [<a href="/pmc/articles/PMC1001217/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC1001217</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/6364997" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 6364997</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>137.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref137">Lewith
|
|
GT, Machin
|
|
D. A randomized trial to evaluate the effect of infra-red stimulation of local trigger poins, versus placebo, on the pain caused by cervical osteoarthrosis. Acupuncture electro-therapeutics research. 1981; 6:277–284 [<a href="https://pubmed.ncbi.nlm.nih.gov/6124087" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 6124087</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>138.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref138">Li
|
|
S, Yu
|
|
B, Zhou
|
|
D, He
|
|
C, Zhuo
|
|
Q, Hulme
|
|
J. Electromagnetic fields for treating osteoarthritis. Cochrane Database of Systematic Reviews
|
|
2013, Issue 12. Art. No.: CD003523. DOI: 10.1002/14651858.CD003523.pub2. [<a href="https://pubmed.ncbi.nlm.nih.gov/24338431" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24338431</span></a>] [<a href="http://dx.crossref.org/10.1002/14651858.CD003523.pub2" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl><dl class="bkr_refwrap"><dt>139.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref139">Lizis
|
|
P, Kobza
|
|
W, Manko
|
|
G. Extracorporeal shockwave therapy vs. kinesiotherapy for osteoarthritis of the knee: A pilot randomized controlled trial. Journal of Back and Musculoskeletal Rehabilitation. 2017; 30(5):1121–1128 [<a href="https://pubmed.ncbi.nlm.nih.gov/28946535" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28946535</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>140.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref140">Lonauer
|
|
G. Controlled double blind study on the efficacy of He-Ne-Laser Beams versus He-Ne-plus infrared-laser beams in the therapy of activated osteoarthritis of finger joints. Lasers surgery medicine. 1986; 6:172</div></dd></dl><dl class="bkr_refwrap"><dt>141.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref141">Lone
|
|
AR, Wafai
|
|
ZA, Buth
|
|
BA, Wani
|
|
TA, Koul
|
|
PA, Khan
|
|
SH. Analgesic efficacy of transcutaneous electrical nerve stimulation compared with diclofenac sodium in osteo-arthritis of the knee. Physiotherapy. 2003; 89(8):478–485</div></dd></dl><dl class="bkr_refwrap"><dt>142.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref142">Loyola-Sanchez
|
|
A, Richardson
|
|
J, Beattie
|
|
KA, Otero-Fuentes
|
|
C, Adachi
|
|
JD, MacIntyre
|
|
NJ. Effect of low-intensity pulsed ultrasound on the cartilage repair in people with mild to moderate knee osteoarthritis: a double-blinded, randomized, placebo-controlled pilot study. Archives of Physical Medicine and Rehabilitation. 2012; 93(1):35–42 [<a href="https://pubmed.ncbi.nlm.nih.gov/22200383" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22200383</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>143.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref143">Lue
|
|
S, Koppikar
|
|
S, Shaikh
|
|
K, Mahendira
|
|
D, Towheed
|
|
TE. Systematic review of non-surgical therapies for osteoarthritis of the hand: an update. Osteoarthritis and Cartilage. 2017; 25(9):1379–1389 [<a href="https://pubmed.ncbi.nlm.nih.gov/28602781" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28602781</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>144.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref144">Luz-Santos
|
|
C, Ribeiro Camatti
|
|
J, Barbosa Paixao
|
|
A, Nunes Sa
|
|
K, Montoya
|
|
P, Lee
|
|
M
|
|
et al. Additive effect of tDCS combined with Peripheral Electrical Stimulation to an exercise program in pain control in knee osteoarthritis: study protocol for a randomized controlled trial. Trials [Electronic Resource]. 2017; 18(1):609 [<a href="/pmc/articles/PMC5740917/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5740917</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/29268764" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29268764</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>145.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref145">MacPherson
|
|
H, Vickers
|
|
A, Bland
|
|
M, Torgerson
|
|
D, Corbett
|
|
M, Spackman
|
|
E et al. Acupuncture for chronic pain and depression in primary care: a programme of research. Acupuncture for chronic pain and depression in primary care: a programme of research. Programme Grants for Applied Research. Southampton (UK). 2017. [<a href="https://pubmed.ncbi.nlm.nih.gov/28121095" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28121095</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>146.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref146">Madani
|
|
AS, Ahrari
|
|
F, Nasiri
|
|
F, Abtahi
|
|
M, Tuner
|
|
J. Low-level laser therapy for management of TMJ osteoarthritis. Cranio. 2014; 32(1):38–44 [<a href="https://pubmed.ncbi.nlm.nih.gov/24660645" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24660645</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>147.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref147">Madhusoodanan
|
|
V, Best
|
|
J, Kalahasty
|
|
K, Blachman-Braun
|
|
R, Horodyski
|
|
L, Masterson
|
|
JM
|
|
et al. A prospective study analyzing both inflation and deflation preference for commonly available inflatable penile prostheses. International Journal of Impotence Research. 2021; 33(6):652–659 [<a href="https://pubmed.ncbi.nlm.nih.gov/32778772" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32778772</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>148.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref148">Mahler
|
|
EAM, Minten
|
|
MJ, Leseman-Hoogenboom
|
|
MM, Poortmans
|
|
PMP, Leer
|
|
JWH, Boks
|
|
SS
|
|
et al. Effectiveness of low-dose radiation therapy on symptoms in patients with knee osteoarthritis: a randomised, double-blinded, sham-controlled trial. Annals of the Rheumatic Diseases. 2019; 78(1):83–90 [<a href="https://pubmed.ncbi.nlm.nih.gov/30366945" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30366945</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>149.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref149">Marini
|
|
I, Gatto
|
|
MR, Bonetti
|
|
GA. Effects of superpulsed low-level laser therapy on temporomandibular joint pain. Clinical Journal of Pain. 2010; 26(7):611–616 [<a href="https://pubmed.ncbi.nlm.nih.gov/20664343" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20664343</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>150.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref150">Marquina
|
|
N, Dumoulin-White
|
|
R, Mandel
|
|
A, Lilge
|
|
L. Laser therapy applications for osteoarthritis and chronic joint pain - A randomized placebo-controlled clinical trial. Photonics and lasers in medicine. 2012; 1(4):299–307</div></dd></dl><dl class="bkr_refwrap"><dt>151.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref151">Mascarin
|
|
NC, Vancini
|
|
RL, Andrade
|
|
ML, Magalhaes Ede
|
|
P, de Lira
|
|
CA, Coimbra
|
|
IB. Effects of kinesiotherapy, ultrasound and electrotherapy in management of bilateral knee osteoarthritis: prospective clinical trial. BMC Musculoskeletal Disorders. 2012; 13:182 [<a href="/pmc/articles/PMC3475115/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3475115</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/22999098" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22999098</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>152.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref152">Melo Mde
|
|
O, Pompeo
|
|
KD, Brodt
|
|
GA, Baroni
|
|
BM, da Silva Junior
|
|
DP, Vaz
|
|
MA. Effects of neuromuscular electrical stimulation and low-level laser therapy on the muscle architecture and functional capacity in elderly patients with knee osteoarthritis: a randomized controlled trial. Clinical Rehabilitation. 2015; 29(6):570–580 [<a href="https://pubmed.ncbi.nlm.nih.gov/25261425" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25261425</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>153.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref153">Melo
|
|
MDO, Pompeo
|
|
KD, Baroni
|
|
BM, Sonda
|
|
FC, Vaz
|
|
MA. Randomised study of the effects of neuromuscular electrical stimulation and low-level laser therapy on muscle activation and pain in patients with knee osteoarthritis. International Journal of Therapy & Rehabilitation. 2019; 26(7):1–13</div></dd></dl><dl class="bkr_refwrap"><dt>154.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref154">Mizusaki Imoto
|
|
A, Peccin
|
|
S, Gomes da Silva
|
|
KN, de Paiva Teixeira
|
|
LE, Abrahao
|
|
MI, Fernandes Moca Trevisani
|
|
V. Effects of neuromuscular electrical stimulation combined with exercises versus an exercise program on the pain and the function in patients with knee osteoarthritis: a randomized controlled trial. BioMed Research International. 2013; 2013:272018 [<a href="/pmc/articles/PMC3787573/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3787573</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/24151589" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24151589</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>155.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref155">Moffett
|
|
JA, Richardson
|
|
PH, Frost
|
|
H, Osborn
|
|
A. A placebo controlled double blind trial to evaluate the effectiveness of pulsed short wave therapy for osteoarthritic hip and knee pain. Pain. 1996; 67(1):121–127 [<a href="https://pubmed.ncbi.nlm.nih.gov/8895239" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8895239</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>156.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref156">Murat
|
|
S, Yumusakhuylu
|
|
Y, Gencoglu
|
|
Z, Icagasioglu
|
|
A, Kesiktas
|
|
N, Altinbilek
|
|
T. Frequency of physical therapy in knee osteoarthritis: A randomized controlled trial. European Research Journal. 2019; 5(5):781–786</div></dd></dl><dl class="bkr_refwrap"><dt>157.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref157">National Institute for Health and Care Excellence. Developing NICE guidelines: the manual [updated October 2020]. London. National Institute for Health and Care Excellence, 2014. Available from: <a href="http://www.nice.org.uk/article/PMG20/chapter/1%20Introduction%20and%20overview" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">http://www<wbr style="display:inline-block"></wbr>​.nice.org.uk<wbr style="display:inline-block"></wbr>​/article/PMG20/chapter<wbr style="display:inline-block"></wbr>​/1%20Introduction%20and%20overview</a></div></dd></dl><dl class="bkr_refwrap"><dt>158.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref158">Nazari
|
|
A, Moezy
|
|
A, Nejati
|
|
P, Mazaherinezhad
|
|
A. Efficacy of high-intensity laser therapy in comparison with conventional physiotherapy and exercise therapy on pain and function of patients with knee osteoarthritis: a randomized controlled trial with 12-week follow up. Lasers in Medical Science. 2019; 34(3):505–516 [<a href="https://pubmed.ncbi.nlm.nih.gov/30178432" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30178432</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>159.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref159">Negm
|
|
A, Lorbergs
|
|
A, Macintyre
|
|
NJ. Efficacy of low frequency pulsed subsensory threshold electrical stimulation vs placebo on pain and physical function in people with knee osteoarthritis: systematic review with meta-analysis. Osteoarthritis and Cartilage. 2013; 21(9):1281–1289 [<a href="https://pubmed.ncbi.nlm.nih.gov/23973142" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23973142</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>160.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref160">Nelson
|
|
FR, Zvirbulis
|
|
R, Pilla
|
|
AA. Non-invasive electromagnetic field therapy produces rapid and substantial pain reduction in early knee osteoarthritis: a randomized double-blind pilot study. Rheumatology International. 2013; 33(8):2169–2173 [<a href="https://pubmed.ncbi.nlm.nih.gov/22451021" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22451021</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>161.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref161">Ng
|
|
MM, Leung
|
|
MC, Poon
|
|
DM. The effects of electro-acupuncture and transcutaneous electrical nerve stimulation on patients with painful osteoarthritic knees: a randomized controlled trial with follow-up evaluation. Journal of Alternative and Complementary Medicine. 2003; 9(5):641–649 [<a href="https://pubmed.ncbi.nlm.nih.gov/14629842" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 14629842</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>162.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref162">Nicolakis
|
|
P, Kollmitzer
|
|
J, Crevenna
|
|
R, Bittner
|
|
C, Erdogmus
|
|
CB, Nicolakis
|
|
J. Pulsed magnetic field therapy for osteoarthritis of the knee--a double-blind sham-controlled trial. Wiener Klinische Wochenschrift. 2002; 114(15–16):678–684 [<a href="https://pubmed.ncbi.nlm.nih.gov/12602111" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 12602111</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>163.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref163">Obotiba
|
|
AD, Swain
|
|
S, Kaur
|
|
J, Doherty
|
|
M, Zhang
|
|
W, Abhishek
|
|
A. Reliability of detection of ultrasound and MRI features of hand osteoarthritis: a systematic review and meta-analysis. Rheumatology. 2022; 61(2):542–553 [<a href="/pmc/articles/PMC8824416/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC8824416</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/34086885" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 34086885</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>164.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref164">Osiri
|
|
M, Welch
|
|
V, Brosseau
|
|
L, Shea
|
|
B, McGowan
|
|
J, Tugwell
|
|
P et al. Transcutaneous electrical nerve stimulation for knee osteoarthritis. Cochrane Database of Systematic Reviews
|
|
2000, Issue 4. Art. No.: CD002823. [<a href="https://pubmed.ncbi.nlm.nih.gov/11034768" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 11034768</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>165.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref165">Ozdemir
|
|
F, Birtane
|
|
M, Kokino
|
|
S. The clinical efficacy of low-power laser therapy on pain and function in cervical osteoarthritis. Clinical Rheumatology. 2001; 20(3):181–184 [<a href="https://pubmed.ncbi.nlm.nih.gov/11434469" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 11434469</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>166.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref166">Ozgonenel
|
|
L, Aytekin
|
|
E, Durmusoglu
|
|
G. A double-blind trial of clinical effects of therapeutic ultrasound in knee osteoarthritis. Ultrasound in Medicine and Biology. 2009; 35(1):44–49 [<a href="https://pubmed.ncbi.nlm.nih.gov/18829151" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 18829151</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>167.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref167">Ozgonenel
|
|
L, Okur
|
|
SC, Dogan
|
|
YP, Caglar
|
|
NS. Effectiveness of therapeutic ultrasound on clinical parameters and ultrasonographic cartilage thickness in knee osteoarthritis: A double-blind trial. Journal of Medical Ultrasound. 2018; 26(4):194–199 [<a href="/pmc/articles/PMC6314098/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6314098</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/30662150" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30662150</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>168.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref168">Ozguclu
|
|
E, Cetin
|
|
A, Cetin
|
|
M, Calp
|
|
E. Additional effect of pulsed electromagnetic field therapy on knee osteoarthritis treatment: a randomized, placebo-controlled study. Clinical Rheumatology. 2010; 29(8):927–931 [<a href="https://pubmed.ncbi.nlm.nih.gov/20473540" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20473540</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>169.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref169">Palmer
|
|
S, Domaille
|
|
M, Cramp
|
|
F, Walsh
|
|
N, Pollock
|
|
J, Kirwan
|
|
J
|
|
et al. Transcutaneous electrical nerve stimulation as an adjunct to education and exercise for knee osteoarthritis: a randomized controlled trial. Arthritis Care and Research. 2014; 66(3):387–394 [<a href="https://pubmed.ncbi.nlm.nih.gov/23983090" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23983090</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>170.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref170">Palmieri-Smith
|
|
RM, Thomas
|
|
AC, Karvonen-Gutierrez
|
|
C, Sowers
|
|
M. A clinical trial of neuromuscular electrical stimulation in improving quadriceps muscle strength and activation among women with mild and moderate osteoarthritis. Physical Therapy. 2010; 90(10):1441–1452 [<a href="https://pubmed.ncbi.nlm.nih.gov/20671100" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20671100</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>171.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref171">Paolillo
|
|
AR, Paolillo
|
|
FR, Joao
|
|
JP, Joao
|
|
HA, Bagnato
|
|
VS. Synergic effects of ultrasound and laser on the pain relief in women with hand osteoarthritis. Lasers in Medical Science. 2015; 30(1):279–286 [<a href="https://pubmed.ncbi.nlm.nih.gov/25239030" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25239030</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>172.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref172">Paolillo
|
|
FR, Paolillo
|
|
AR, Joao
|
|
JP, Frasca
|
|
D, Duchene
|
|
M, Joao
|
|
HA
|
|
et al. Ultrasound plus low-level laser therapy for knee osteoarthritis rehabilitation: a randomized, placebo-controlled trial. Rheumatology International. 2018; 38(5):785–793 [<a href="https://pubmed.ncbi.nlm.nih.gov/29480363" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29480363</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>173.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref173">Park
|
|
S, Min
|
|
S, Park
|
|
SH, Yoo
|
|
J, Jee
|
|
YS. Influence of isometric exercise combined with electromyostimulation on inflammatory cytokine levels, muscle strength, and knee joint function in elderly women with early knee osteoarthritis. Frontiers in Physiology. 2021; 12:688260 [<a href="/pmc/articles/PMC8313868/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC8313868</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/34326779" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 34326779</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>174.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref174">Peroz
|
|
I, Chun
|
|
YH, Karageorgi
|
|
G, Schwerin
|
|
C, Bernhardt
|
|
O, Roulet
|
|
JF
|
|
et al. A multicenter clinical trial on the use of pulsed electromagnetic fields in the treatment of temporomandibular disorders. Journal of Prosthetic Dentistry. 2004; 91(2):180–187 [<a href="https://pubmed.ncbi.nlm.nih.gov/14970765" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 14970765</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>175.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref175">Pietrosimone
|
|
B, Luc-Harkey
|
|
BA, Harkey
|
|
MS, Davis-Wilson
|
|
HC, Pfeiffer
|
|
SJ, Schwartz
|
|
TA
|
|
et al. Using tens to enhance therapeutic exercise in individuals with knee osteoarthritis. Medicine and Science in Sports and Exercise. 2020; 52(10):2086–2095 [<a href="https://pubmed.ncbi.nlm.nih.gov/32251254" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32251254</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>176.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref176">Pietrosimone
|
|
BG, Saliba
|
|
SA, Hart
|
|
JM, Hertel
|
|
J, Ingersoll
|
|
CD. Contralateral effects of disinhibitory tens on quadriceps function in people with knee osteoarthritis following unilateral treatment. North American Journal of Sports Physical Therapy. 2010; 5(3):111–121 [<a href="/pmc/articles/PMC2971644/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC2971644</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/21589667" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21589667</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>177.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref177">Pietrosimone
|
|
BG, Saliba
|
|
SA, Hart
|
|
JM, Hertel
|
|
J, Kerrigan
|
|
DC, Ingersoll
|
|
CD. Effects of disinhibitory transcutaneous electrical nerve stimulation and therapeutic exercise on sagittal plane peak knee kinematics and kinetics in people with knee osteoarthritis during gait: a randomized controlled trial. Clinical Rehabilitation. 2010; 24(12):1091–1101 [<a href="https://pubmed.ncbi.nlm.nih.gov/20713439" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20713439</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>178.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref178">Pietrosimone
|
|
BG, Saliba
|
|
SA, Hart
|
|
JM, Hertel
|
|
J, Kerrigan
|
|
DC, Ingersoll
|
|
CD. Effects of transcutaneous electrical nerve stimulation and therapeutic exercise on quadriceps activation in people with tibiofemoral osteoarthritis. Journal of Orthopaedic and Sports Physical Therapy. 2011; 41(1):4–12 [<a href="https://pubmed.ncbi.nlm.nih.gov/21282869" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21282869</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>179.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref179">Pipitone
|
|
N, Scott
|
|
DL. Magnetic pulse treatment for knee osteoarthritis: a randomised, double-blind, placebo-controlled study. Current Medical Research and Opinion. 2001; 17(3):190–196 [<a href="https://pubmed.ncbi.nlm.nih.gov/11900312" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 11900312</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>180.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref180">Pipitone
|
|
N, Scott
|
|
DL. Pulsating electro-magnetic fields (PEMF) for the osteoarthritis of the knee: results of a double-blind, controlled, randomised study. Zeitschrift für Rheumatologie. 2001; 60(Suppl 1):88</div></dd></dl><dl class="bkr_refwrap"><dt>181.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref181">Polat
|
|
CS, Dogan
|
|
A, Ozcan
|
|
DS, Koseoglu
|
|
BF, Akselim
|
|
SK, Onat
|
|
SS. The effectiveness of transcutaneous electrical nerve stimulation in knee osteoarthritis with neuropathic pain component: a randomized controlled study. Turk osteoporoz dergisi. 2017; 23(2):47–51</div></dd></dl><dl class="bkr_refwrap"><dt>182.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref182">Quirk
|
|
AS, Newman
|
|
RJ, Newman
|
|
KJ. An evaluation of interferential therapy, shortwave diathermy and exercise in the treatment of osteoarthrosis of the knee. Physiotherapy. 1985; 71(2):55–57</div></dd></dl><dl class="bkr_refwrap"><dt>183.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref183">Raj
|
|
NB, Saha
|
|
S, Razali
|
|
H, Othman
|
|
NYH, Mahadeva Rao
|
|
US. Does proprioception of knee improve after various forms of training in osteoarthritis of knee?
|
|
Research journal of pharmacy and technology. 2019; 12(9):4379–4386</div></dd></dl><dl class="bkr_refwrap"><dt>184.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref184">Rattanachaiyanont
|
|
M, Kuptniratsaikul
|
|
V. No additional benefit of shortwave diathermy over exercise program for knee osteoarthritis in peri-/post-menopausal women: an equivalence trial. Osteoarthritis and Cartilage. 2008; 16(7):823–828 [<a href="https://pubmed.ncbi.nlm.nih.gov/18178111" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 18178111</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>185.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref185">Rayegani
|
|
SM, Raeissadat
|
|
SA, Heidari
|
|
S, Moradi-Joo
|
|
M. Safety and effectiveness of low-level laser therapy in patients with knee osteoarthritis: A systematic review and meta-analysis. Journal of Lasers in Medical Sciences. 2017; 8(Suppl 1):S12–S19 [<a href="/pmc/articles/PMC5642172/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5642172</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/29071029" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29071029</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>186.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref186">Rodriguez-Merchan
|
|
EC. Conservative treatment of acute knee osteoarthritis: A review of the Cochrane Library. Journal of Acute Disease. 2016; 5(3):190–193</div></dd></dl><dl class="bkr_refwrap"><dt>187.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref187">Rosemffet
|
|
MG, Schneeberger
|
|
EE, Citera
|
|
G, Sgobba
|
|
ME, Laiz
|
|
C, Schmulevich
|
|
H
|
|
et al. Effects of functional electrostimulation on pain, muscular strength, and functional capacity in patients with osteoarthritis of the knee. JCR: Journal of Clinical Rheumatology. 2004; 10(5):246–249 [<a href="https://pubmed.ncbi.nlm.nih.gov/17043521" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 17043521</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>188.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref188">Rutjes
|
|
AW, Nuesch
|
|
E, Sterchi
|
|
R, Juni
|
|
P. Therapeutic ultrasound for osteoarthritis of the knee or hip. Cochrane Database of Systematic Reviews
|
|
2010, Issue 1. Art. No.: CD003132. DOI: 10.1002/14651858.CD003132.pub2. [<a href="https://pubmed.ncbi.nlm.nih.gov/20091539" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20091539</span></a>] [<a href="http://dx.crossref.org/10.1002/14651858.CD003132.pub2" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl><dl class="bkr_refwrap"><dt>189.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref189">Rutjes
|
|
AW, Nuesch
|
|
E, Sterchi
|
|
R, Kalichman
|
|
L, Hendriks
|
|
E, Osiri
|
|
M et al. Transcutaneous electrostimulation for osteoarthritis of the knee. Cochrane Database of Systematic Reviews
|
|
2009, Issue 4. Art. No.: CD002823. DOI: 10.1002/14651858.CD002823.pub2. [<a href="/pmc/articles/PMC7120411/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7120411</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/19821296" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19821296</span></a>] [<a href="http://dx.crossref.org/10.1002/14651858.CD002823.pub2" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl><dl class="bkr_refwrap"><dt>190.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref190">Sangtong
|
|
K, Chupinijrobkob
|
|
C, Putthakumnerd
|
|
W, Kuptniratsaikul
|
|
V. Does adding transcutaneous electrical nerve stimulation to therapeutic ultrasound affect pain or function in people with osteoarthritis of the knee? A randomized controlled trial. Clinical Rehabilitation. 2019; 33(7):1197–1205 [<a href="https://pubmed.ncbi.nlm.nih.gov/30935225" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30935225</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>191.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref191">Selfe
|
|
TK, Bourguignon
|
|
C, Taylor
|
|
AG. Effects of noninvasive interactive neurostimulation on symptoms of osteoarthritis of the knee: a randomized, sham-controlled pilot study. Journal of Alternative and Complementary Medicine. 2008; 14(9):1075–1081 [<a href="/pmc/articles/PMC2810549/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC2810549</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/19055333" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19055333</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>192.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref192">Sener
|
|
O, Hizmetli
|
|
S, Karadag
|
|
A, Hayta
|
|
E. Investigation of short-wave diathermy genotoxic effect in patients with knee osteoarthritis. Turk osteoporoz dergisi. 2019; 25(2):53–57</div></dd></dl><dl class="bkr_refwrap"><dt>193.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref193">Shen
|
|
X, Zhao
|
|
L, Ding
|
|
G, Tan
|
|
M, Gao
|
|
J, Wang
|
|
L
|
|
et al. Effect of combined laser acupuncture on knee osteoarthritis: a pilot study. Lasers in Medical Science. 2009; 24(2):129–136 [<a href="https://pubmed.ncbi.nlm.nih.gov/18180980" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 18180980</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>194.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref194">Shimoura
|
|
K, Iijima
|
|
H, Suzuki
|
|
Y, Aoyama
|
|
T. Immediate effects of transcutaneous electrical nerve stimulation on pain and physical performance in individuals with preradiographic knee osteoarthritis: A randomized controlled trial. Archives of Physical Medicine and Rehabilitation. 2019; 100(2):300–306.e301 [<a href="https://pubmed.ncbi.nlm.nih.gov/30315763" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30315763</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>195.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref195">Smith
|
|
CR, Lewith
|
|
GT, Machin
|
|
D. TNS and osteo-arthritic pain. Preliminary study to establish a controlled method of assessing transcutaneous nerve stimulation as a treatment for the pain caused by osteo-arthritis of the knee. Physiotherapy. 1983; 69(8):266–268 [<a href="https://pubmed.ncbi.nlm.nih.gov/6351130" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 6351130</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>196.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref196">Song
|
|
HJ, Seo
|
|
HJ, Kim
|
|
D. Effectiveness of high-intensity laser therapy in the management of patients with knee osteoarthritis: A systematic review and meta-analysis of randomized controlled trials. Journal of Back and Musculoskeletal Rehabilitation. 2020; 33(6):875–884 [<a href="https://pubmed.ncbi.nlm.nih.gov/32831189" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32831189</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>197.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref197">Stange-Rezende
|
|
L, Stamm
|
|
TA, Schiffert
|
|
T, Sahinbegovic
|
|
E, Gaiger
|
|
A, Smolen
|
|
J
|
|
et al. Clinical study on the effect of infrared radiation of a tiled stove on patients with hand osteoarthritis. Scandinavian Journal of Rheumatology. 2006; 35(6):476–480 [<a href="https://pubmed.ncbi.nlm.nih.gov/17343258" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 17343258</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>198.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref198">Stausholm
|
|
MB, Naterstad
|
|
IF, Joensen
|
|
J, Lopes-Martins
|
|
RAB, Saebo
|
|
H, Lund
|
|
H
|
|
et al. Efficacy of low-level laser therapy on pain and disability in knee osteoarthritis: systematic review and meta-analysis of randomised placebo-controlled trials. BMJ Open. 2019; 9(10):e031142 [<a href="/pmc/articles/PMC6830679/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6830679</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/31662383" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31662383</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>199.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref199">Steinhilber
|
|
B, Haupt
|
|
G, Miller
|
|
R, Janssen
|
|
P, Krauss
|
|
I. Exercise therapy in patients with hip osteoarthritis: Effect on hip muscle strength and safety aspects of exercise-results of a randomized controlled trial. Modern Rheumatology. 2017; 27(3):493–502 [<a href="https://pubmed.ncbi.nlm.nih.gov/27486681" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27486681</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>200.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref200">Stelian
|
|
J, Gil
|
|
I, Habot
|
|
B, Rosenthal
|
|
M, Abramovici
|
|
I, Kutok
|
|
N
|
|
et al. Improvement of pain and disability in elderly patients with degenerative osteoarthritis of the knee treated with narrow-band light therapy. Journal of the American Geriatrics Society. 1992; 40(1):23–26 [<a href="https://pubmed.ncbi.nlm.nih.gov/1727843" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 1727843</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>201.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref201">Sutbeyaz
|
|
ST, Sezer
|
|
N, Koseoglu
|
|
BF. The effect of pulsed electromagnetic fields in the treatment of cervical osteoarthritis: a randomized, double-blind, sham-controlled trial. Rheumatology International. 2006; 26(4):320–324 [<a href="https://pubmed.ncbi.nlm.nih.gov/15986086" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 15986086</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>202.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref202">Talbot
|
|
LA, Gaines
|
|
JM, Ling
|
|
SM, Metter
|
|
EJ. A home-based protocol of electrical muscle stimulation for quadriceps muscle strength in older adults with osteoarthritis of the knee. Journal of Rheumatology. 2003; 30(7):1571–1578 [<a href="https://pubmed.ncbi.nlm.nih.gov/12858461" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 12858461</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>203.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref203">Tan
|
|
JM, Middleton
|
|
KJ, Hart
|
|
HF, Menz
|
|
HB, Crossley
|
|
KM, Munteanu
|
|
SE
|
|
et al. Immediate effects of foot orthoses on lower limb biomechanics, pain, and confidence in individuals with patellofemoral osteoarthritis. Gait and Posture. 2020; 76:51–57 [<a href="https://pubmed.ncbi.nlm.nih.gov/31731134" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31731134</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>204.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref204">Tascioglu
|
|
F, Armagan
|
|
O, Tabak
|
|
Y, Corapci
|
|
I, Oner
|
|
C. Low power laser treatment in patients with knee osteoarthritis. Swiss Medical Weekly. 2004; 134(17–18):254–258 [<a href="https://pubmed.ncbi.nlm.nih.gov/15243853" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 15243853</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>205.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref205">Tascioglu
|
|
F, Kuzgun
|
|
S, Armagan
|
|
O, Ogutler
|
|
G. Short-term effectiveness of ultrasound therapy in knee osteoarthritis. Journal of International Medical Research. 2010; 38(4):1233–1242 [<a href="https://pubmed.ncbi.nlm.nih.gov/20925995" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20925995</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>206.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref206">Tavares
|
|
DRB, Okazaki
|
|
JEF, Rocha
|
|
AP, Santana
|
|
MVA, Pinto
|
|
A, Civile
|
|
VT
|
|
et al. Effects of transcranial direct current stimulation on knee osteoarthritis pain in elderly subjects with defective endogenous pain-inhibitory systems: Protocol for a randomized controlled trial. JMIR Research Protocols. 2018; 7(10):e11660 [<a href="/pmc/articles/PMC6234349/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6234349</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/30373731" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30373731</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>207.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref207">Taylor
|
|
P, Hallett
|
|
M, Flaherty
|
|
L. Treatment of osteoarthritis of the knee with transcutaneous electrical nerve stimulation. Pain. 1981; 11(2):233–240 [<a href="https://pubmed.ncbi.nlm.nih.gov/7033891" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 7033891</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>208.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref208">Thamsborg
|
|
G, Florescu
|
|
A, Oturai
|
|
P, Fallentin
|
|
E, Tritsaris
|
|
K, Dissing
|
|
S. Treatment of knee osteoarthritis with pulsed electromagnetic fields: a randomized, double-blind, placebo-controlled study. Osteoarthritis and Cartilage. 2005; 13(7):575–581 [<a href="https://pubmed.ncbi.nlm.nih.gov/15979009" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 15979009</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>209.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref209">Tok
|
|
F, Aydemir
|
|
K, Peker
|
|
F, Safaz
|
|
I, Taskaynatan
|
|
MA, Ozgul
|
|
A. The effects of electrical stimulation combined with continuous passive motion versus isometric exercise on symptoms, functional capacity, quality of life and balance in knee osteoarthritis: randomized clinical trial. Rheumatology International. 2011; 31(2):177–181 [<a href="https://pubmed.ncbi.nlm.nih.gov/20012051" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20012051</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>210.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref210">Tomruk Sutbeyaz
|
|
S, Sezer
|
|
N, Albayrak
|
|
N, Koseoglu
|
|
F. Effectiveness of low frequency pulsed electromagnetic fields in the treatment of knee osteoarthritis: randomized, controlled trial. Journal of rheumatology and medical rehabilitation. 2007; 18(1):6–9</div></dd></dl><dl class="bkr_refwrap"><dt>211.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref211">Trock
|
|
DH, Bollet
|
|
AJ, Dyer
|
|
RH, Jr., Fielding
|
|
LP, Miner
|
|
WK, Markoll
|
|
R. A double-blind trial of the clinical effects of pulsed electromagnetic fields in osteoarthritis. Journal of Rheumatology. 1993; 20(3):456–460 [<a href="https://pubmed.ncbi.nlm.nih.gov/8478852" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8478852</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>212.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref212">Trock
|
|
DH, Bollet
|
|
AJ, Markoll
|
|
R. The effect of pulsed electromagnetic fields in the treatment of osteoarthritis of the knee and cervical spine. Report of randomized, double blind, placebo controlled trials. Journal of Rheumatology. 1994; 21(10):1903–1911 [<a href="https://pubmed.ncbi.nlm.nih.gov/7837158" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 7837158</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>213.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref213">Ulus
|
|
Y, Tander
|
|
B, Akyol
|
|
Y, Durmus
|
|
D, Buyukakincak
|
|
O, Gul
|
|
U
|
|
et al. Therapeutic ultrasound versus sham ultrasound for the management of patients with knee osteoarthritis: a randomized double-blind controlled clinical study. International Journal of Rheumatic Diseases. 2012; 15(2):197–206 [<a href="https://pubmed.ncbi.nlm.nih.gov/22462424" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22462424</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>214.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref214">Usman
|
|
Z, Maharaj
|
|
SS, Kaka
|
|
B. Effects of combination therapy and infrared radiation on pain, physical function, and quality of life in subjects with knee osteoarthritis: A randomized controlled study. Hong kong physiotherapy journal. 2019; 39(2):133–142 [<a href="/pmc/articles/PMC6900333/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6900333</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/31889764" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31889764</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>215.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref215">Vance
|
|
CG, Rakel
|
|
BA, Blodgett
|
|
NP, DeSantana
|
|
JM, Amendola
|
|
A, Zimmerman
|
|
MB
|
|
et al. Effects of transcutaneous electrical nerve stimulation on pain, pain sensitivity, and function in people with knee osteoarthritis: a randomized controlled trial. Physical Therapy. 2012; 92(7):898–910 [<a href="/pmc/articles/PMC3386514/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3386514</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/22466027" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22466027</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>216.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref216">Wang
|
|
H, Zhang
|
|
C, Gao
|
|
C, Zhu
|
|
S, Yang
|
|
L, Wei
|
|
Q
|
|
et al. Effects of short-wave therapy in patients with knee osteoarthritis: a systematic review and meta-analysis. Clinical Rehabilitation. 2017; 31(5):660–671 [<a href="https://pubmed.ncbi.nlm.nih.gov/28118736" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28118736</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>217.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref217">Wang
|
|
TS, Guo
|
|
P, Li
|
|
G, Wang
|
|
JW. Extracorporeal shockwave therapy for chronic knee pain: A multicenter, randomized controlled trial. Alternative Therapies in Health and Medicine. 2020; 26(2):34–37 [<a href="https://pubmed.ncbi.nlm.nih.gov/31221934" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31221934</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>218.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref218">Woods
|
|
B, Manca
|
|
A, Weatherly
|
|
H, Saramago
|
|
P, Sideris
|
|
E, Giannopoulou
|
|
C
|
|
et al. Cost-effectiveness of adjunct non-pharmacological interventions for osteoarthritis of the knee. PLoS ONE [Electronic Resource]. 2017; 12(3):e0172749 [<a href="/pmc/articles/PMC5340388/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5340388</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/28267751" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28267751</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>219.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref219">Wu
|
|
Z, Ding
|
|
X, Lei
|
|
G, Zeng
|
|
C, Wei
|
|
J, Li
|
|
J
|
|
et al. Efficacy and safety of the pulsed electromagnetic field in osteoarthritis: a meta-analysis. BMJ Open. 2018; 8(12):e022879 [<a href="/pmc/articles/PMC6303578/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6303578</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/30552258" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30552258</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>220.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref220">Wuschech
|
|
H, von Hehn
|
|
U, Mikus
|
|
E, Funk
|
|
RH. Effects of PEMF on patients with osteoarthritis: Results of a prospective, placebo-controlled, double-blind study. Bioelectromagnetics. 2015; 36(8):576–585 [<a href="https://pubmed.ncbi.nlm.nih.gov/26562074" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26562074</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>221.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref221">Wyszynska
|
|
J, Bal-Bochenska
|
|
M. Efficacy of high-intensity laser therapy in treating knee osteoarthritis: A first systematic review. Photomedicine and Laser Surgery. 2018; 36(7):343–353 [<a href="https://pubmed.ncbi.nlm.nih.gov/29688827" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29688827</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>222.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref222">Yang
|
|
PF, Li
|
|
D, Zhang
|
|
SM, Wu
|
|
Q, Tang
|
|
J, Huang
|
|
LK
|
|
et al. Efficacy of ultrasound in the treatment of osteoarthritis of the knee. Orthopaedic Audio-Synopsis Continuing Medical Education [Sound Recording]. 2011; 3(3):181–187 [<a href="/pmc/articles/PMC6583622/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6583622</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/22009649" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22009649</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>223.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref223">Yavuz
|
|
M, Ataoglu
|
|
S, Ozsahin
|
|
M, Baki
|
|
AE, Icmeli
|
|
C. Compared effects and effectiveness in applications of isokinetic exercise, laser, and diclophenac iontophoresis in primary osteoarthritis of knee. Duzce medical journal. 2013; 15(3):15–21</div></dd></dl><dl class="bkr_refwrap"><dt>224.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref224">Yegin
|
|
T, Altan
|
|
L, Kasapoglu Aksoy
|
|
M. The effect of therapeutic ultrasound on pain and physical function in patients with knee osteoarthritis. Ultrasound in Medicine and Biology. 2017; 43(1):187–194 [<a href="https://pubmed.ncbi.nlm.nih.gov/27727020" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27727020</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>225.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref225">Yildiz
|
|
SK, Ozkan
|
|
FU, Aktas
|
|
I, Silte
|
|
AD, Kaysin
|
|
MY, Badur
|
|
NB. The effectiveness of ultrasound treatment for the management of knee osteoarthritis: a randomized, placebo-controlled, double-blind study. Turkish Journal of Medical Sciences. 2015; 45(6):1187–1191 [<a href="https://pubmed.ncbi.nlm.nih.gov/26775369" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26775369</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>226.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref226">Young
|
|
S, Woodbury
|
|
MG, Fryday
|
|
FK, Donovan
|
|
T. Efficacy of interferential current stimulation alone for pain reduction in patients with osteoarthritis of the knee: a randomized placebo control clinical trial. Physical Therapy. 1991; 71(6):852</div></dd></dl><dl class="bkr_refwrap"><dt>227.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref227">Youssef
|
|
EF, Muaidi
|
|
QI, Shanb
|
|
AA. Effect of laser therapy on chronic osteoarthritis of the knee in older subjects. Journal of Lasers in Medical Sciences. 2016; 7(2):112–119 [<a href="/pmc/articles/PMC4909009/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4909009</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/27330707" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27330707</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>228.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref228">Yuan
|
|
Y, Shen
|
|
W, Han
|
|
Q, Liang
|
|
D, Chen
|
|
L, Yin
|
|
Q
|
|
et al. Clinical observation of pulsed radiofrequency in treatment of knee osteoarthritis. International Journal of Clinical and Experimental Medicine. 2016; 9(10):20050–20055</div></dd></dl><dl class="bkr_refwrap"><dt>229.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref229">Yurtkuran
|
|
M, Alp
|
|
A, Konur
|
|
S, Ozcakir
|
|
S, Bingol
|
|
U. Laser acupuncture in knee osteoarthritis: a double-blind, randomized controlled study. Photomedicine and Laser Surgery. 2007; 25(1):14–20 [<a href="https://pubmed.ncbi.nlm.nih.gov/17352632" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 17352632</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>230.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref230">Yuvarani
|
|
G, Thonisha Xavier
|
|
L, Mohan Kumar
|
|
G, Rajalaxmi
|
|
V. To compare the effectiveness between LASER and neuromuscular electrical stimulation in knee osteoarthritis. Biomedicine (india). 2018; 38(1):142–146</div></dd></dl><dl class="bkr_refwrap"><dt>231.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref231">Zammit
|
|
G, Menz
|
|
H, Munteanu
|
|
S, Landorf
|
|
K, Gilheany
|
|
M. Interventions for treating osteoarthritis of the big toe joint. Cochrane Database of Systematic Reviews
|
|
2010, Issue 9. Art. No.: CD007809. DOI: 10.1002/14651858.CD007809.pub2. [<a href="https://pubmed.ncbi.nlm.nih.gov/20824867" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20824867</span></a>] [<a href="http://dx.crossref.org/10.1002/14651858.CD007809.pub2" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl><dl class="bkr_refwrap"><dt>232.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref232">Zeng
|
|
C, Li
|
|
H, Yang
|
|
T, Deng
|
|
ZH, Yang
|
|
Y, Zhang
|
|
Y
|
|
et al. Effectiveness of continuous and pulsed ultrasound for the management of knee osteoarthritis: a systematic review and network meta-analysis. Osteoarthritis and Cartilage. 2014; 22(8):1090–1099 [<a href="https://pubmed.ncbi.nlm.nih.gov/24999112" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24999112</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>233.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref233">Zeng
|
|
C, Li
|
|
H, Yang
|
|
T, Deng
|
|
ZH, Yang
|
|
Y, Zhang
|
|
Y
|
|
et al. Electrical stimulation for pain relief in knee osteoarthritis: systematic review and network meta-analysis. Osteoarthritis and Cartilage. 2015; 23(2):189–202 [<a href="https://pubmed.ncbi.nlm.nih.gov/25497083" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25497083</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>234.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref234">Zhang
|
|
C, Shi
|
|
J, Zhu
|
|
C, Xiang
|
|
T, Yi
|
|
Z, Kong
|
|
Y. Effect of ultrasound therapy for knee osteoarthritis: A meta-analysis of randomized, double-blind, placebo-controlled clinical trials. International Journal of Clinical and Experimental Medicine. 2016; 9(11):20552–20561</div></dd></dl><dl class="bkr_refwrap"><dt>235.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref235">Zhang
|
|
C, Xie
|
|
Y, Luo
|
|
X, Ji
|
|
Q, Lu
|
|
C, He
|
|
C
|
|
et al. Effects of therapeutic ultrasound on pain, physical functions and safety outcomes in patients with knee osteoarthritis: a systematic review and meta-analysis. Clinical Rehabilitation. 2016; 30(10):960–971 [<a href="https://pubmed.ncbi.nlm.nih.gov/26451008" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26451008</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>236.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref236">Zhang
|
|
YF, Liu
|
|
Y, Chou
|
|
SW, Weng
|
|
H. Dose-related effects of radial extracorporeal shock wave therapy for knee osteoarthritis: A randomized controlled trial. Journal of Rehabilitation Medicine. 2021; 53(1):00144 [<a href="/pmc/articles/PMC8772366/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC8772366</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/33367924" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 33367924</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>237.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref237">Zhao
|
|
Z, Jing
|
|
R, Shi
|
|
Z, Zhao
|
|
B, Ai
|
|
Q, Xing
|
|
G. Efficacy of extracorporeal shockwave therapy for knee osteoarthritis: a randomized controlled trial. Journal of Surgical Research. 2013; 185(2):661–666 [<a href="https://pubmed.ncbi.nlm.nih.gov/23953895" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23953895</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>238.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref238">Zhong
|
|
Z, Liu
|
|
B, Liu
|
|
G, Chen
|
|
J, Li
|
|
Y, Chen
|
|
J
|
|
et al. A randomized controlled trial on the effects of low-dose extracorporeal shockwave therapy in patients with knee osteoarthritis. Archives of Physical Medicine and Rehabilitation. 2019; 100(9):1695–1702 [<a href="https://pubmed.ncbi.nlm.nih.gov/31194946" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31194946</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>239.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref239">Zhou
|
|
XY, Zhang
|
|
XX, Yu
|
|
GY, Zhang
|
|
ZC, Wang
|
|
F, Yang
|
|
YL
|
|
et al. Effects of low-intensity pulsed ultrasound on knee osteoarthritis: A meta-analysis of randomized clinical trials. BioMed Research International. 2018; 2018:7469197 [<a href="/pmc/articles/PMC6076961/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6076961</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/30105243" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30105243</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>240.</dt><dd><div class="bk_ref" id="niceng226er7.s1.1.ref240">Zizic
|
|
TM, Hoffman
|
|
KC, Holt
|
|
PA, Hungerford
|
|
DS, O’Dell
|
|
JR, Jacobs
|
|
MA
|
|
et al. The treatment of osteoarthritis of the knee with pulsed electrical stimulation. Journal of Rheumatology. 1995; 22(9):1757–1761 [<a href="https://pubmed.ncbi.nlm.nih.gov/8523357" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8523357</span></a>]</div></dd></dl></dl></div></div></div><div id="appendixesappgroup1"><h2 id="_appendixesappgroup1_">Appendices</h2><div id="niceng226er7.appa"><h3>Appendix A. Review protocols</h3><p id="niceng226er7.appa.et1"><a href="/books/NBK589223/bin/niceng226er7-appa-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Review protocol for clinical and cost-effectiveness of electrotherapy in the management of osteoarthritis</a><span class="small"> (PDF, 1.0M)</span></p><p id="niceng226er7.appa.et2"><a href="/books/NBK589223/bin/niceng226er7-appa-et2.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Table 63. Health economic review protocol</a><span class="small"> (PDF, 933K)</span></p></div><div id="niceng226er7.appb"><h3>Appendix B. Literature search strategies</h3><ul><li class="half_rhythm"><div>What is the clinical and cost-effectiveness of electrotherapy for the management of osteoarthritis?</div></li></ul><p>The literature searches for this review are detailed below and complied with the methodology outlined in Developing NICE guidelines: the manual.<a class="bibr" href="#niceng226er7.s1.1.ref157" rid="niceng226er7.s1.1.ref157"><sup>157</sup></a></p><p>For more information, please see the <a href="/books/NBK589223/bin/methods-report-pdf-11251849933.pdf">Methodology</a> review published as part of the accompanying documents for this guideline.</p><p id="niceng226er7.appb.et1"><a href="/books/NBK589223/bin/niceng226er7-appb-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">B.1. Clinical search literature search strategy</a><span class="small"> (PDF, 943K)</span></p><p id="niceng226er7.appb.et2"><a href="/books/NBK589223/bin/niceng226er7-appb-et2.pdf" class="bk_dwnld_icn bk_dwnld_pdf">B.2. Health Economics literature search strategy</a><span class="small"> (PDF, 945K)</span></p></div><div id="niceng226er7.appc"><h3>Appendix C. Effectiveness evidence study selection</h3><p id="niceng226er7.appc.et1"><a href="/books/NBK589223/bin/niceng226er7-appc-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Figure 1. Flow chart of clinical study selection for the review of the clinical and cost-effectiveness of electrotherapy for osteoarthritis</a><span class="small"> (PDF, 896K)</span></p></div><div id="niceng226er7.appd"><h3>Appendix D. Effectiveness evidence</h3><p id="niceng226er7.appd.et1"><a href="/books/NBK589223/bin/niceng226er7-appd-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (2.3M)</span></p></div><div id="niceng226er7.appe"><h3>Appendix E. Forest plots</h3><p id="niceng226er7.appe.et1"><a href="/books/NBK589223/bin/niceng226er7-appe-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">E.1. Pulsed short-wave therapy</a><span class="small"> (PDF, 966K)</span></p><p id="niceng226er7.appe.et2"><a href="/books/NBK589223/bin/niceng226er7-appe-et2.pdf" class="bk_dwnld_icn bk_dwnld_pdf">E.2. Interferential therapy</a><span class="small"> (PDF, 934K)</span></p><p id="niceng226er7.appe.et3"><a href="/books/NBK589223/bin/niceng226er7-appe-et3.pdf" class="bk_dwnld_icn bk_dwnld_pdf">E.3. Neuromuscular electrical stimulation</a><span class="small"> (PDF, 933K)</span></p><p id="niceng226er7.appe.et4"><a href="/books/NBK589223/bin/niceng226er7-appe-et4.pdf" class="bk_dwnld_icn bk_dwnld_pdf">E.4. Extracorporeal shockwave therapy</a><span class="small"> (PDF, 922K)</span></p><p id="niceng226er7.appe.et5"><a href="/books/NBK589223/bin/niceng226er7-appe-et5.pdf" class="bk_dwnld_icn bk_dwnld_pdf">E.5. Laser therapy</a><span class="small"> (PDF, 961K)</span></p><p id="niceng226er7.appe.et6"><a href="/books/NBK589223/bin/niceng226er7-appe-et6.pdf" class="bk_dwnld_icn bk_dwnld_pdf">E.6. Transcutaneous electrical nerve stimulation</a><span class="small"> (PDF, 951K)</span></p><p id="niceng226er7.appe.et7"><a href="/books/NBK589223/bin/niceng226er7-appe-et7.pdf" class="bk_dwnld_icn bk_dwnld_pdf">E.7. Ultrasound</a><span class="small"> (PDF, 962K)</span></p><p id="niceng226er7.appe.et8"><a href="/books/NBK589223/bin/niceng226er7-appe-et8.pdf" class="bk_dwnld_icn bk_dwnld_pdf">E.8. Combination therapy</a><span class="small"> (PDF, 958K)</span></p></div><div id="niceng226er7.appf"><h3>Appendix F. GRADE tables</h3><p id="niceng226er7.appf.et1"><a href="/books/NBK589223/bin/niceng226er7-appf-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">F.1. Pulsed short-wave therapy compared to sham electrotherapy and no treatment</a><span class="small"> (PDF, 1.0M)</span></p><p id="niceng226er7.appf.et2"><a href="/books/NBK589223/bin/niceng226er7-appf-et2.pdf" class="bk_dwnld_icn bk_dwnld_pdf">F.2. Interferential therapy compared to pulsed short-wave therapy, laser therapy, sham electrotherapy and no treatment</a><span class="small"> (PDF, 1014K)</span></p><p id="niceng226er7.appf.et3"><a href="/books/NBK589223/bin/niceng226er7-appf-et3.pdf" class="bk_dwnld_icn bk_dwnld_pdf">F.3. Neuromuscular electrical stimulation compared to no treatment</a><span class="small"> (PDF, 1002K)</span></p><p id="niceng226er7.appf.et4"><a href="/books/NBK589223/bin/niceng226er7-appf-et4.pdf" class="bk_dwnld_icn bk_dwnld_pdf">F.4. Extracorporeal shockwave therapy compared to sham electrotherapy and no treatment</a><span class="small"> (PDF, 989K)</span></p><p id="niceng226er7.appf.et5"><a href="/books/NBK589223/bin/niceng226er7-appf-et5.pdf" class="bk_dwnld_icn bk_dwnld_pdf">F.5. Laser therapy compared to pulsed short-wave therapy, neuromuscular electrical stimulation, sham electrotherapy and no treatment</a><span class="small"> (PDF, 1.0M)</span></p><p id="niceng226er7.appf.et6"><a href="/books/NBK589223/bin/niceng226er7-appf-et6.pdf" class="bk_dwnld_icn bk_dwnld_pdf">F.6. Transcutaneous electrical nerve stimulation compared to pulsed short-wave therapy, interferential therapy, sham electrotherapy and no treatment</a><span class="small"> (PDF, 1.0M)</span></p><p id="niceng226er7.appf.et7"><a href="/books/NBK589223/bin/niceng226er7-appf-et7.pdf" class="bk_dwnld_icn bk_dwnld_pdf">F.7. Ultrasound compared to pulsed short-wave therapy, neuromuscular electrical stimulation, transcutaneous electrical nerve stimulation, sham electrotherapy and no treatment</a><span class="small"> (PDF, 1.0M)</span></p><p id="niceng226er7.appf.et8"><a href="/books/NBK589223/bin/niceng226er7-appf-et8.pdf" class="bk_dwnld_icn bk_dwnld_pdf">F.8. Combination therapy compared to interferential therapy, neuromuscular electrical stimulation, laser therapy,ultrasound, transcutaneous electrical nerve stimulation, sham electrotherapy and no treatment</a><span class="small"> (PDF, 1.0M)</span></p></div><div id="niceng226er7.appg"><h3>Appendix G. Economic evidence study selection</h3><p id="niceng226er7.appg.et1"><a href="/books/NBK589223/bin/niceng226er7-appg-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (946K)</span></p></div><div id="niceng226er7.apph"><h3>Appendix H. Economic evidence tables</h3><p id="niceng226er7.apph.et1"><a href="/books/NBK589223/bin/niceng226er7-apph-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (953K)</span></p></div><div id="niceng226er7.appi"><h3>Appendix I. Health economic model</h3><p>No original economic modelling was undertaken.</p></div><div id="niceng226er7.appj"><h3>Appendix J. Excluded studies</h3><div id="niceng226er7.appj.s1"><h4>Clinical studies</h4><p id="niceng226er7.appj.et1"><a href="/books/NBK589223/bin/niceng226er7-appj-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (930K)</span></p></div><div id="niceng226er7.appj.s2"><h4>Health Economic studies</h4><p>Published health economic studies that met the inclusion criteria (relevant population, comparators, economic study design, published 2005 or later and not from non-OECD country or USA) but that were excluded following appraisal of applicability and methodological quality are listed below. See the health economic protocol for more details.</p><p>None.</p></div></div><div id="niceng226er7.appk"><h3>Appendix K. Research recommendations – full details</h3><div id="niceng226er7.appk.s1"><h4>K.1.1. Research recommendation</h4><p>What is the clinical and cost effectiveness of extracorporeal shockwave therapy for managing osteoarthritis?</p></div><div id="niceng226er7.appk.s2"><h4>K.1.2. Why this is important</h4><p>Many treatments have been proposed to help reduce osteoarthritis symptoms, such as pain and reduction in physical function. In this guideline, a lot of treatments have been found to be ineffective based on limited evidence. Electrotherapy was one of these treatments, where the evidence showed a significant amount of heterogeneity in the outcomes, which may be linked to inconsistency in the use of appropriate sham interventions and low quality study design (including trials with very few participants). Given this, the committee agreed that there was insufficient evidence of benefit from electrotherapy to recommend it in this guideline. However, the inconsistency in effect indicated that there is uncertainty in the efficacy, therefore further research may provide a clearer answer. In particular, extracorporeal shockwave therapy showed some evidence of benefit compared to sham. However, this was based on small trials, where the committee agreed that the sham therapy used as a comparator was likely to be an inadequate sham technique to ensure blinding and so did not consider the evidence as conclusive. Therefore, further research into this electrotherapy modality may help to elucidate the true effect.</p></div><div id="niceng226er7.appk.s3"><h4>K.1.3. Rationale for research recommendation</h4><p id="niceng226er7.appk.et1"><a href="/books/NBK589223/bin/niceng226er7-appk-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (924K)</span></p></div><div id="niceng226er7.appk.s4"><h4>K.1.4. Modified PICO table</h4><p id="niceng226er7.appk.et2"><a href="/books/NBK589223/bin/niceng226er7-appk-et2.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (931K)</span></p></div></div></div></div><div class="fm-sec"><div><p>Final</p></div><div><p>Evidence reviews underpinning recommendation 1.3.9 and research recommendations in the NICE guideline</p></div><div><p><b>Disclaimer</b>: The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The recommendations in this guideline are not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.</p><p>Local commissioners and/or providers have a responsibility to enable the guideline to be applied when individual health professionals and their patients or service users wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with compliance with those duties.</p><p>NICE guidelines cover health and care in England. Decisions on how they apply in other UK countries are made by ministers in the <a href="http://wales.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Welsh Government</a>, <a href="http://www.scotland.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Scottish Government</a>, and <a href="http://www.northernireland.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Northern Ireland Executive</a>. All NICE guidance is subject to regular review and may be updated or withdrawn.</p></div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright</a> © NICE 2022.</div><div class="small"><span class="label">Bookshelf ID: NBK589223</span><span class="label">PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/36791245" title="PubMed record of this title" ref="pagearea=meta&targetsite=entrez&targetcat=link&targettype=pubmed">36791245</a></span></div></div><div class="small-screen-prev"></div><div class="small-screen-next"></div></article><article data-type="table-wrap" id="figobniceng226er7tab1"><div id="niceng226er7.tab1" class="table"><h3><span class="label">Table 1</span><span class="title">PICO characteristics of review question</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab1_lrgtbl__"><table><tbody><tr><th id="hd_b_niceng226er7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><td headers="hd_b_niceng226er7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Inclusion:
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<ul><li class="half_rhythm"><div>Adults (age ≥16 years) with osteoarthritis affecting any joint</div></li></ul>
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To note that where evidence for other rare forms of osteoarthritis is identified the committee will stratify into the most appropriate group.</p>
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<p>Exclusion:
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<ul><li class="half_rhythm"><div>Children (age ≤16 years)</div></li><li class="half_rhythm"><div>People with conditions that may make them susceptible to osteoarthritis or often occur alongside osteoarthritis (including: crystal arthritis, inflammatory arthritis, septic arthritis, diseases of childhood that may predispose to osteoarthritis, medical conditions presenting with joint inflammation and malignancy).</div></li><li class="half_rhythm"><div>Studies in people with meniscal injury without osteoarthritis</div></li><li class="half_rhythm"><div>Studies with an unclear population (e,g, type of arthritis, proportion of participants with osteoarthritis)</div></li><li class="half_rhythm"><div>Spinal osteoarthritis</div></li></ul></p>
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</td></tr><tr><th id="hd_b_niceng226er7.tab1_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Interventions</th><td headers="hd_b_niceng226er7.tab1_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Non-invasive electrotherapy interventions (minimum intervention duration 1 week), including:
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<ul><li class="half_rhythm"><div>Pulsed short-wave therapy</div></li><li class="half_rhythm"><div>Interferential therapy</div></li><li class="half_rhythm"><div>Neuromuscular electrical stimulation</div></li><li class="half_rhythm"><div>Extracorporeal shockwave therapy</div></li><li class="half_rhythm"><div>Laser therapy</div></li><li class="half_rhythm"><div>Transcutaneous electrical nerve stimulation (TENS)</div></li><li class="half_rhythm"><div>Ultrasound</div></li><li class="half_rhythm"><div>Combination therapy (ultrasound and interferential therapy)</div></li></ul></td></tr><tr><th id="hd_b_niceng226er7.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comparisons</th><td headers="hd_b_niceng226er7.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p><ul><li class="half_rhythm"><div>Compared to each other</div></li><li class="half_rhythm"><div>Sham electrotherapy</div></li><li class="half_rhythm"><div>No intervention (including either):
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<ul class="circle"><li class="half_rhythm"><div>Electrotherapy versus no treatment*</div></li><li class="half_rhythm"><div>Electrotherapy plus additional treatment versus additional treatment alone**</div></li></ul></div></li></ul>
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<i>*No treatment defined as either (1) doing nothing or (2) very low intensity intervention such as advice</i></p>
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<p><i>**Inclusion of studies where additional treatment is the same in each arm will be assessed on a case by case basis. Studies including high intensity additional treatment may not be included due to the risk that treatment could have an interaction with the intervention of interest and mask the true treatment effect</i>.</p>
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</td></tr><tr><th id="hd_b_niceng226er7.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes</th><td headers="hd_b_niceng226er7.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Stratify by ≤/>3 months (longest time-point in each):
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<ul><li class="half_rhythm"><div>Health-related quality of life [validated patient-reported outcomes, continuous data prioritised]</div></li><li class="half_rhythm"><div>Pain [validated patient-reported outcomes, continuous data prioritised]</div></li><li class="half_rhythm"><div>Physical function [validated patient-reported outcomes, continuous data prioritised]</div></li><li class="half_rhythm"><div>Psychological distress [validated patient-reported outcomes, continuous data prioritised]</div></li><li class="half_rhythm"><div>Osteoarthritis flares [validated patient-reported outcomes, continuous data prioritised]</div></li><li class="half_rhythm"><div>Mild adverse events [dichotomous data prioritised]</div></li><li class="half_rhythm"><div>Moderate/major adverse events [dichotomous data prioritised]</div></li></ul></td></tr><tr><th id="hd_b_niceng226er7.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design</th><td headers="hd_b_niceng226er7.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RCTs or systematic reviews of RCTs</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab2"><div id="niceng226er7.tab2" class="table"><h3><span class="label">Table 2</span><span class="title">Summary of studies included in the pulsed short-wave therapy compared to sham electrotherapy comparison</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab2_lrgtbl__"><table><thead><tr><th id="hd_h_niceng226er7.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study</th><th id="hd_h_niceng226er7.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention and comparison</th><th id="hd_h_niceng226er7.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><th id="hd_h_niceng226er7.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes</th><th id="hd_h_niceng226er7.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comments</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Atamaz 2012<a class="bibr" href="#niceng226er7.s1.1.ref22" rid="niceng226er7.s1.1.ref22"><sup>22</sup></a></td><td headers="hd_h_niceng226er7.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p><b>Transcutaneous electrical nerve stimulation</b> (n=37)</p>
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<p>TENS (frequency 80Hz, 10-30mA intensity) for 20 minutes three times a week for 3 weeks</p>
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<p><b>Interferential therapy</b> (n=31)</p>
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<p>Interferential currents (frequency 100Hz generated by 4kHz sinusoidal waves) for 3 weeks</p>
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<p><b>Pulsed short-wave therapy</b> (n=32)</p>
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<p>Pulsed short-wave diathermy (10cm diameter condenser plate, frequency 27.12mHz, input 300W, mean output 3.2W) for 3 weeks</p>
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<p><b>Sham electrotherapy (TENS)</b> (n=37)</p>
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<p>Sham TENS</p>
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<p><b>Sham electrotherapy (interferential therapy)</b> (n=35)</p>
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<p>Sham interferential therapy</p>
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<p><b>Sham electrotherapy (pulsed short-wave therapy)</b> (n=31)</p>
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<p>Sham pulsed short-wave therapy</p>
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<p>
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<b>Concomitant therapy:</b>
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</p>
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<p>All people had an exercise program conducted in groups of 4-5 people three times a week for 3 weeks involving stretching, isometric quadriceps exercises and chair lift/minisquats. This was supplemented with additional instruction for home exercise. All people also attended an education program consisting of one 1 hour session discussing the functional anatomy of the knee, ergonomic principles, and understanding of osteoarthritis.</p>
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</td><td headers="hd_h_niceng226er7.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>
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<b>Knee osteoarthritis</b>
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</p>
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<p>Mean age (SD): 61.5 (7.5) years</p>
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<p>N = 203</p>
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<p>Definition: People with knee osteoarthritis according to the American College of Rheumatology criteria with radiologically confirmation with a Kellgren Lawrence grade of 2 or 3</p>
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<p>Severity: Kellgren Lawrence grade 2-3</p>
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<p>Duration of symptoms (mean [SD]): 43.7 (49.1) months.</p>
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<p>Presence of multimorbidities: Not stated/Unclear</p>
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</td><td headers="hd_h_niceng226er7.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Pain at ≤3 months and >3 months</p>
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<p>Physical function at ≤3 months and >3 months</p>
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</td><td headers="hd_h_niceng226er7.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Bagnato 2016<a class="bibr" href="#niceng226er7.s1.1.ref27" rid="niceng226er7.s1.1.ref27"><sup>27</sup></a></td><td headers="hd_h_niceng226er7.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p><b>Pulsed short-wave therapy</b> (n=33)</p>
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<p>Pulsed electromagnetic field therapy (frequency 27.12MHz, pulse rate 100Hz, 100µs burst width, peak burst power 0.0098W covering a surface area of 103cm2) for 4 weeks</p>
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<p><b>Sham electrotherapy</b> (n=33)</p>
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<p>Sham electrotherapy (device that did not emit a field)</p>
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<p>
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<b>Concomitant therapy:</b>
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</p>
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<p>No additional information.</p>
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</td><td headers="hd_h_niceng226er7.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>
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<b>Knee osteoarthritis</b>
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</p>
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<p>Mean age (SD): 67.7 (10.9) years</p>
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<p>N = 66</p>
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<p>Definition: A diagnosis of primary osteoarthritis of the knee according to the American College of Rheumatology criteria, including radiological evidence of osteoarthritis</p>
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<p>Severity: Not stated</p>
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<p>Duration of symptoms (mean [SD]): 12.1 (8.2) years</p>
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<p>Presence of multimorbidities: Not stated/Unclear</p>
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</td><td headers="hd_h_niceng226er7.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Quality of life at ≤3 months</p>
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<p>Pain at ≤3 months</p>
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<p>Physical function at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Callaghan 2005<a class="bibr" href="#niceng226er7.s1.1.ref41" rid="niceng226er7.s1.1.ref41"><sup>41</sup></a></td><td headers="hd_h_niceng226er7.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Pulsed short-wave therapy</b> (n=20)</p>
|
|
<p>Pulsed short-wave therapy (active high frequency (27 mHz) pulsed shortwave for 20 minutes to the affected knee joint using a dose of 200 microseconds and 400 pulses per second with an output of 10W or active high frequency (27mHz) pulsed shortwave for 20 minutes at a dose of 400 microseconds and 400 pulses per second, with an output of 20W) for 2 weeks</p>
|
|
<p><b>Sham electrotherapy</b> (n=10)</p>
|
|
<p>Sham electrotherapy</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>No additional information.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 60.4 (7.7) years</p>
|
|
<p>N = 30</p>
|
|
<p>Definition: Primary generalised osteoarthritis and a diagnosis of osteoarthritis knee with radiographic evidence (Kellgren Lawrence grade 3-4)</p>
|
|
<p>Severity: Kellgren Lawrence grade 3-4</p>
|
|
<p>Duration of symptoms: Not stated</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Quality of life at ≤3 months</p>
|
|
<p>Pain at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">De Paula Gomes 2020<a class="bibr" href="#niceng226er7.s1.1.ref66" rid="niceng226er7.s1.1.ref66"><sup>66</sup></a></td><td headers="hd_h_niceng226er7.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Interferential therapy</b> (n=20)</p>
|
|
<p>The sessions were held three times a week, over 8 weeks (24 sessions), on alternate days, lasting approximately 90 minutes each treatment session.</p>
|
|
<p>Interferential therapy (n=20)</p>
|
|
<p>ICT was performed using a premodulated tetrapolar method with a carrier frequency of 4KHz, 1/1s sweep mode, 75 Hz frequency modulation amplitude, 25Hz delta frequency modulation amplitude, and automatic vector mode for 40 minutes.</p>
|
|
<p><b>Short wave therapy</b> (n=20)</p>
|
|
<p>a thermopulse (Ibramed, Amparo, Sao Paolo, Brazil) device set to continuous mode, 27.12MHz frequency and 150W input was used for 20 minutes, and the intensity was defined based on each participant reporting a warm sensation (one sensation, described as soft but pleasant heat).</p>
|
|
<p><b>Laser therapy</b> (n=20)</p>
|
|
<p>Prior to the exercise protocol, participants in the exercise and photobiomodulation (PHOTO) group underwent photobiomodulation therapy using a laserpulse device (Ibramed, Amparo, SP, Brazil). The power of each infrared laser was as follows: wavelength of 904nm, frequency of 9500Hz, pulse duration of 60ns, peak power of 70W, average power of 0.04W, energy density of 6J/cm² applied on eight points, with a total dose of 48J/cm², each session.</p>
|
|
<p><b>Sham electrotherapy</b> (n=20)</p>
|
|
<p><b>No treatment</b> (n=20)</p>
|
|
<p>Exercise therapy only (supervised strength exercises)</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>None of the participants undertook any form of physical therapy, in addition to the one stipulate. In addition they did not use intra-articular, anti-inflammatory or chondroprotective corticosteroids. The use of medications for concomitant diseases was not controlled.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): Exercise group: 67.85 (4.49) years, exercise+placebo group: 69.4 (4.45) years, exercise+ICT group: 71.85 (2.62) years, exercise+SDT group: 68.45 (4.62) years, exercise+PHOTO group: 65.75 (4.48) years</p>
|
|
<p>N = 100</p>
|
|
<p>Definition: Unilateral knee OA according to American College of Rheumatology criteria, made through examination and the written opinion of a specialist in rheumatic disease.</p>
|
|
<p>Severity (NRS pain score): Exercise group: 6.55 (1.09), exercise+placebo group: 6.50 (0.68), exercise+ICT group: 6.65 (0.98), exercise+SDT group: 6.40 (0.99), exercise+PHOTO group: 6.70 (0.86)</p>
|
|
<p>Duration of symptoms: Not stated/unclear</p>
|
|
<p>Presence of multi-morbidities: Not stated/unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at ≤3 months</p>
|
|
<p>Physical function at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Fary 2011<a class="bibr" href="#niceng226er7.s1.1.ref79" rid="niceng226er7.s1.1.ref79"><sup>79</sup></a></p>
|
|
<p>Subsidiary paper: Fary 2008<a class="bibr" href="#niceng226er7.s1.1.ref80" rid="niceng226er7.s1.1.ref80"><sup>80</sup></a></p>
|
|
</td><td headers="hd_h_niceng226er7.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Pulsed short-wave therapy</b> (n=34)</p>
|
|
<p>Pulsed electrical stimulation delivering a pulsed asymmetrically biphasic, exponentially decreasing waveform with a frequency of 100Hz and a pulse width of 4ms. Delivered 7 hours daily, preferably overnight, for 26 weeks.</p>
|
|
<p><b>Sham electrotherapy</b> (n=36)</p>
|
|
<p>Placebo device (identical, but set to switch off after 3 minutes of use)</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>People were instructed to continue their usual treatment for osteoarthritis throughout the study (including prescribed medications, health professional interventions such as exercise programs, and complementary therapies). However, they were counselled against starting any new treatments</p>
|
|
</td><td headers="hd_h_niceng226er7.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 69.8 (10.3) years</p>
|
|
<p>N = 70</p>
|
|
<p>Definition: Diagnosis in accordance with the American College of Rheumatology modified clinical classification system with plain radiographs being available for all participants</p>
|
|
<p>Severity: Kellgren Lawrence grades 1-4, median grade 3</p>
|
|
<p>Duration of symptoms (mean [SD]): 12.0 (10.5) years</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Quality of life at >3 months</p>
|
|
<p>Pain at >3 months</p>
|
|
<p>Physical function at >3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Fukuda 2011<a class="bibr" href="#niceng226er7.s1.1.ref83" rid="niceng226er7.s1.1.ref83"><sup>83</sup></a></td><td headers="hd_h_niceng226er7.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Pulsed short-wave therapy</b> (n=63)</p>
|
|
<p>Low or high dose pulsed short-wave therapy (carrying frequency of 27.12 MHz, peak power of 250W, pulse duration of 400 microseconds, maximum power of 145Hz, resulting in a mean power of 14.5W. The low dose group was completed over 19 minutes per session delivering 17kJ of energy. The high dose group was completed over 38 minutes delivering 33kJ of energy.</p>
|
|
<p><b>Sham electrotherapy</b> (n=23)</p>
|
|
<p>Sham electrotherapy (kept on standby mode during 19 minutes without the current delivered)</p>
|
|
<p><b>No treatment</b> (n=35)</p>
|
|
<p>No treatment</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>No advice was given to participants in all groups in relation to physical activities, except to maintain their daily activities and to avoid using anti-inflammatory drugs</p>
|
|
</td><td headers="hd_h_niceng226er7.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 61.0 (9.3) years</p>
|
|
<p>N = 121</p>
|
|
<p>Definition: Primary grade 2-3 knee osteoarthritis based on Gupta and colleagues’ radiographic criteria and have had joint or anterior knee pain for at least 3 months</p>
|
|
<p>Severity: Gupta and colleagues radiographic criteria: grade 2-3</p>
|
|
<p>Duration of symptoms: At least 3 months</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Quality of life at ≤3 months and >3 months</p>
|
|
<p>Pain at ≤3 months and >3 months</p>
|
|
<p>Physical function at ≤3 months and >3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Garland 2007<a class="bibr" href="#niceng226er7.s1.1.ref86" rid="niceng226er7.s1.1.ref86"><sup>86</sup></a></td><td headers="hd_h_niceng226er7.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Pulsed short-wave therapy</b> (n=34)</p>
|
|
<p>Pulsed electrical stimulation using a 100Hz, negative pulsed signal, turned up to a maximum of 12V over 12 weeks</p>
|
|
<p><b>Sham electrotherapy</b> (n=36)</p>
|
|
<p>Placebo treatment (the devices were shut off when the dose was adjusted)</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>Stable NSAID and/or analgesic use was maintained 1 month prior to and throughout the study rather than being withdrawn to produce a disease flare</p>
|
|
</td><td headers="hd_h_niceng226er7.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 66.1 (10.9) years</p>
|
|
<p>N = 70</p>
|
|
<p>Definition: Moderate to severe osteoarthritis with persistence of pain on NSAID and/or analgesic therapy and the presence of Kellgren-Lawrence grade 3-4 changes on standing, weight bearing, and semiflexed x-ray views of the knees</p>
|
|
<p>Severity: Kellgren Lawrence grade 3-4</p>
|
|
<p>Duration of symptoms (mean [range]): 8.4 (0.2-44) years</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at ≤3 months</p>
|
|
<p>Physical function at ≤3 months</p>
|
|
<p>Mild adverse events at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Moffett 1996<a class="bibr" href="#niceng226er7.s1.1.ref155" rid="niceng226er7.s1.1.ref155"><sup>155</sup></a></td><td headers="hd_h_niceng226er7.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Pulsed short-wave therapy</b> (n=30)</p>
|
|
<p>Pulsed short wave therapy with 9 sessions of treatment over 3 weeks, each application lasting 15 minutes</p>
|
|
<p><b>Sham electrotherapy</b> (n=30)</p>
|
|
<p>Placebo treatment (same device, assigned random number settings on the machine that would produce a non-functioning result)</p>
|
|
<p><b>No treatment</b> (n=30)</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>No additional information</p>
|
|
</td><td headers="hd_h_niceng226er7.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 63.5 (9.9) years</p>
|
|
<p>N = 90</p>
|
|
<p>Definition: People with osteoarthritis of the hip or knee with radiological changes</p>
|
|
<p>Severity: Not stated</p>
|
|
<p>Duration of symptoms (mean [SD]): 92.1 (124.4) months</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at ≤3 months</p>
|
|
<p>Psychological distress at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Nelson 2013<a class="bibr" href="#niceng226er7.s1.1.ref160" rid="niceng226er7.s1.1.ref160"><sup>160</sup></a></td><td headers="hd_h_niceng226er7.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Pulsed short-wave therapy</b> (n=15)</p>
|
|
<p>Pulsed short wave therapy with a pulsed electromagnetic field consisting of a 7ms burst of 6.8mHz sinusoidal waves repeating at 1 burst/s delivering a peak induced electric field of 34+/-8V/m used twice daily for 15 minutes</p>
|
|
<p><b>Sham electrotherapy</b> (n=19)</p>
|
|
<p>Sham devices</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>Standard care could include unrestricted NSAID use. Standard care was allowed throughout</p>
|
|
</td><td headers="hd_h_niceng226er7.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 57.1 (2.9) years</p>
|
|
<p>N = 34</p>
|
|
<p>Definition: People with knee pain and an imaging study confirming articular cartilage loss</p>
|
|
<p>Severity: Kellgren Lawrence grade (mean [SD]): 2.8 (0.3)</p>
|
|
<p>Duration of symptoms: At least 3 months</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain at ≤3 months</td><td headers="hd_h_niceng226er7.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Ozguclu 2010<a class="bibr" href="#niceng226er7.s1.1.ref168" rid="niceng226er7.s1.1.ref168"><sup>168</sup></a></td><td headers="hd_h_niceng226er7.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Pulsed short-wave therapy</b> (n=20)</p>
|
|
<p>Pulsed electromagnetic therapy using 2 pairs of solenoid applicators. Applied at a frequency of 50Hz, 30-G intensity, 90s interval, 30 minute durations, 5 sessions weekly for 2 weeks.</p>
|
|
<p><b>Sham electrotherapy</b> (n=20)</p>
|
|
<p>Sham devices</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>In each session 20 minutes hot pack and 5 minutes of therapeutic ultrasound were given. People were taught terminal isometric knee exercise to complete at home as required (three times a day, 30 repeats each). People were allowed to take paracetamol for knee pain if necessary. Other pain treatments (including NSAIDs) were not allowed</p>
|
|
</td><td headers="hd_h_niceng226er7.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 61.3 (7.8) years</p>
|
|
<p>N = 40</p>
|
|
<p>Definition: Diagnosis of knee osteoarthritis according to the American College of Rheumatology</p>
|
|
<p>Severity: Kellgren Lawrence grade 2 and above</p>
|
|
<p>Duration of symptoms: Not stated</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at ≤3 months</p>
|
|
<p>Physical function at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pipitone 2001<a class="bibr" href="#niceng226er7.s1.1.ref179" rid="niceng226er7.s1.1.ref179"><sup>179</sup></a></td><td headers="hd_h_niceng226er7.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Pulsed short-wave therapy</b> (n=34)</p>
|
|
<p>Pulsed short wave therapy using unipolar magnetic devices generating pulsed treatment. Pulses were selectable at three base frequencies (3Hz, 7.8Hz and 20Hz). Rise time of 1 microseconds, a decay time of 10 microseconds, a low magnetic ouput (<0.5 gauss), range of activity of up to 30cm around the unit. People were instructed to use the devices at 7.8Hz in the morning and afternoon, and 3Hz in the evening for 6 weeks</p>
|
|
<p><b>Sham electrotherapy</b> (n=19)</p>
|
|
<p>Sham devices (with a 9V battery, which forced it to switch off automatically after a 10 minute period)</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>No additional information</p>
|
|
</td><td headers="hd_h_niceng226er7.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (range): 63.0 (40-84) years</p>
|
|
<p>N = 69</p>
|
|
<p>Definition: Radiographic evidence and symptoms of osteoarthritis (incompletely relieved by conventional treatments) as judged by the criteria of the American College of Rheumatology</p>
|
|
<p>Severity: Not stated</p>
|
|
<p>Duration of symptoms (mean [range]): 72 (5.5-372) months</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Quality of life at ≤3 months</p>
|
|
<p>Pain at ≤3 months</p>
|
|
<p>Physical function at ≤3 months</p>
|
|
<p>Mild adverse events at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Thamsborg 2005<a class="bibr" href="#niceng226er7.s1.1.ref208" rid="niceng226er7.s1.1.ref208"><sup>208</sup></a></td><td headers="hd_h_niceng226er7.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Pulsed short-wave therapy</b> (n=45)</p>
|
|
<p>Pulsed short wave therapy using electromagnetic coils (a pulse generating using +/-50V in 50Hz pulses changing voltage in 3ms intervals) over 6 weeks</p>
|
|
<p><b>Sham electrotherapy</b> (n=45)</p>
|
|
<p>Sham devices (same coil but used a DC current leading to a constant magnetic field rather than a pulsed one)</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>No additional information</p>
|
|
</td><td headers="hd_h_niceng226er7.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 60.0 (8.7) years</p>
|
|
<p>N = 90</p>
|
|
<p>Definition: Painful knee osteoarthritis of the femorotibial compartment fulfilling the combined clinical and radiological criteria of the American College of Rheumatology</p>
|
|
<p>Severity: Not stated</p>
|
|
<p>Duration of symptoms: Not stated</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at ≤3 months</p>
|
|
<p>Physical function at ≤3 months</p>
|
|
<p>Mild adverse events at ≤3 months</p>
|
|
<p>Moderate/major adverse events at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Trock 1993<a class="bibr" href="#niceng226er7.s1.1.ref211" rid="niceng226er7.s1.1.ref211"><sup>211</sup></a></td><td headers="hd_h_niceng226er7.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Pulsed short-wave therapy</b> (n=15)</p>
|
|
<p>Pulsed electromagnetic field therapy using an extremely low frequency (less than 30Hz) varying, pulsed electromagnetic field averaging 10-20 gauss of energy at a coil current of up to 2A from a power source of 120V AC (pulse phase duration 67ms, pause duration 0.1s). Given for 30 minutes, 3-5 sessions per week for 18 treatments.</p>
|
|
<p><b>Sham electrotherapy</b> (n=12)</p>
|
|
<p>Same device but switched off.</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>People were allowed to continue any treatment on a stable dose at the start of the trial</p>
|
|
</td><td headers="hd_h_niceng226er7.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Mixed osteoarthritis (knee, hand or ankle)</b>
|
|
</p>
|
|
<p>Age not stated</p>
|
|
<p>N = 27</p>
|
|
<p>Definition: Diagnosis of osteoarthritis according to criteria by Altman, including radiographic evidence for all but one</p>
|
|
<p>Severity: Not stated</p>
|
|
<p>Duration of symptoms: At least one year duration</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain at ≤3 months</td><td headers="hd_h_niceng226er7.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Wuschech 2015<a class="bibr" href="#niceng226er7.s1.1.ref220" rid="niceng226er7.s1.1.ref220"><sup>220</sup></a></td><td headers="hd_h_niceng226er7.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Pulsed short-wave therapy</b> (n=44)</p>
|
|
<p>Pulsed short wave therapy using pulsed electromagnetic field therapy. Disc area of 28cm2, disc rotation varied in 2Hz steps to produce frequencies between 4 and 12Hz, magnetic flux density of 420mT (peak-to-peak) on the device surface. Delivered for 18 days.</p>
|
|
<p><b>Sham electrotherapy</b> (n=13)</p>
|
|
<p>Sham devices (same device but no magnetic materials)</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>No additional information</p>
|
|
</td><td headers="hd_h_niceng226er7.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 61.1 (12.0) years</p>
|
|
<p>N = 57</p>
|
|
<p>Definition: Osteoarthritis in their knee joint according to the American College of Rheumatology criteria</p>
|
|
<p>Severity: American College of Rheumatology severity level (mean [SD]): 2.8 (0.8)</p>
|
|
<p>Duration of symptoms: Not stated</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at ≤3 months</p>
|
|
<p>Physical function at ≤3 months</p>
|
|
<p>Mild adverse events at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Zizic 1995<a class="bibr" href="#niceng226er7.s1.1.ref240" rid="niceng226er7.s1.1.ref240"><sup>240</sup></a></td><td headers="hd_h_niceng226er7.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Pulsed short-wave therapy</b> (n=41)</p>
|
|
<p>Pulsed short wave therapy using electrical impulses generated as low frequency (100Hz), low amplitude, monophasic spiked signal via a skin surface electrode. People were advised to use it for 6-10 hours/day during the 4 week treatment period.</p>
|
|
<p><b>Sham electrotherapy</b> (n=37)</p>
|
|
<p>Sham devices (same device but switched off after reaching the subthreshold level)</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>Background, stable NSAID therapy was permitted as long as people remained symptomatic despite such therapy</p>
|
|
</td><td headers="hd_h_niceng226er7.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Age: >20 years</p>
|
|
<p>N = 78</p>
|
|
<p>Definition: Pain in the involved knee that was aggravated by activity and relieved by rest; morning stiffness upon rising or after disuse; at least one physical finding of joint crepitus, tenderness upon motion, swelling, or decreased range of motion; the presence of at least one of the following radiological findings in the involved knee: narrowing of the joint space of either the medial or lateral compartment on standing anteroposterior radiograph, subchondral bony sclerosis, or osteophyte formation.</p>
|
|
<p>Severity: Not stated</p>
|
|
<p>Duration of symptoms: Not stated</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Mild adverse events at ≤3 months</td><td headers="hd_h_niceng226er7.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab3"><div id="niceng226er7.tab3" class="table"><h3><span class="label">Table 3</span><span class="title">Summary of studies included in the pulsed short-wave therapy compared to no treatment comparison</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab3/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab3_lrgtbl__"><table><thead><tr><th id="hd_h_niceng226er7.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study</th><th id="hd_h_niceng226er7.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention and comparison</th><th id="hd_h_niceng226er7.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><th id="hd_h_niceng226er7.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes</th><th id="hd_h_niceng226er7.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comments</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Akyol 2010<a class="bibr" href="#niceng226er7.s1.1.ref6" rid="niceng226er7.s1.1.ref6"><sup>6</sup></a></td><td headers="hd_h_niceng226er7.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Pulsed short-wave therapy</b> (n=20)</p>
|
|
<p>Short-wave diathermy and isokinetic exercise using a frequency of 27.12 MHz for 20 minutes per knee 3 times a week for 4 weeks</p>
|
|
<p><b>No treatment</b> (n=20)</p>
|
|
<p>Isokinetic exercises only 3 times a week for 4 weeks</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>The use of NSAID, other analgesic drugs and antidepressant drugs was not permitted during the study period. Any pretreatment with these drugs had to be discontinued 7 days before the start of study. The use of other medication for comorbid diseases was permitted during study period.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 57.2 (9.5) years</p>
|
|
<p>N = 40</p>
|
|
<p>Definition: Bilateral knee osteoarthritis according to the American College of Rheumatology criteria with confirmation in standing anteroposterior and lateral radiographs of both knees</p>
|
|
<p>Severity: Kellgren Lawrence grades <4</p>
|
|
<p>Duration of symptoms (mean [SD]): 71.03 (60.98) months</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Quality of life at ≤3 months and >3 months</p>
|
|
<p>Pain at ≤3 months and >3 months</p>
|
|
<p>Physical function at ≤3 months and >3 months</p>
|
|
<p>Psychological distress at ≤3 months and >3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cetin 2008<a class="bibr" href="#niceng226er7.s1.1.ref44" rid="niceng226er7.s1.1.ref44"><sup>44</sup></a></td><td headers="hd_h_niceng226er7.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Pulsed short-wave therapy</b> (n=20)</p>
|
|
<p>Short-wave diathermy, hot packs and isokinetic exercise using a frequency of 27.12 MHz for 15 minutes per knee 3 times a week for 8 weeks</p>
|
|
<p><b>Transcutaneous electrical nerve stimulation</b> (n=20)</p>
|
|
<p>TENS, hot packs and isokinetic exercise. Unit set to 60-100Hz, pulse duration set to 60ms for 24 sessions, 3 times a week for 8 weeks.</p>
|
|
<p><b>Ultrasound</b> (n=20)</p>
|
|
<p>Ultrasound, hot packs and isokinetic exercise. 1MHz ultrasound head, intensity of 1.5W/cm2, 3 times a week for 8 weeks</p>
|
|
<p><b>No treatment</b> (n=20)</p>
|
|
<p>Hot pack and isokinetic exercise only</p>
|
|
<p>A fifth group (n=20) was reported by not included as it did not fulfil the inclusion criteria</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>After application of physical agents, each person underwent individual warm up exercises on a stationary bike set for 20 cycles/min for 5 mins before undergoing muscle-strengthening exercises. People were instructed to continue taking any current medications and not to start any new therapies for knee osteoarthritis during the 8 week studies.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 59.8 (9.2) years</p>
|
|
<p>N = 100</p>
|
|
<p>Definition: Defined by the American College of Rheumatology with radiographic confirmation</p>
|
|
<p>Severity: Radiographic grade 1-4, median grade 3</p>
|
|
<p>Duration of symptoms: Not stated</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain at ≤3 months</td><td headers="hd_h_niceng226er7.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">De Paula Gomes 2020<a class="bibr" href="#niceng226er7.s1.1.ref66" rid="niceng226er7.s1.1.ref66"><sup>66</sup></a></td><td headers="hd_h_niceng226er7.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Interferential therapy</b> (n=20)</p>
|
|
<p>The sessions were held three times a week, over 8 weeks (24 sessions), on alternate days, lasting approximately 90 minutes each treatment session.</p>
|
|
<p>Interferential therapy (n=20)</p>
|
|
<p>ICT was performed using a premodulated tetrapolar method with a carrier frequency of 4KHz, 1/1s sweep mode, 75 Hz frequency modulation amplitude, 25Hz delta frequency modulation amplitude, and automatic vector mode for 40 minutes.</p>
|
|
<p><b>Short wave therapy</b> (n=20)</p>
|
|
<p>a thermopulse (Ibramed, Amparo, Sao Paolo, Brazil) device set to continuous mode, 27.12MHz frequency and 150W input was used for 20 minutes, and the intensity was defined based on each participant reporting a warm sensation (one sensation, described as soft but pleasant heat).</p>
|
|
<p><b>Laser therapy</b> (n=20)</p>
|
|
<p>Prior to the exercise protocol, participants in the exercise and photobiomodulation (PHOTO) group underwent photobiomodulation therapy using a laserpulse device (Ibramed, Amparo, SP, Brazil). The power of each infrared laser was as follows: wavelength of 904nm, frequency of 9500Hz, pulse duration of 60ns, peak power of 70W, average power of 0.04W, energy density of 6J/cm² applied on eight points, with a total dose of 48J/cm², each session.</p>
|
|
<p><b>Sham electrotherapy</b> (n=20)</p>
|
|
<p><b>No treatment</b> (n=20)</p>
|
|
<p>Exercise therapy only (supervised strength exercises)</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>None of the participants undertook any form of physical therapy, in addition to the one stipulate. In addition they did not use intra-articular, anti-inflammatory or chondroprotective corticosteroids. The use of medications for concomitant diseases was not controlled.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): Exercise group: 67.85 (4.49) years, exercise+placebo group: 69.4 (4.45) years, exercise+ICT group: 71.85 (2.62) years, exercise+SDT group: 68.45 (4.62) years, exercise+PHOTO group: 65.75 (4.48) years</p>
|
|
<p>N = 100</p>
|
|
<p>Definition: Unilateral knee OA according to American College of Rheumatology criteria, made through examination and the written opinion of a specialist in rheumatic disease.</p>
|
|
<p>Severity (NRS pain score): Exercise group: 6.55 (1.09), exercise+placebo group: 6.50 (0.68), exercise+ICT group: 6.65 (0.98), exercise+SDT group: 6.40 (0.99), exercise+PHOTO group: 6.70 (0.86)</p>
|
|
<p>Duration of symptoms: Not stated/unclear</p>
|
|
<p>Presence of multi-morbidities: Not stated/unclear
|
|
</p>
|
|
</td><td headers="hd_h_niceng226er7.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at ≤3 months</p>
|
|
<p>Physical function at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Fukuda 2011<a class="bibr" href="#niceng226er7.s1.1.ref83" rid="niceng226er7.s1.1.ref83"><sup>83</sup></a></td><td headers="hd_h_niceng226er7.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Pulsed short-wave therapy</b> (n=63)</p>
|
|
<p>Low or high dose pulsed short-wave therapy (carrying frequency of 27.12 MHz, peak power of 250W, pulse duration of 400 microseconds, maximum power of 145Hz, resulting in a mean power of 14.5W. The low dose group was completed over 19 minutes per session delivering 17kJ of energy. The high dose group was completed over 38 minutes delivering 33kJ of energy.</p>
|
|
<p><b>Sham electrotherapy</b> (n=23)</p>
|
|
<p>Sham electrotherapy (kept on standby mode during 19 minutes without the current delivered)</p>
|
|
<p><b>No treatment</b> (n=35)</p>
|
|
<p>No treatment</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>No advice was given to participants in all groups in relation to physical activities, except to maintain their daily activities and to avoid using anti-inflammatory drugs</p>
|
|
</td><td headers="hd_h_niceng226er7.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 61.0 (9.3) years</p>
|
|
<p>N = 121</p>
|
|
<p>Definition: Primary grade 2-3 knee osteoarthritis based on Gupta and colleagues’ radiographic criteria and have had joint or anterior knee pain for at least 3 months</p>
|
|
<p>Severity: Gupta and colleagues radiographic criteria: grade 2-3</p>
|
|
<p>Duration of symptoms: At least 3 months</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Quality of life at ≤3 months and >3 months</p>
|
|
<p>Pain at ≤3 months and >3 months</p>
|
|
<p>Physical function at ≤3 months and >3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Moffett 1996<a class="bibr" href="#niceng226er7.s1.1.ref155" rid="niceng226er7.s1.1.ref155"><sup>155</sup></a></td><td headers="hd_h_niceng226er7.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Pulsed short-wave therapy</b> (n=30)</p>
|
|
<p>Pulsed short wave therapy with 9 sessions of treatment over 3 weeks, each application lasting 15 minutes</p>
|
|
<p><b>Sham electrotherapy</b> (n=30)</p>
|
|
<p>Placebo treatment (same device, assigned random number settings on the machine that would produce a non-functioning result)</p>
|
|
<p><b>No treatment</b> (n=30)</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>No additional information</p>
|
|
</td><td headers="hd_h_niceng226er7.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 63.5 (9.9) years</p>
|
|
<p>N = 90</p>
|
|
<p>Definition: People with osteoarthritis of the hip or knee with radiological changes</p>
|
|
<p>Severity: Not stated</p>
|
|
<p>Duration of symptoms (mean [SD]): 92.1 (124.4) months</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at ≤3 months</p>
|
|
<p>Psychological distress at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab4"><div id="niceng226er7.tab4" class="table"><h3><span class="label">Table 4</span><span class="title">Summary of studies included in the interferential therapy compared to pulsed short-wave therapy comparison</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab4/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab4_lrgtbl__"><table><thead><tr><th id="hd_h_niceng226er7.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study</th><th id="hd_h_niceng226er7.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention and comparison</th><th id="hd_h_niceng226er7.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><th id="hd_h_niceng226er7.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes</th><th id="hd_h_niceng226er7.tab4_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comments</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Atamaz 2012<a class="bibr" href="#niceng226er7.s1.1.ref22" rid="niceng226er7.s1.1.ref22"><sup>22</sup></a></td><td headers="hd_h_niceng226er7.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Transcutaneous electrical nerve stimulation</b> (n=37)</p>
|
|
<p>TENS (frequency 80Hz, 10-30mA intensity) for 20 minutes three times a week for 3 weeks</p>
|
|
<p><b>Interferential therapy</b> (n=31)</p>
|
|
<p>Interferential currents (frequency 100Hz generated by 4kHz sinusoidal waves) for 3 weeks</p>
|
|
<p><b>Pulsed short-wave therapy</b> (n=32)</p>
|
|
<p>Pulsed short-wave diathermy (10cm diameter condenser plate, frequency 27.12mHz, input 300W, mean output 3.2W) for 3 weeks</p>
|
|
<p><b>Sham electrotherapy (TENS)</b> (n=37)</p>
|
|
<p>Sham TENS</p>
|
|
<p><b>Sham electrotherapy (interferential therapy)</b> (n=35)</p>
|
|
<p>Sham interferential therapy</p>
|
|
<p><b>Sham electrotherapy (pulsed short-wave therapy)</b> (n=31)</p>
|
|
<p>Sham pulsed short-wave therapy</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>All people had an exercise program conducted in groups of 4-5 people three times a week for 3 weeks involving stretching, isometric quadriceps exercises and chair lift/minisquats. This was supplemented with additional instruction for home exercise. All people also attended an education program consisting of one 1 hour session discussing the functional anatomy of the knee, ergonomic principles, and understanding of osteoarthritis.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Knee osteoarthritis</p>
|
|
<p>Mean age (SD): 61.5 (7.5) years</p>
|
|
<p>N = 203</p>
|
|
<p>Definition: People with knee osteoarthritis according to the American College of Rheumatology criteria with radiologically confirmation with a Kellgren Lawrence grade of 2 or 3</p>
|
|
<p>Severity: Kellgren Lawrence grade 2-3</p>
|
|
<p>Duration of symptoms (mean [SD]): 43.7 (49.1) months.</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at ≤3 months and >3 months</p>
|
|
<p>Physical function at ≤3 months and >3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab4_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">De Paula Gomes 2020<a class="bibr" href="#niceng226er7.s1.1.ref66" rid="niceng226er7.s1.1.ref66"><sup>66</sup></a></td><td headers="hd_h_niceng226er7.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Interferential therapy</b> (n=20)</p>
|
|
<p>The sessions were held three times a week, over 8 weeks (24 sessions), on alternate days, lasting approximately 90 minutes each treatment session.</p>
|
|
<p>Interferential therapy (n=20)</p>
|
|
<p>ICT was performed using a premodulated tetrapolar method with a carrier frequency of 4KHz, 1/1s sweep mode, 75 Hz frequency modulation amplitude, 25Hz delta frequency modulation amplitude, and automatic vector mode for 40 minutes.</p>
|
|
<p><b>Short wave therapy</b> (n=20)</p>
|
|
<p>a thermopulse (Ibramed, Amparo, Sao Paolo, Brazil) device set to continuous mode, 27.12MHz frequency and 150W input was used for 20 minutes, and the intensity was defined based on each participant reporting a warm sensation (one sensation, described as soft but pleasant heat).</p>
|
|
<p><b>Laser therapy</b> (n=20)</p>
|
|
<p>Prior to the exercise protocol, participants in the exercise and photobiomodulation (PHOTO) group underwent photobiomodulation therapy using a laserpulse device (Ibramed, Amparo, SP, Brazil). The power of each infrared laser was as follows: wavelength of 904nm, frequency of 9500Hz, pulse duration of 60ns, peak power of 70W, average power of 0.04W, energy density of 6J/cm² applied on eight points, with a total dose of 48J/cm², each session.</p>
|
|
<p><b>Sham electrotherapy</b> (n=20)</p>
|
|
<p><b>No treatment</b> (n=20)</p>
|
|
<p>Exercise therapy only (supervised strength exercises)</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>None of the participants undertook any form of physical therapy, in addition to the one stipulate. In addition they did not use intra-articular, anti-inflammatory or chondroprotective corticosteroids. The use of medications for concomitant diseases was not controlled.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Knee osteoarthritis</p>
|
|
<p>Mean age (SD): Exercise group: 67.85 (4.49) years, exercise+placebo group: 69.4 (4.45) years, exercise+ICT group: 71.85 (2.62) years, exercise+SDT group: 68.45 (4.62) years, exercise+PHOTO group: 65.75 (4.48) years</p>
|
|
<p>N = 100</p>
|
|
<p>Definition: Unilateral knee OA according to American College of Rheumatology criteria, made through examination and the written opinion of a specialist in rheumatic disease.</p>
|
|
<p>Severity (NRS pain score): Exercise group: 6.55 (1.09), exercise+placebo group: 6.50 (0.68), exercise+ICT group: 6.65 (0.98), exercise+SDT group: 6.40 (0.99), exercise+PHOTO group: 6.70 (0.86)</p>
|
|
<p>Duration of symptoms: Not stated/unclear</p>
|
|
<p>Presence of multi-morbidities: Not stated/unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at ≤3 months</p>
|
|
<p>Physical function at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab4_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab5"><div id="niceng226er7.tab5" class="table"><h3><span class="label">Table 5</span><span class="title">Summary of studies included in the interferential therapy compared to laser therapy comparison</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab5/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab5_lrgtbl__"><table><thead><tr><th id="hd_h_niceng226er7.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study</th><th id="hd_h_niceng226er7.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention and comparison</th><th id="hd_h_niceng226er7.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><th id="hd_h_niceng226er7.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes</th><th id="hd_h_niceng226er7.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comments</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Alqualo-Costa 2020<a class="bibr" href="#niceng226er7.s1.1.ref15" rid="niceng226er7.s1.1.ref15"><sup>15</sup></a></td><td headers="hd_h_niceng226er7.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Interferential therapy</b> (n=42)</p>
|
|
<p>Interferential current (IFC) three times a week for 4 week (12 sessions). Duration of each session ranged from 40 to 50 minutes. Parameters were used as follows: carrier current frequency of 4000Hz; amplitude-modulated frequency of 50Hz; sweep frequency of 50Hz; swing pattern of 1:1 second, and the current amplitude was increased until the patient reported strong but comfortable and non-painful stimulation paraesthesia.</p>
|
|
<p><b>Laser therapy</b> (n=42)</p>
|
|
<p>Three times a week for 4 week (12 sessions). Duration of each session ranged from 40 to 50 minutes, and used a probe with a wavelength of 904nm, with a dose of 3J per point, totalling 9 points, total energy of 27J per session, peak power of 70W, pulse repetition frequency of 9500Hz, pulse duration of 60ns, average power of 40mW, application time of 75 seconds per point, and beam cross-sectional area of 0.5cm².</p>
|
|
<p><b>Combination therapy</b> (n=42)</p>
|
|
<p>IFC plus PBM (interferential current plus photobiomodulation). Three times a week for 4 weeks (12 sessions).</p>
|
|
<p><b>Sham electrotherapy</b> (n=42)</p>
|
|
<p>Sham IFC and PBM.</p>
|
|
<p>Three times a week for 4 week (12 sessions).</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>No analgesics 4 hours before the intervention.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): IFC group: 64.5 (7.8) years, PBM group: 61.3 (9.4) years, IFC+PBM group: 65.7 (10.1) years, placebo group: 65.3 (8.5) years</p>
|
|
<p>N = 168</p>
|
|
<p>Definition:</p>
|
|
<p>American College of Rheumatology criteria</p>
|
|
<p>Severity (Kellgren-Lawrence):</p>
|
|
<p>(Score 2): IFC group: 24, PBM group: 23, IFC+PBM group: 27, placebo group: 24</p>
|
|
<p>(Score 3): IFC group: 17, PBM group: 19, IFC+PBM group: 15, placebo group: 18</p>
|
|
<p>(Score 4): IFC group: 1, PBM group: 1, IFC+PBM group: 0, placebo group: 0</p>
|
|
<p>Duration of symptoms: not reported</p>
|
|
<p>Presence of multi-morbidities: Not stated/unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain at ≤3 months and >3 months</td><td headers="hd_h_niceng226er7.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">De Paula Gomes 2020<a class="bibr" href="#niceng226er7.s1.1.ref66" rid="niceng226er7.s1.1.ref66"><sup>66</sup></a></td><td headers="hd_h_niceng226er7.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Interferential therapy</b> (n=20)</p>
|
|
<p>The sessions were held three times a week, over 8 weeks (24 sessions), on alternate days, lasting approximately 90 minutes each treatment session.</p>
|
|
<p>Interferential therapy (n=20)</p>
|
|
<p>ICT was performed using a premodulated tetrapolar method with a carrier frequency of 4KHz, 1/1s sweep mode, 75 Hz frequency modulation amplitude, 25Hz delta frequency modulation amplitude, and automatic vector mode for 40 minutes.</p>
|
|
<p><b>Short wave therapy</b> (n=20)</p>
|
|
<p>a thermopulse (Ibramed, Amparo, Sao Paolo, Brazil) device set to continuous mode, 27.12MHz frequency and 150W input was used for 20 minutes, and the intensity was defined based on each participant reporting a warm sensation (one sensation, described as soft but pleasant heat).</p>
|
|
<p><b>Laser therapy</b> (n=20)</p>
|
|
<p>Prior to the exercise protocol, participants in the exercise and photobiomodulation (PHOTO) group underwent photobiomodulation therapy using a laserpulse device (Ibramed, Amparo, SP, Brazil). The power of each infrared laser was as follows: wavelength of 904nm, frequency of 9500Hz, pulse duration of 60ns, peak power of 70W, average power of 0.04W, energy density of 6J/cm² applied on eight points, with a total dose of 48J/cm², each session.</p>
|
|
<p><b>Sham electrotherapy</b> (n=20)</p>
|
|
<p><b>No treatment</b> (n=20)</p>
|
|
<p>Exercise therapy only (supervised strength exercises)</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>None of the participants undertook any form of physical therapy, in addition to the one stipulate. In addition they did not use intra-articular, anti-inflammatory or chondroprotective corticosteroids. The use of medications for concomitant diseases was not controlled.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): Exercise group: 67.85 (4.49) years, exercise+placebo group: 69.4 (4.45) years, exercise+ICT group: 71.85 (2.62) years, exercise+SDT group: 68.45 (4.62) years, exercise+PHOTO group: 65.75 (4.48) years</p>
|
|
<p>N = 100</p>
|
|
<p>Definition: Unilateral knee OA according to American College of Rheumatology criteria, made through examination and the written opinion of a specialist in rheumatic disease.</p>
|
|
<p>Severity (NRS pain score): Exercise group: 6.55 (1.09), exercise+placebo group: 6.50 (0.68), exercise+ICT group: 6.65 (0.98), exercise+SDT group: 6.40 (0.99), exercise+PHOTO group: 6.70 (0.86)</p>
|
|
<p>Duration of symptoms: Not stated/unclear</p>
|
|
<p>Presence of multi-morbidities: Not stated/unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at ≤3 months</p>
|
|
<p>Physical function at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab6"><div id="niceng226er7.tab6" class="table"><h3><span class="label">Table 6</span><span class="title">Summary of studies included in the interferential therapy compared to sham electrotherapy comparison</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab6/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab6_lrgtbl__"><table><thead><tr><th id="hd_h_niceng226er7.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study</th><th id="hd_h_niceng226er7.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention and comparison</th><th id="hd_h_niceng226er7.tab6_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><th id="hd_h_niceng226er7.tab6_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes</th><th id="hd_h_niceng226er7.tab6_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comments</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Alqualo-Costa 2020<a class="bibr" href="#niceng226er7.s1.1.ref15" rid="niceng226er7.s1.1.ref15"><sup>15</sup></a></td><td headers="hd_h_niceng226er7.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Interferential therapy</b> (n=42)</p>
|
|
<p>Interferential current (IFC) three times a week for 4 week (12 sessions). Duration of each session ranged from 40 to 50 minutes. Parameters were used as follows: carrier current frequency of 4000Hz; amplitude-modulated frequency of 50Hz; sweep frequency of 50Hz; swing pattern of 1:1 second, and the current amplitude was increased until the patient reported strong but comfortable and non-painful stimulation paraesthesia.</p>
|
|
<p><b>Laser therapy</b> (n=42)</p>
|
|
<p>Three times a week for 4 week (12 sessions). Duration of each session ranged from 40 to 50 minutes, and used a probe with a wavelength of 904nm, with a dose of 3J per point, totalling 9 points, total energy of 27J per session, peak power of 70W, pulse repetition frequency of 9500Hz, pulse duration of 60ns, average power of 40mW, application time of 75 seconds per point, and beam cross-sectional area of 0.5cm².</p>
|
|
<p><b>Combination therapy</b> (n=42)</p>
|
|
<p>IFC plus PBM (interferential current plus photobiomodulation). Three times a week for 4 weeks (12 sessions).</p>
|
|
<p><b>Sham electrotherapy</b> (n=42)</p>
|
|
<p>Sham IFC and PBM.</p>
|
|
<p>Three times a week for 4 week (12 sessions).</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>No analgesics 4 hours before the intervention.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab6_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): IFC group: 64.5 (7.8) years, PBM group: 61.3 (9.4) years, IFC+PBM group: 65.7 (10.1) years, placebo group: 65.3 (8.5) years</p>
|
|
<p>N = 168</p>
|
|
<p>Definition: American College of Rheumatology criteria</p>
|
|
<p>Severity (Kellgren-Lawrence):</p>
|
|
<p>(Score 2): IFC group: 24, PBM group: 23, IFC+PBM group: 27, placebo group: 24</p>
|
|
<p>(Score 3): IFC group: 17, PBM group: 19, IFC+PBM group: 15, placebo group: 18</p>
|
|
<p>(Score 4): IFC group: 1, PBM group: 1, IFC+PBM group: 0, placebo group: 0</p>
|
|
<p>Duration of symptoms: not reported</p>
|
|
<p>Presence of multi-morbidities: Not stated/unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab6_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain at ≤3 months and >3 months</td><td headers="hd_h_niceng226er7.tab6_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Atamaz 2012<a class="bibr" href="#niceng226er7.s1.1.ref22" rid="niceng226er7.s1.1.ref22"><sup>22</sup></a></td><td headers="hd_h_niceng226er7.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Transcutaneous electrical nerve stimulation</b> (n=37)</p>
|
|
<p>TENS (frequency 80Hz, 10-30mA intensity) for 20 minutes three times a week for 3 weeks</p>
|
|
<p><b>Interferential therapy</b> (n=31)</p>
|
|
<p>Interferential currents (frequency 100Hz generated by 4kHz sinusoidal waves) for 3 weeks</p>
|
|
<p><b>Pulsed short-wave therapy</b> (n=32)</p>
|
|
<p>Pulsed short-wave diathermy (10cm diameter condenser plate, frequency 27.12mHz, input 300W, mean output 3.2W) for 3 weeks</p>
|
|
<p><b>Sham electrotherapy (TENS)</b> (n=37)</p>
|
|
<p>Sham TENS</p>
|
|
<p><b>Sham electrotherapy (interferential therapy)</b> (n=35)</p>
|
|
<p>Sham interferential therapy</p>
|
|
<p><b>Sham electrotherapy (pulsed short-wave therapy)</b> (n=31)</p>
|
|
<p>Sham pulsed short-wave therapy</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>All people had an exercise program conducted in groups of 4-5 people three times a week for 3 weeks involving stretching, isometric quadriceps exercises and chair lift/minisquats. This was supplemented with additional instruction for home exercise. All people also attended an education program consisting of one 1 hour session discussing the functional anatomy of the knee, ergonomic principles, and understanding of osteoarthritis.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab6_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 61.5 (7.5) years</p>
|
|
<p>N = 203</p>
|
|
<p>Definition: People with knee osteoarthritis according to the American College of Rheumatology criteria with radiologically confirmation with a Kellgren Lawrence grade of 2 or 3</p>
|
|
<p>Severity: Kellgren Lawrence grade 2-3</p>
|
|
<p>Duration of symptoms (mean [SD]): 43.7 (49.1) months.</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab6_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at ≤3 months and >3 months</p>
|
|
<p>Physical function at ≤3 months and >3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab6_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">De Paula Gomes 2020<a class="bibr" href="#niceng226er7.s1.1.ref66" rid="niceng226er7.s1.1.ref66"><sup>66</sup></a></td><td headers="hd_h_niceng226er7.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Interferential therapy</b> (n=20)</p>
|
|
<p>The sessions were held three times a week, over 8 weeks (24 sessions), on alternate days, lasting approximately 90 minutes each treatment session.</p>
|
|
<p>Interferential therapy (n=20)</p>
|
|
<p>ICT was performed using a premodulated tetrapolar method with a carrier frequency of 4KHz, 1/1s sweep mode, 75 Hz frequency modulation amplitude, 25Hz delta frequency modulation amplitude, and automatic vector mode for 40 minutes.</p>
|
|
<p><b>Short wave therapy</b> (n=20)</p>
|
|
<p>a thermopulse (Ibramed, Amparo, Sao Paolo, Brazil) device set to continuous mode, 27.12MHz frequency and 150W input was used for 20 minutes, and the intensity was defined based on each participant reporting a warm sensation (one sensation, described as soft but pleasant heat).</p>
|
|
<p><b>Laser therapy</b> (n=20)</p>
|
|
<p>Prior to the exercise protocol, participants in the exercise and photobiomodulation (PHOTO) group underwent photobiomodulation therapy using a laserpulse device (Ibramed, Amparo, SP, Brazil). The power of each infrared laser was as follows: wavelength of 904nm, frequency of 9500Hz, pulse duration of 60ns, peak power of 70W, average power of 0.04W, energy density of 6J/cm² applied on eight points, with a total dose of 48J/cm², each session.</p>
|
|
<p><b>Sham electrotherapy</b> (n=20)</p>
|
|
<p><b>No treatment</b> (n=20)</p>
|
|
<p>Exercise therapy only (supervised strength exercises)</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>None of the participants undertook any form of physical therapy, in addition to the one stipulate. In addition they did not use intra-articular, anti-inflammatory or chondroprotective corticosteroids. The use of medications for concomitant diseases was not controlled.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab6_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): Exercise group: 67.85 (4.49) years, exercise+placebo group: 69.4 (4.45) years, exercise+ICT group: 71.85 (2.62) years, exercise+SDT group: 68.45 (4.62) years, exercise+PHOTO group: 65.75 (4.48) years</p>
|
|
<p>N = 100</p>
|
|
<p>Definition: Unilateral knee OA according to American College of Rheumatology criteria, made through examination and the written opinion of a specialist in rheumatic disease.</p>
|
|
<p>Severity (NRS pain score): Exercise group: 6.55 (1.09), exercise+placebo group: 6.50 (0.68), exercise+ICT group: 6.65 (0.98), exercise+SDT group: 6.40 (0.99), exercise+PHOTO group: 6.70 (0.86)</p>
|
|
<p>Duration of symptoms: Not stated/unclear</p>
|
|
<p>Presence of multi-morbidities: Not stated/unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab6_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at ≤3 months</p>
|
|
<p>Physical function at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab6_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Gundog 2012<a class="bibr" href="#niceng226er7.s1.1.ref91" rid="niceng226er7.s1.1.ref91"><sup>91</sup></a></td><td headers="hd_h_niceng226er7.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Interferential therapy</b> (n=45)</p>
|
|
<p>Interferential therapy are different frequencies (40Hz, 100Hz or 180Hz) applied 5 times a week for 3 weeks (carrier frequency 4kHz)</p>
|
|
<p><b>Sham electrotherapy</b> (n=15)</p>
|
|
<p>Sham treatment (no current delivered)</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>No additional information</p>
|
|
</td><td headers="hd_h_niceng226er7.tab6_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 60.0 (9.1) years</p>
|
|
<p>N = 60</p>
|
|
<p>Definition: Clinical (criteria of the American College of Rheumatology) and radiologic (a grade of 2 or 3 on the Kellgren Lawrence scale for severity of osteoarthritis) osteoarthritis of the knee for at least 6 months duration</p>
|
|
<p>Severity: Not stated</p>
|
|
<p>Duration of symptoms: At least 6 months</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab6_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at ≤3 months</p>
|
|
<p>Physical function at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab6_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab7"><div id="niceng226er7.tab7" class="table"><h3><span class="label">Table 7</span><span class="title">Summary of studies included in the interferential therapy compared to no treatment comparison</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab7/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab7_lrgtbl__"><table><thead><tr><th id="hd_h_niceng226er7.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study</th><th id="hd_h_niceng226er7.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention and comparison</th><th id="hd_h_niceng226er7.tab7_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><th id="hd_h_niceng226er7.tab7_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes</th><th id="hd_h_niceng226er7.tab7_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comments</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">De Paula Gomes 2020<a class="bibr" href="#niceng226er7.s1.1.ref66" rid="niceng226er7.s1.1.ref66"><sup>66</sup></a></td><td headers="hd_h_niceng226er7.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Interferential therapy</b> (n=20)</p>
|
|
<p>The sessions were held three times a week, over 8 weeks (24 sessions), on alternate days, lasting approximately 90 minutes each treatment session.</p>
|
|
<p>Interferential therapy (n=20)</p>
|
|
<p>ICT was performed using a premodulated tetrapolar method with a carrier frequency of 4KHz, 1/1s sweep mode, 75 Hz frequency modulation amplitude, 25Hz delta frequency modulation amplitude, and automatic vector mode for 40 minutes.</p>
|
|
<p><b>Short wave therapy</b> (n=20)</p>
|
|
<p>a thermopulse (Ibramed, Amparo, Sao Paolo, Brazil) device set to continuous mode, 27.12MHz frequency and 150W input was used for 20 minutes, and the intensity was defined based on each participant reporting a warm sensation (one sensation, described as soft but pleasant heat).</p>
|
|
<p><b>Laser therapy</b> (n=20)</p>
|
|
<p>Prior to the exercise protocol, participants in the exercise and photobiomodulation (PHOTO) group underwent photobiomodulation therapy using a laserpulse device (Ibramed, Amparo, SP, Brazil). The power of each infrared laser was as follows: wavelength of 904nm, frequency of 9500Hz, pulse duration of 60ns, peak power of 70W, average power of 0.04W, energy density of 6J/cm² applied on eight points, with a total dose of 48J/cm², each session.</p>
|
|
<p><b>Sham electrotherapy</b> (n=20)</p>
|
|
<p><b>No treatment</b> (n=20)</p>
|
|
<p>Exercise therapy only (supervised strength exercises)</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>None of the participants undertook any form of physical therapy, in addition to the one stipulate. In addition they did not use intra-articular, anti-inflammatory or chondroprotective corticosteroids. The use of medications for concomitant diseases was not controlled.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab7_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): Exercise group: 67.85 (4.49) years, exercise+placebo group: 69.4 (4.45) years, exercise+ICT group: 71.85 (2.62) years, exercise+SDT group: 68.45 (4.62) years, exercise+PHOTO group: 65.75 (4.48) years</p>
|
|
<p>N = 100</p>
|
|
<p>Definition: Unilateral knee OA according to American College of Rheumatology criteria, made through examination and the written opinion of a specialist in rheumatic disease.</p>
|
|
<p>Severity (NRS pain score): Exercise group: 6.55 (1.09), exercise+placebo group: 6.50 (0.68), exercise+ICT group: 6.65 (0.98), exercise+SDT group: 6.40 (0.99), exercise+PHOTO group: 6.70 (0.86)</p>
|
|
<p>Duration of symptoms: Not stated/unclear</p>
|
|
<p>Presence of multi-morbidities: Not stated/unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab7_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at ≤3 months</p>
|
|
<p>Physical function at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab7_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab8"><div id="niceng226er7.tab8" class="table"><h3><span class="label">Table 8</span><span class="title">Summary of studies included in the neuromuscular electrical stimulation compared to no treatment comparison</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab8/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab8_lrgtbl__"><table><thead><tr><th id="hd_h_niceng226er7.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study</th><th id="hd_h_niceng226er7.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention and comparison</th><th id="hd_h_niceng226er7.tab8_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><th id="hd_h_niceng226er7.tab8_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes</th><th id="hd_h_niceng226er7.tab8_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comments</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Arslan 2020<a class="bibr" href="#niceng226er7.s1.1.ref21" rid="niceng226er7.s1.1.ref21"><sup>21</sup></a></td><td headers="hd_h_niceng226er7.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Neuromuscular electrical stimulation</b> (n=21)</p>
|
|
<p>NMES and combined physiotherapy. Both groups received a combined physiotherapy programme, with 5 sessions per week. It included a hot pack, therapeutic ultrasound, TENS and exercise programme.</p>
|
|
<p><b>No treatment</b> (n=17)</p>
|
|
<p>
|
|
<b>Concomitant treatment:</b>
|
|
</p>
|
|
<p>Both groups received a combined physiotherapy programme, with 5 sessions per week. It included a hot pack, therapeutic ultrasound, TENS and exercise programme.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab8_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 71 (12) years</p>
|
|
<p>N = 43</p>
|
|
<p>Definition: stage 2 or 3 on Kellgren Lawrence staging.</p>
|
|
<p>Severity: 48.43 (28.85) vs 52.29 (30.20)</p>
|
|
<p>Duration of symptoms (years): not reported</p>
|
|
<p>Presence of multi-morbidities: Not stated/unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab8_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Quality of life at ≤3 months</p>
|
|
<p>Pain at ≤3 months</p>
|
|
<p>Physical function at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab8_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Bruce-brand 2012<a class="bibr" href="#niceng226er7.s1.1.ref36" rid="niceng226er7.s1.1.ref36"><sup>36</sup></a></td><td headers="hd_h_niceng226er7.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Neuromuscular electrical stimulation</b> (n=14)</p>
|
|
<p>Neuromuscular electrical stimulation (maximum root mean square output current 18mA, output frequency 50Hz, pulse width changes between 100-400 microseconds) for 20 minutes, 5 days a week for 6 weeks with exercise training after each treatment.</p>
|
|
<p><b>No treatment</b> (n=13)</p>
|
|
<p>No treatment</p>
|
|
<p>A third group (n=14) was reported but not included in the analysis as it did not fulfil the inclusion criteria.</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>Standard care was available to all including osteoarthritis education, weight loss, pharmacologic therapy and physical therapy</p>
|
|
</td><td headers="hd_h_niceng226er7.tab8_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 64.0 (5.4) years</p>
|
|
<p>N = 41</p>
|
|
<p>Definition: Symptomatic moderate to severe knee osteoarthritis confirmed radiographically as Kellgren Lawrence grade 3-4</p>
|
|
<p>Severity: Kellgren Lawrence grade 3-4</p>
|
|
<p>Duration of symptoms: Not stated</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab8_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Quality of life at ≤3 months</p>
|
|
<p>Pain at ≤3 months</p>
|
|
<p>Physical function at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab8_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Elboim-gabyzon 2013<a class="bibr" href="#niceng226er7.s1.1.ref76" rid="niceng226er7.s1.1.ref76"><sup>76</sup></a></td><td headers="hd_h_niceng226er7.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Neuromuscular electrical stimulation</b> (n=33)</p>
|
|
<p>Neuromuscular electrical stimulation to the rectus femoris proximal muscle belly and the vastus medialis muscle belly (150V, 100ms pulse duration, 1000mA intensity) for 12 bieweely treatments over 6 weeks</p>
|
|
<p><b>No treatment</b> (n=30)</p>
|
|
<p>No electrotherapy treatment</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>All people participated in a group exercise programme, with 6-8 subjects in each group. The exercise sessions involved muscle strengthening exercises, functional activities and balance training. They took 45 minutes to complete. Patient education was incorporated into each session including information on self-management, which included activity and exercise planning, and a discussion of pain-coping strategies</p>
|
|
</td><td headers="hd_h_niceng226er7.tab8_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 68.2 (8.0) years</p>
|
|
<p>N = 63</p>
|
|
<p>Definition: Radiographic evidence of knee osteoarthritis at grade at least 2 according to the Kellgren</p>
|
|
<p>Lawrence classification</p>
|
|
<p>Severity: Kellgren Lawrence at least grade 2</p>
|
|
<p>Duration of symptoms (mean [SD]): 4.3 (5.6) years.</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab8_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain at ≤3 months</td><td headers="hd_h_niceng226er7.tab8_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Laufer 2014<a class="bibr" href="#niceng226er7.s1.1.ref131" rid="niceng226er7.s1.1.ref131"><sup>131</sup></a></td><td headers="hd_h_niceng226er7.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Neuromuscular electrical stimulation</b> (n=25)</p>
|
|
<p>Neuromuscular electrical stimulation to the quadriceps femoris muscle giving 10 contractions at the maximal tolerated intensity for 12 sessions over 6 weeks</p>
|
|
<p><b>No treatment</b> (n=25)</p>
|
|
<p>No electrotherapy treatment</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>An exercise program was completed with quadriceps muscle strengthening exercise.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab8_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 68.9 (7.7) years</p>
|
|
<p>N = 50</p>
|
|
<p>Definition: Knee osteoarthritis at grade 2 or higher, according to the Kellgren and Lawrence classification</p>
|
|
<p>Severity: Kellgren Lawrence radiographic grade 2 or higher</p>
|
|
<p>Duration of symptoms (mean [SD]): 4.7 (6.1) years.</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab8_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain at ≤3 months and >3 months</td><td headers="hd_h_niceng226er7.tab8_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Mizusaki imoto 2013<a class="bibr" href="#niceng226er7.s1.1.ref154" rid="niceng226er7.s1.1.ref154"><sup>154</sup></a></td><td headers="hd_h_niceng226er7.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Neuromuscular electrical stimulation</b> (n=50)</p>
|
|
<p>Neuromuscular electrical stimulation to the rectus femoris and vastus medialis muscle (pulsed current, biphasic, asymmetrical, rectangular waveform, frequency 50Hz, pulse duration 250microseconds, contraction time 10s, rest time 30s every 20 minutes, current intensity at the maximum tolerable)</p>
|
|
<p><b>No treatment</b> (n=50)</p>
|
|
<p>No electrotherapy treatment</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>Exercise including 10 minutes on a stationary bicycle, stretching of hamstring muscles (3 repetitions of 30 seconds) with the aid of an elastic band, and loaded quadriceps strengthening exercises combined with NMES. Performed in a sitting position with the knee and hip flexed to 90 degrees, people contracted their quadriceps at each NMES stimulus. Paracetamol was prescribed for pain, and diacerein and chloroquine for osteoarthritis control.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab8_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 61.1 (6.8) years</p>
|
|
<p>N = 100</p>
|
|
<p>Definition: Knee osteoarthritis based on the American College of Rheumatology criteria</p>
|
|
<p>Severity: Kellgren Lawrence grade 2-4, median grade 2</p>
|
|
<p>Duration of symptoms: Not stated</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab8_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at ≤3 months</p>
|
|
<p>Physical function at ≤3 months</p>
|
|
<p>Mild adverse events at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab8_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Palmieri-smith 2010<a class="bibr" href="#niceng226er7.s1.1.ref170" rid="niceng226er7.s1.1.ref170"><sup>170</sup></a></td><td headers="hd_h_niceng226er7.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Neuromuscular electrical stimulation</b> (n=16)</p>
|
|
<p>Neuromuscular electrical stimulation 3 times per week over 4 weeks. Stimulating contractions to the quadriceps musculature (one limb only). Applied through a 2500Hz alternating current, modulated at 50 bursts per second, with a ramp up time of 2 seconds. The electrical current was set for a sequence of 10 seconds on (including the ramp up time) and 50 seconds off.</p>
|
|
<p><b>No treatment</b> (n=14)</p>
|
|
<p>No electrotherapy treatment</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>No additional information.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab8_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 57.4 (2.9) years</p>
|
|
<p>N = 30</p>
|
|
<p>Definition: Knee osteoarthritis with radiographic evidence, defined as a score of at least 2 on the Kellgren and Lawrence scale</p>
|
|
<p>Severity: Kellgren Lawrence grade 2-3, majority grade 2</p>
|
|
<p>Duration of symptoms: Not stated</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab8_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at ≤3 months and >3 months</p>
|
|
<p>Physical function at ≤3 months and >3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab8_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab9"><div id="niceng226er7.tab9" class="table"><h3><span class="label">Table 9</span><span class="title">Summary of studies included in the extracorporeal shockwave therapy compared to sham electrotherapy comparison</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab9/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab9_lrgtbl__"><table><thead><tr><th id="hd_h_niceng226er7.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study</th><th id="hd_h_niceng226er7.tab9_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention and comparison</th><th id="hd_h_niceng226er7.tab9_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><th id="hd_h_niceng226er7.tab9_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes</th><th id="hd_h_niceng226er7.tab9_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comments</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cho 2016<a class="bibr" href="#niceng226er7.s1.1.ref58" rid="niceng226er7.s1.1.ref58"><sup>58</sup></a></td><td headers="hd_h_niceng226er7.tab9_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Extracorporeal shockwave therapy</b> (n=9)</p>
|
|
<p>Extracorporeal shockwave therapy administered as 1000 impulses of shockwave at 0.05mL/mm2 on the proximal medial tibia of the affected knee over 2 weeks</p>
|
|
<p><b>Sham electrotherapy</b> (n=9)</p>
|
|
<p>Sham therapy (same number of impulses, but shockwave of 0mJ/mm2) over 2 weeks</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>No additional information</p>
|
|
</td><td headers="hd_h_niceng226er7.tab9_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 74.1 (7.0) years</p>
|
|
<p>N = 18</p>
|
|
<p>Definition: Unilateral or bilateral knee osteoarthritis of at least Kellgren Lawrence grade 1</p>
|
|
<p>Severity: Kellgren Lawrence grade (mean [SD]): 1.9 (1.1)</p>
|
|
<p>Duration of symptoms: Not stated</p>
|
|
<p>Presence of multimorbidities: High morbidity score (At least everyone had previously had a stroke)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab9_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain at ≤3 months</td><td headers="hd_h_niceng226er7.tab9_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Participants were people with knee osteoarthritis who had also had a chronic stroke.</td></tr><tr><td headers="hd_h_niceng226er7.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Wang 2020<a class="bibr" href="#niceng226er7.s1.1.ref217" rid="niceng226er7.s1.1.ref217"><sup>217</sup></a></td><td headers="hd_h_niceng226er7.tab9_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Extracorporeal shockwave therapy</b> (n=36)</p>
|
|
<p>Extracorporeal shockwave therapy using a shockwave of 0.25 mJ/mm² for 4000 pulses in total at a frequency of 15 Hz/s. Therapy three times weekly for a total of 10 weeks.</p>
|
|
<p><b>Sham electrotherapy</b> (n=36)</p>
|
|
<p>Using a shockwave of 0 mJ/mm². The probe emitted the same noises as the therapy probe. Therapy three times weekly for a total of 10 weeks.</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>No additional information.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab9_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Age (years): ≤75 years</p>
|
|
<p>N = 72</p>
|
|
<p>Definition: Chronic knee pain (for more than 3 months) with a duration of morning knee stiffness of less than 30 minutes</p>
|
|
<p>Severity: Not stated/unclear</p>
|
|
<p>Duration of symptoms (mean [SD]): 7.9 (3.7) years</p>
|
|
<p>Presence of multi-morbidities: Not stated/unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab9_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at ≤3 months</p>
|
|
<p>Physical function at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab9_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Zhang 2021<a class="bibr" href="#niceng226er7.s1.1.ref236" rid="niceng226er7.s1.1.ref236"><sup>236</sup></a></td><td headers="hd_h_niceng226er7.tab9_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Extracorporeal shockwave therapy</b> (n=75)</p>
|
|
<p>Radial extracorporeal shockwave therapy (rESWT)</p>
|
|
<p>Participants received 4 sessions of rEWST, one week apart, with a shock frequency of 8Hs per session. The treatment protocols for the 4 rEWST groups were as follows: LD/2000, with a positive EFD of 0.12mJ/mm2 and 4000 impulses per session; HD/2000, with a positive EFD of 0.24mJ/mm2 and 2000 impulses per session; and HD/4000, with a positive EFD of 0.24mJ/mm2 and 4000 impulses per session.</p>
|
|
<p><b>Sham electrotherapy</b> (n=14)</p>
|
|
<p>The placebo group also received 4 sessions of rEWST, one week apart, with a shock frequency of 8Hz per session, but was treated with the minimum positive EFD 0.02mJ/mm2 and 1000 impulses per session.</p>
|
|
<p>
|
|
<b>Concomitant treatment:</b>
|
|
</p>
|
|
<p>All participants were prevented from receiving any additional treatments, such as physical therapy, oral or parenteral steroid medications, anti-inflammatory drugs, stretching, acupuncture, orthotics etc., throughout the treatment sessions.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab9_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Knee osteoarthritis</b>Mean age (SD): LD/2000 group: 60.84 (8.36) years, LD/4000 group: 62.70 (7.50) years, HD/2000 group: 58.21 (9.47) years, HD/4000 group: 63.65 (6.94) years, control group: 61.5 (5.43) years</p>
|
|
<p>N = 89</p>
|
|
<p>Definition: Diagnosed by 2 expert physicians according to American College of Rheumatology criteria.</p>
|
|
<p>Severity: Not stated/unclear</p>
|
|
<p>Duration of symptoms (months): LD/2000 group: 17.15 (5.36), LD/4000 group: 19.92(6.85), HD/2000 group: 18.56(7.48), HD/4000 group: 16.67 (4.72), control group: 15.73 (8.37)</p>
|
|
<p>Presence of multi-morbidities: Not stated/unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab9_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain at ≤3 months</td><td headers="hd_h_niceng226er7.tab9_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Zhao 2013<a class="bibr" href="#niceng226er7.s1.1.ref237" rid="niceng226er7.s1.1.ref237"><sup>237</sup></a></td><td headers="hd_h_niceng226er7.tab9_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Extracorporeal shockwave therapy</b> (n=34)</p>
|
|
<p>Extracorporeal shockwave therapy delivered at weekly intervals of 4 weeks. Delivered as 4000 pulses in total and applied at 0.25mJ/mm2 and a frequency of 6Hz.</p>
|
|
<p><b>Sham electrotherapy</b> (n=36)</p>
|
|
<p>Sham therapy (same number of impulses, but shockwave of 0mJ/mm2)</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>No additional information</p>
|
|
</td><td headers="hd_h_niceng226er7.tab9_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 60.9 (10.6) years</p>
|
|
<p>N = 70</p>
|
|
<p>Definition: People with a diagnosis of primary symptomatic knee osteoarthritis according to the criteria of the American College of Rheumatology</p>
|
|
<p>Severity: Kellgren Lawrence grade 2-3, median grade 2</p>
|
|
<p>Duration of symptoms: At least 3 months</p>
|
|
<p>Presence of multimorbidities: Not stated/unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab9_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at ≤3 months</p>
|
|
<p>Physical function at ≤3 months</p>
|
|
<p>Mild adverse events at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab9_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Zhong 2019<a class="bibr" href="#niceng226er7.s1.1.ref238" rid="niceng226er7.s1.1.ref238"><sup>238</sup></a></td><td headers="hd_h_niceng226er7.tab9_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Extracorporeal shockwave therapy</b> (n=32)</p>
|
|
<p>Once a week for 4 consecutive weeks (4 sessions in total).</p>
|
|
<p>The parameters of therapy included a total of 2000 pulses of 8Hz frequency at 2.5 bars of pneumatic pressure. The first 1000 pulses were evenly distributed to pain points (the maximum number of pain points is 4).</p>
|
|
<p><b>Sham therapy</b> (n=31)</p>
|
|
<p>Participants assigned to the placebo group were managed by the same physical therapist with the same ESWT protocol, but the air pressure was set at 0.2 bar. The stress value was set by the researcher responsible for randomisation. Participants and therapists could hear a sound similar to that of the regular ESWT, in order to enhance the sham design, but they were not able to see the dashboard.</p>
|
|
<p>
|
|
<b>Concomitant treatment:</b>
|
|
</p>
|
|
<p>All participants were educated on a simple home exercise programme for the first visit. the programme was comprised of a single knee extensor muscle strengthening. The patient sat in a chair, straightened his/ her knee as far as possible, kept it for 10 seconds, repeated 10 times, and did 3 groups per day. therapist- applied manual forces were not permitted in the exercise programme. The home exercise was supervised by a physiotherapist once every 3 days over the phone.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab9_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 62.8 (7.9) years</p>
|
|
<p>N = 63</p>
|
|
<p>Definition: Diagnosis by rehabilitation physicians in accordance with American College of Rheumatology criteria and radiographic criteria (Kellgren Lawrence grade)</p>
|
|
<p>Severity (WOMAC pain at baseline): 6.6 (1.5) vs 7.0 (1.9)</p>
|
|
<p>Duration of knee pain (months): 34.7 (15.4) vs 34.1 (14.2)</p>
|
|
<p>Kellgren-Lawrence grade: II (n): ESWT group: 23, placebo group: 24</p>
|
|
<p>Kellgren-Lawrence grade: III (n): ESWT group: 9, placebo group: 7</p>
|
|
<p>Presence of multi-morbidities: Not stated/unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab9_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at ≤3 months</p>
|
|
<p>Physical function at ≤3 months</p>
|
|
<p>Mild adverse events at ≤3 months</p>
|
|
<p>Moderate/major adverse events at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab9_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab10"><div id="niceng226er7.tab10" class="table"><h3><span class="label">Table 10</span><span class="title">Summary of studies included in the extracorporeal shockwave therapy compared to no treatment comparison</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab10/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab10_lrgtbl__"><table><thead><tr><th id="hd_h_niceng226er7.tab10_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study</th><th id="hd_h_niceng226er7.tab10_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention and comparison</th><th id="hd_h_niceng226er7.tab10_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><th id="hd_h_niceng226er7.tab10_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes</th><th id="hd_h_niceng226er7.tab10_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comments</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab10_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Eftekharsadat 2019<a class="bibr" href="#niceng226er7.s1.1.ref74" rid="niceng226er7.s1.1.ref74"><sup>74</sup></a></td><td headers="hd_h_niceng226er7.tab10_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Extracorporeal shockwave therapy</b> (n= 25)</p>
|
|
<p>ESWT. Participants received 5 sessions of shock wave therapy through 3 weeks Then, radial ESWT was used with shockwaves of 2000 pulses/session with an energy flux density of 0.18mJ/mm², the energy level of 2-4, a frequency of 10-16Hz, and pulse rate of 160/ minute were generally applied each session.</p>
|
|
<p><b>Combination therapy</b> (n=25)</p>
|
|
<p>Participants received 10 sessions (3 sessions, weekly) of physical therapy including hot pack, TENS and ultrasound (US, HP: 74.5 degrees C, 20 minutes on the affected knee, TENS: pulse duration 20-100 microseconds, 50% duty cycle, current amplitude, maximum tolerated tingling, frequency <200pps, US: frequency of 1 MHz, the intensity of 2.5 W/cm², and duty cycle of 25%, and the probe of US was applied for 10 minutes.</p>
|
|
<p><b>No treatment</b> (n=25)</p>
|
|
<p>The exercise programme was applied to all 3 groups. It consisted of the isometric strengthening of the quadriceps muscle in the form of 3 submaximal isometric contractions with gradually increasing intensity combined with weight- bearing water and land based exercises. Additionally, participants were advised to only use acetaminophen for pain relief in the event of severe pain and activities of daily living modifications (e.g. weight loss and the avoidance of heavy lifting, long-distance walking, and high-impact exercises) were taught as well.</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>None of the participants undertook any form of physical therapy, in addition to the ones stipulated. In addition, they did not use intra-articular, anti-inflammatory or chondroprotective corticosteroids. The use of medications for concomitant diseases was not controlled</p>
|
|
</td><td headers="hd_h_niceng226er7.tab10_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): ESWT group: 58.00 (5.97) years, PT group: 55.76 (6.06) years, exercise group: 58.16 (7.20) years</p>
|
|
<p>N = 75</p>
|
|
<p>Definition: American College of Rheumatology criteria</p>
|
|
<p>Severity:(VAS score at baseline): ESWT group: 7.00 (1.63), combination group: 7.16 (1.37), exercise group: 6.32(1.44)</p>
|
|
<p>Duration of symptoms: Not stated/unclear</p>
|
|
<p>Presence of multi-morbidities: Not stated/unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab10_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at ≤3 months</p>
|
|
<p>Physical function at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab10_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The combination therapy and extracorporeal shockwave therapy arms were not compared to each other as the combination therapy did not include the extracorporeal shockwave therapy as a component.</td></tr><tr><td headers="hd_h_niceng226er7.tab10_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Gunaydin 2020<a class="bibr" href="#niceng226er7.s1.1.ref90" rid="niceng226er7.s1.1.ref90"><sup>90</sup></a></td><td headers="hd_h_niceng226er7.tab10_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Extracorporeal shockwave therapy</b> (n=18)</p>
|
|
<p>ESWT intervention was performed once a week for 6 weeks. During the treatment, participants were placed in supine position, and the affected knee was flexed at 90 degrees. Before starting, the intervention area on the tibiofemoral and patellofemoral joints was identified with a pen. The probe was then placed on the painted area after a gel application. An average of 2000 beats at a frequency of 6-8Hz was used per session. During the application, peroneal nerve and vein structures were avoided.</p>
|
|
<p><b>No treatment</b> (n=20)</p>
|
|
<p>A third arm (n=22) was included in the study (receiving kinesio taping). This arm was not included in the analysis as it did not fulfil the inclusion criteria in the protocol.</p>
|
|
<p>
|
|
<b>Concomitant treatment:</b>
|
|
</p>
|
|
<p>Home exercise, prescribed by a physiotherapist for 12 weeks (no further details).</p>
|
|
</td><td headers="hd_h_niceng226er7.tab10_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 58.8 (6.2) years</p>
|
|
<p>N = 60</p>
|
|
<p>Definition: Diagnosis made by an orthopaedic surgeon. Kellgren-Lawrence grade 1-3.</p>
|
|
<p>Severity (baseline VAS during squats): ESWT group: 8.38 (3.42), exercise group: 7.84 (2.14)</p>
|
|
<p>Duration of pain: not reported</p>
|
|
<p>Presence of multi-morbidities: Not stated/unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab10_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain at ≤3 months</td><td headers="hd_h_niceng226er7.tab10_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab11"><div id="niceng226er7.tab11" class="table"><h3><span class="label">Table 11</span><span class="title">Summary of studies included in the pulsed short-wave therapy compared to laser therapy comparison</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab11/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab11_lrgtbl__"><table><thead><tr><th id="hd_h_niceng226er7.tab11_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study</th><th id="hd_h_niceng226er7.tab11_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention and comparison</th><th id="hd_h_niceng226er7.tab11_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><th id="hd_h_niceng226er7.tab11_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes</th><th id="hd_h_niceng226er7.tab11_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comments</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab11_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">De Paula Gomes 2020<a class="bibr" href="#niceng226er7.s1.1.ref66" rid="niceng226er7.s1.1.ref66"><sup>66</sup></a></td><td headers="hd_h_niceng226er7.tab11_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Interferential therapy</b> (n=20)</p>
|
|
<p>The sessions were held three times a week, over 8 weeks (24 sessions), on alternate days, lasting approximately 90 minutes each treatment session.</p>
|
|
<p>Interferential therapy (n=20)</p>
|
|
<p>ICT was performed using a premodulated tetrapolar method with a carrier frequency of 4KHz, 1/1s sweep mode, 75 Hz frequency modulation amplitude, 25Hz delta frequency modulation amplitude, and automatic vector mode for 40 minutes.</p>
|
|
<p><b>Short wave therapy</b> (n=20)</p>
|
|
<p>a thermopulse (Ibramed, Amparo, Sao Paolo, Brazil) device set to continuous mode, 27.12MHz frequency and 150W input was used for 20 minutes, and the intensity was defined based on each participant reporting a warm sensation (one sensation, described as soft but pleasant heat).</p>
|
|
<p><b>Laser therapy</b> (n=20)</p>
|
|
<p>Prior to the exercise protocol, participants in the exercise and photobiomodulation (PHOTO) group underwent photobiomodulation therapy using a laserpulse device (Ibramed, Amparo, SP, Brazil). The power of each infrared laser was as follows: wavelength of 904nm, frequency of 9500Hz, pulse duration of 60ns, peak power of 70W, average power of 0.04W, energy density of 6J/cm² applied on eight points, with a total dose of 48J/cm², each session.</p>
|
|
<p><b>Sham electrotherapy</b> (n=20)</p>
|
|
<p><b>No treatment</b> (n=20)</p>
|
|
<p>Exercise therapy only (supervised strength exercises)</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>None of the participants undertook any form of physical therapy, in addition to the one stipulate. In addition they did not use intra-articular, anti-inflammatory or chondroprotective corticosteroids. The use of medications for concomitant diseases was not controlled.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab11_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): Exercise group: 67.85 (4.49) years, exercise+placebo group: 69.4 (4.45) years, exercise+ICT group: 71.85 (2.62) years, exercise+SDT group: 68.45 (4.62) years, exercise+PHOTO group: 65.75 (4.48) years</p>
|
|
<p>N = 100</p>
|
|
<p>Definition: Unilateral knee OA according to American College of Rheumatology criteria, made through examination and the written opinion of a specialist in rheumatic disease.</p>
|
|
<p>Severity (NRS pain score): Exercise group: 6.55 (1.09), exercise+placebo group: 6.50 (0.68), exercise+ICT group: 6.65 (0.98), exercise+SDT group: 6.40 (0.99), exercise+PHOTO group: 6.70 (0.86)</p>
|
|
<p>Duration of symptoms: Not stated/unclear</p>
|
|
<p>Presence of multi-morbidities: Not stated/unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab11_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at ≤3 months</p>
|
|
<p>Physical function at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab11_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab12"><div id="niceng226er7.tab12" class="table"><h3><span class="label">Table 12</span><span class="title">Summary of studies included in the laser therapy compared to neuromuscular electrical stimulation comparison</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab12/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab12_lrgtbl__"><table><thead><tr><th id="hd_h_niceng226er7.tab12_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study</th><th id="hd_h_niceng226er7.tab12_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention and comparison</th><th id="hd_h_niceng226er7.tab12_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><th id="hd_h_niceng226er7.tab12_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes</th><th id="hd_h_niceng226er7.tab12_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comments</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab12_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Melo mde 2015<a class="bibr" href="#niceng226er7.s1.1.ref152" rid="niceng226er7.s1.1.ref152"><sup>152</sup></a></td><td headers="hd_h_niceng226er7.tab12_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Combination therapy</b> (n=15)</p>
|
|
<p>Laser and neuromuscular electrical stimulation (combination of the same protocols for the other two) delivered over 8 weeks.</p>
|
|
<p><b>Laser therapy</b> (n=15)</p>
|
|
<p>Low level laser therapy delivered as 30 seconds per point, 6J energy per point (36J in total) for 4 weeks, then a reduction of the dose by 30% for the remaining 4 weeks</p>
|
|
<p><b>Neuromuscular electrical stimulation</b> (n=15)</p>
|
|
<p>Neuromuscular electrical stimulation sessions twice a week, at 48 hour intervals, over an 8 week period with a progressive increase in intensity and volume.</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>Kinesthetic exercise including stretching and isometric exercises for the entire lower limb conducted in supervised 20 minute sessions.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab12_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 68.8 (5.1) years</p>
|
|
<p>N = 45</p>
|
|
<p>Definition: Grade 2 or 3 knee osteoarthritis diagnosed by a traumatology-orthopaedic physician according to the criteria proposed by Kellgren and Lawrence</p>
|
|
<p>Severity: Kellgren-Lawrence grade 2-3</p>
|
|
<p>Duration of symptoms: Not stated</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab12_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain at ≤3 months</td><td headers="hd_h_niceng226er7.tab12_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab13"><div id="niceng226er7.tab13" class="table"><h3><span class="label">Table 13</span><span class="title">Summary of studies included in the laser therapy compared to sham electrotherapy comparison</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab13/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab13_lrgtbl__"><table><thead><tr><th id="hd_h_niceng226er7.tab13_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study</th><th id="hd_h_niceng226er7.tab13_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention and comparison</th><th id="hd_h_niceng226er7.tab13_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><th id="hd_h_niceng226er7.tab13_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes</th><th id="hd_h_niceng226er7.tab13_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comments</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab13_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Alfredo 2012<a class="bibr" href="#niceng226er7.s1.1.ref10" rid="niceng226er7.s1.1.ref10"><sup>10</sup></a></p>
|
|
<p>Subsidiary paper: Alfredo 2018<a class="bibr" href="#niceng226er7.s1.1.ref11" rid="niceng226er7.s1.1.ref11"><sup>11</sup></a></p>
|
|
</td><td headers="hd_h_niceng226er7.tab13_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Laser therapy</b> (n=24)</p>
|
|
<p>Low-intensity laser therapy (using gallium arsenide laser, wavelength 904nm, frequency 700Hz, average power 60mW, peak power 20W, pulse duration 4.3ms, 50 seconds per area, area 0.5cm2) followed by exercise. 3 times a week for 3 weeks (exercise for an additional 8 weeks after laser therapy ends)</p>
|
|
<p><b>Sham electrotherapy</b> (n=22)</p>
|
|
<p>Placebo laser with exercise three times a week for 3 weeks (exercise for an additional 8 weeks after laser therapy ends)</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>No additional information</p>
|
|
</td><td headers="hd_h_niceng226er7.tab13_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 61.7 (7.2) years</p>
|
|
<p>N = 46</p>
|
|
<p>Definition: Knee osteoarthritis with levels 2-4 according to the Kellgren Lawrence grade</p>
|
|
<p>Severity: Osteoarthritis grade 2-4, median grade 3</p>
|
|
<p>Duration of symptoms: Not stated</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab13_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at ≤3 months and >3 months</p>
|
|
<p>Physical function at ≤3 months and >3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab13_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab13_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Alghadir 2014<a class="bibr" href="#niceng226er7.s1.1.ref13" rid="niceng226er7.s1.1.ref13"><sup>13</sup></a></td><td headers="hd_h_niceng226er7.tab13_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Laser therapy</b> (n=20)</p>
|
|
<p>Laser therapy (Ga-As laser, wavelength 850nm, power 100mW, spot size 1.0mm, total dose 48J/cm2) Eight points irradiated. Conducted over 4 weeks.</p>
|
|
<p><b>Sham electrotherapy</b> (n=20)</p>
|
|
<p>Placebo laser therapy</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>Hot packs were wrapped in toweling and placed on the target knees for 20 minutes followed by laser therapy. All people were given an isometric knee extension and straight leg raising exercise program to complete at home for 10 times/set, for 3 sets. All people were advised to keep their activity level and medication unchanged (paracetamol 2g daily) throughout the study period.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab13_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 56.1 (8.0) years</p>
|
|
<p>N = 40</p>
|
|
<p>Definition: Knee osteoarthritis according to the American College of Rheumatology criteria with knee osteoarthritis of grade 2-3 according to the Kellgren and Lawrence grade</p>
|
|
<p>Severity: Kellgren Lawrence grade 2-3, median grade 2</p>
|
|
<p>Duration of symptoms (mean [SD]): 9.6 (4.0) months</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab13_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at ≤3 months</p>
|
|
<p>Physical function at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab13_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab13_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Alqualo-Costa, 2020<a class="bibr" href="#niceng226er7.s1.1.ref15" rid="niceng226er7.s1.1.ref15"><sup>15</sup></a></td><td headers="hd_h_niceng226er7.tab13_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Interferential therapy</b> (n=42)</p>
|
|
<p>Interferential current (IFC) three times a week for 4 week (12 sessions). Duration of each session ranged from 40 to 50 minutes. Parameters were used as follows: carrier current frequency of 4000Hz; amplitude-modulated frequency of 50Hz; sweep frequency of 50Hz; swing pattern of 1:1 second, and the current amplitude was increased until the patient reported strong but comfortable and non-painful stimulation paraesthesia.</p>
|
|
<p><b>Laser therapy</b> (n=42)</p>
|
|
<p>Three times a week for 4 week (12 sessions). Duration of each session ranged from 40 to 50 minutes, and used a probe with a wavelength of 904nm, with a dose of 3J per point, totalling 9 points, total energy of 27J per session, peak power of 70W, pulse repetition frequency of 9500Hz, pulse duration of 60ns, average power of 40mW, application time of 75 seconds per point, and beam cross-sectional area of 0.5cm².</p>
|
|
<p><b>Combination therapy</b> (n=42)</p>
|
|
<p>IFC plus PBM (interferential current plus photobiomodulation). Three times a week for 4 weeks (12 sessions).</p>
|
|
<p><b>Sham electrotherapy</b> (n=42)</p>
|
|
<p>Sham IFC and PBM.</p>
|
|
<p>Three times a week for 4 week (12 sessions).</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>No analgesics 4 hours before the intervention.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab13_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): IFC group: 64.5(7.8) years, PBM group: 61.3 (9.4) years, IFC+PBM group: 65.7 (10.1) years, placebo group: 65.3 (8.5) years</p>
|
|
<p>N = 168</p>
|
|
<p>Definition: American College of Rheumatology criteria</p>
|
|
<p>Severity (Kellgren-Lawrence):</p>
|
|
<p>(Score 2): IFC group: 24, PBM group: 23, IFC+PBM group: 27, placebo group: 24</p>
|
|
<p>(Score 3): IFC group: 17, PBM group: 19, IFC+PBM group: 15, placebo group: 18</p>
|
|
<p>(Score 4): IFC group: 1, PBM group: 1, IFC+PBM group: 0, placebo group: 0</p>
|
|
<p>Duration of symptoms: not reported</p>
|
|
<p>Presence of multi-morbidities: Not stated/unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab13_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain at ≤3 months and >3 months</td><td headers="hd_h_niceng226er7.tab13_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab13_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Basford 1987<a class="bibr" href="#niceng226er7.s1.1.ref29" rid="niceng226er7.s1.1.ref29"><sup>29</sup></a></td><td headers="hd_h_niceng226er7.tab13_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Laser therapy</b> (n=47)</p>
|
|
<p>0.9mW continuous wave Helium-Neon (632.8nm) laser 3 times a week for 3 weeks</p>
|
|
<p><b>Sham electrotherapy</b> (n=34)</p>
|
|
<p>Sham laser therapy (a concealed switch is switched off to turn off the laser)</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>No additional information</p>
|
|
</td><td headers="hd_h_niceng226er7.tab13_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Thumb osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age: 59.1 years</p>
|
|
<p>N = 81</p>
|
|
<p>Definition: Symptomatic osteoarthritis of the thumb</p>
|
|
<p>Severity: Not stated</p>
|
|
<p>Duration of symptoms (mean): 9.1 years</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab13_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Mild adverse events at ≤3 months</td><td headers="hd_h_niceng226er7.tab13_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab13_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Brosseau 2005<a class="bibr" href="#niceng226er7.s1.1.ref35" rid="niceng226er7.s1.1.ref35"><sup>35</sup></a></td><td headers="hd_h_niceng226er7.tab13_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Laser therapy</b> (n=42)</p>
|
|
<p>Low-intensity laser therapy (using gallium arsenide laser, wavelength 860nm, frequency 20Hz, average power 60mW, area 0.01cm2) for 20 minutes. 3 times a week for 6 weeks.</p>
|
|
<p><b>Sham electrotherapy</b> (n=46)</p>
|
|
<p>Sham laser therapy</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>No additional information</p>
|
|
</td><td headers="hd_h_niceng226er7.tab13_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 64.7 (10.1) years</p>
|
|
<p>N = 88</p>
|
|
<p>Definition: Diagnosis made by rheumatologists and consistent with the clinical criteria as set out by the American College of Rheumatology classification of osteoarthritis of the hand, the radiologic criteria according to Kallman and the disease activity criteria according to the Doyle Articular Index</p>
|
|
<p>Severity: Not stated</p>
|
|
<p>Duration of symptoms (mean [SD]): 8.0 (8.3) years</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab13_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at ≤3 months and >3 months</p>
|
|
<p>Physical function at ≤3 months and >3 months</p>
|
|
<p>Mild adverse events at ≤3 months and >3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab13_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab13_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Bulow 1994<a class="bibr" href="#niceng226er7.s1.1.ref37" rid="niceng226er7.s1.1.ref37"><sup>37</sup></a></td><td headers="hd_h_niceng226er7.tab13_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Laser therapy</b> (n=13)</p>
|
|
<p>Laser (Ga-Al-As, wavelength 830nm, mean effect 25mW, continuous beam, irradiation area 0.28cm2) 2-4 treatments per week for a total of 9 treatments over 3 weeks</p>
|
|
<p><b>Sham electrotherapy</b> (n=14)</p>
|
|
<p>Placebo laser (laser was switched off)</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>Analgesics and NSAIDs were permitted including weak simple analgesics, NSAIDs and dextropropoxifen and opioids. These were noted for each participant.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab13_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (range): 74 (60-86) years</p>
|
|
<p>N = 27</p>
|
|
<p>Definition: Clinically and x-ray verified uni- or bilateral osteoarthritis of the knee with exercise induced pain for at least 6 months</p>
|
|
<p>Severity: Not stated</p>
|
|
<p>Duration of symptoms: at least 6 months</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab13_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Mild adverse events at ≤3 months</td><td headers="hd_h_niceng226er7.tab13_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab13_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cantero-tellez 2020<a class="bibr" href="#niceng226er7.s1.1.ref42" rid="niceng226er7.s1.1.ref42"><sup>42</sup></a></td><td headers="hd_h_niceng226er7.tab13_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Laser therapy</b> (n=22)</p>
|
|
<p>Delivery parameters were established according to the acknowledged guidelines and were peak power 3.0W (duty cycle of 50%, mean power 1.5W), with intense super pulse mode, combined wavelength of 800 +970nM, pulse frequency 2Hz, energy dose 75J per session, spot size 5cm2, and treatment frequency three times per week. The phase time was 15 seconds, with a total treatment time of 45 seconds.</p>
|
|
<p><b>Sham therapy</b> (n=21)</p>
|
|
<p>The same equipment was used with a pen emitting a red guide light and a warning sound, but without the emission of a laser beam. All conditions including indicator lights and sounds in the laser application were therefore identical in both groups, except the laser irradiation, which was not visible.</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>No therapeutic exercises, modalities, or other complementary treatments were provided in order to not interfere with assessment of the individual effectiveness of laser therapy.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab13_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Thumb osteoarthritis</p>
|
|
<p>Mean age (SD): 71 (12) years</p>
|
|
<p>N = 43</p>
|
|
<p>Definition (intervention versus control): American College of Rheumatology diagnosis of thumb carpometacarpal osteoarthritis in dominant hand with a radiographic stage of 1-2.</p>
|
|
<p>Severity: 6.3 (1.2) vs 5.9 (1.1)</p>
|
|
<p>Duration of symptoms (years): not reported</p>
|
|
<p>Presence of multi-morbidities: Not stated/unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab13_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain at ≤3 months</td><td headers="hd_h_niceng226er7.tab13_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab13_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">De Paula Gomes 2020<a class="bibr" href="#niceng226er7.s1.1.ref66" rid="niceng226er7.s1.1.ref66"><sup>66</sup></a></td><td headers="hd_h_niceng226er7.tab13_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Interferential therapy</b> (n=20)</p>
|
|
<p>The sessions were held three times a week, over 8 weeks (24 sessions), on alternate days, lasting approximately 90 minutes each treatment session.</p>
|
|
<p>Interferential therapy (n=20)</p>
|
|
<p>ICT was performed using a premodulated tetrapolar method with a carrier frequency of 4KHz, 1/1s sweep mode, 75 Hz frequency modulation amplitude, 25Hz delta frequency modulation amplitude, and automatic vector mode for 40 minutes.</p>
|
|
<p><b>Short wave therapy</b> (n=20)</p>
|
|
<p>a thermopulse (Ibramed, Amparo, Sao Paolo, Brazil) device set to continuous mode, 27.12MHz frequency and 150W input was used for 20 minutes, and the intensity was defined based on each participant reporting a warm sensation (one sensation, described as soft but pleasant heat).</p>
|
|
<p><b>Laser therapy</b> (n=20)</p>
|
|
<p>Prior to the exercise protocol, participants in the exercise and photobiomodulation (PHOTO) group underwent photobiomodulation therapy using a laserpulse device (Ibramed, Amparo, SP, Brazil). The power of each infrared laser was as follows: wavelength of 904nm, frequency of 9500Hz, pulse duration of 60ns, peak power of 70W, average power of 0.04W, energy density of 6J/cm² applied on eight points, with a total dose of 48J/cm², each session.</p>
|
|
<p><b>Sham electrotherapy</b> (n=20)</p>
|
|
<p><b>No treatment</b> (n=20)</p>
|
|
<p>Exercise therapy only (supervised strength exercises)</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>None of the participants undertook any form of physical therapy, in addition to the one stipulate. In addition they did not use intra-articular, anti-inflammatory or chondroprotective corticosteroids. The use of medications for concomitant diseases was not controlled.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab13_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): Exercise group: 67.85 (4.49) years, exercise+placebo group: 69.4 (4.45) years, exercise+ICT group: 71.85 (2.62) years, exercise+SDT group: 68.45 (4.62) years, exercise+PHOTO group: 65.75 (4.48) years</p>
|
|
<p>N = 100</p>
|
|
<p>Definition: Unilateral knee OA according to American College of Rheumatology criteria, made through examination and the written opinion of a specialist in rheumatic disease.</p>
|
|
<p>Severity (NRS pain score): Exercise group: 6.55 (1.09), exercise+placebo group: 6.50 (0.68), exercise+ICT group: 6.65 (0.98), exercise+SDT group: 6.40 (0.99), exercise+PHOTO group: 6.70 (0.86)</p>
|
|
<p>Duration of symptoms: Not stated/unclear</p>
|
|
<p>Presence of multi-morbidities: Not stated/unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab13_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at ≤3 months</p>
|
|
<p>Physical function at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab13_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab13_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Fukuda 2011<a class="bibr" href="#niceng226er7.s1.1.ref84" rid="niceng226er7.s1.1.ref84"><sup>84</sup></a></td><td headers="hd_h_niceng226er7.tab13_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Laser therapy</b> (n=13)</p>
|
|
<p>Laser (AsGa laser, wavelength 904nm, frequency 700Hz, mean power of 60mW, peak power of 20W, 50 seconds per point, beam area of 0.5cm2) given over 3 weeks</p>
|
|
<p><b>Sham electrotherapy</b> (n=14)</p>
|
|
<p>Placebo laser</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>People with knee pain and reduced functional ability over the preceding three months and a radiographic examination showing knee osteoarthritis of grade 2-4 according to the classification of Kellgren and Lawrence.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab13_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 63.0 (8.6) years</p>
|
|
<p>N = 47</p>
|
|
<p>Definition: People with knee pain and reduced functional ability over the preceding three months and a radiographic examination showing knee osteoarthritis of grade 2-4 according to the classification of Kellgren and Lawrence</p>
|
|
<p>Severity: Kellgren Lawrence grade 2-4, median grade 2</p>
|
|
<p>Duration of symptoms: Not stated</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab13_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain at ≤3 months</td><td headers="hd_h_niceng226er7.tab13_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab13_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Gur 2003<a class="bibr" href="#niceng226er7.s1.1.ref92" rid="niceng226er7.s1.1.ref92"><sup>92</sup></a></td><td headers="hd_h_niceng226er7.tab13_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Laser therapy</b> (n=60)</p>
|
|
<p>Laser (AsGa laser, wavelength 904nm, frequency 700Hz. Either 5 minutes of 3J total dose, or 3 minutes of 2J. Both were combined with exercise. Completed as 10 treatments over 14 weeks.</p>
|
|
<p><b>Sham electrotherapy</b> (n=30)</p>
|
|
<p>Placebo laser</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>All people received exercise therapy that was continued for 14 weeks and involved isometric quadriceps exercise (straight leg raising).</p>
|
|
</td><td headers="hd_h_niceng226er7.tab13_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 59.7 (7.0) years</p>
|
|
<p>N = 90</p>
|
|
<p>Definition: Osteoarthritis according to the American College of Rheumatology criteria and radiographic evidence of knee osteoarthritis of Kelgren-Lawrence grade 2-4</p>
|
|
<p>Severity: Radiographic grade 2-4, median grade 3</p>
|
|
<p>Duration of symptoms (mean [SD]): 57.0 (45.0) months</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab13_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain at ≤3 months</td><td headers="hd_h_niceng226er7.tab13_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab13_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Gworys 2012<a class="bibr" href="#niceng226er7.s1.1.ref93" rid="niceng226er7.s1.1.ref93"><sup>93</sup></a></td><td headers="hd_h_niceng226er7.tab13_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Laser therapy</b> (n=94)</p>
|
|
<p>Laser performed once a day, 5 days a week over 2 weeks. Group 1 received one-wave laser irradiation (wave length 810nm, dose 8J/point, surface density of energy 12.7 J/cm², power 400mW, surface density of power 634.9 mW/cm²) in the continuous mode. Group 2 received MLS laser irradiation (power 1100mW, frequency 2000Hz, dose 12.4 J/point, energy density 6.21 J/cm²). Group 3, received MLS laser irradiation (power 1100mW, frequency 2000Hz, dose 6.6J/point, energy density 3.28J/cm²).</p>
|
|
<p><b>Sham electrotherapy</b> (n=31)</p>
|
|
<p>Placebo laser</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>No additional information</p>
|
|
</td><td headers="hd_h_niceng226er7.tab13_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 64.0 (11.3) years</p>
|
|
<p>N = 125</p>
|
|
<p>Definition: Diagnosis of knee osteoarthritis according to the criteria established by the American College of Rheumatology</p>
|
|
<p>Severity: 2nd degree joint injury according to Seyfried on the basis of clinical examination</p>
|
|
<p>Duration of symptoms: Pain for at least 6 weeks</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab13_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain at ≤3 months</td><td headers="hd_h_niceng226er7.tab13_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab13_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Helianthi 2016<a class="bibr" href="#niceng226er7.s1.1.ref96" rid="niceng226er7.s1.1.ref96"><sup>96</sup></a></td><td headers="hd_h_niceng226er7.tab13_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Laser therapy</b> (n=31)</p>
|
|
<p>Laser acupuncture (output power 50mW, output power 25mW/cm2, wavelength 785nm, dose 4J for 80 seconds at each point) given twice a week for 10 sessions</p>
|
|
<p><b>Sham electrotherapy</b> (n=31)</p>
|
|
<p>Placebo laser</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>People were allowed to take paracetamol as required for severe pain (with a maximum dose of 4g/day).</p>
|
|
</td><td headers="hd_h_niceng226er7.tab13_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 69 (5) years</p>
|
|
<p>N = 62</p>
|
|
<p>Definition: People with grade 2 and grade 3 knee osteoarthritis based on the Kellgren-Lawrence grading scale, either unilateral or bilateral and who also had average pain intensity of more than 40 on a 100mm visual analogue scale</p>
|
|
<p>Severity: Grade 2-3 (median grade 3)</p>
|
|
<p>Duration of symptoms: Not stated</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab13_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain at ≤3 months</td><td headers="hd_h_niceng226er7.tab13_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab13_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Hinman 2014<a class="bibr" href="#niceng226er7.s1.1.ref97" rid="niceng226er7.s1.1.ref97"><sup>97</sup></a></td><td headers="hd_h_niceng226er7.tab13_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Laser therapy</b> (n=71)</p>
|
|
<p>Laser acupuncture (measured output 10mW, energy output 0.2J/point) given over 12 weeks</p>
|
|
<p><b>Sham electrotherapy</b> (n=70)</p>
|
|
<p>Placebo laser</p>
|
|
<p><b>No treatment</b> (n=71)</p>
|
|
<p>A fourth group (n=70) was not included as it did not fulfil the inclusion criteria for this review.</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>No additional information</p>
|
|
</td><td headers="hd_h_niceng226er7.tab13_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 63.6 (8.4) years</p>
|
|
<p>N = 282</p>
|
|
<p>Definition: Knee pain of longer than 3 months duration, knee pain on most days with average severity of 4 or more out of 10 on a numeric rating scale, and had morning stiffness lasting less than 30 minutes (consistent with a clinical diagnosis of osteoarthritis)</p>
|
|
<p>Severity: Not stated</p>
|
|
<p>Duration of symptoms: Median 5-<10 years</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab13_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Quality of life at ≤3 months and >3 months</p>
|
|
<p>Pain at ≤3 months and >3 months</p>
|
|
<p>Physical function at ≤3 months and >3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab13_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab13_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Hsieh 2012<a class="bibr" href="#niceng226er7.s1.1.ref100" rid="niceng226er7.s1.1.ref100"><sup>100</sup></a></td><td headers="hd_h_niceng226er7.tab13_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Laser therapy</b> (n=37)</p>
|
|
<p>Short-term monochromatic infrared energy (radiant power at 6.24W, gallium-aluminium arsenide diodes, 890nm, 40 minutes of treatment) achieved 3 times a week for 2 weeks</p>
|
|
<p><b>Sham electrotherapy</b> (n=35)</p>
|
|
<p>Placebo laser</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>No additional information</p>
|
|
</td><td headers="hd_h_niceng226er7.tab13_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 61.2 (10.7) years</p>
|
|
<p>N = 72</p>
|
|
<p>Definition: Combined clinical and radiographic criteria of knee osteoarthritis, as established by the American college of Rheumatology</p>
|
|
<p>Severity: Kellgren Lawrence scores of 2 or greater in both knees</p>
|
|
<p>Duration of symptoms: Not stated</p>
|
|
<p>Presence of multimorbidities: High morbidity score</p>
|
|
</td><td headers="hd_h_niceng226er7.tab13_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Quality of life at ≤3 months</p>
|
|
<p>Pain at ≤3 months</p>
|
|
<p>Physical function at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab13_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab13_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Kheshie 2014<a class="bibr" href="#niceng226er7.s1.1.ref120" rid="niceng226er7.s1.1.ref120"><sup>120</sup></a></td><td headers="hd_h_niceng226er7.tab13_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Laser therapy</b> (n=38)</p>
|
|
<p>High or low intensity laser therapy. High intensity (using a Nd:YAG laser, 1250J through three treatment phases) and low intensity (using a gallium-arsenide diode laser, 830nm wavelength, 800mW output power, average energy density of 50J/cm2, frequency of 1kHz, duty cycle of 80%).</p>
|
|
<p><b>Sham electrotherapy</b> (n=15)</p>
|
|
<p>Placebo laser</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>All groups received an exercise program consisting of active range of motion exercises, muscle strengthening, and flexibility exercises. These were completed in a supervised form and at home.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab13_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 54.6 (8.49) years</p>
|
|
<p>N = 53</p>
|
|
<p>Definition: Painful knee osteoarthritis for at least 6 months with degenerative osteoarthritic knee of grade 2-3 or less based on radiographic diagnosis in the Kellgren and Lawrence grading of osteoarthritis</p>
|
|
<p>Severity: Radiographic grade 2-3, median grade 2</p>
|
|
<p>Duration of symptoms: At least 3 months</p>
|
|
<p>Presence of multimorbidities: Not stated/unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab13_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at ≤3 months</p>
|
|
<p>Physical function at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab13_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab13_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Madani 2014<a class="bibr" href="#niceng226er7.s1.1.ref146" rid="niceng226er7.s1.1.ref146"><sup>146</sup></a></td><td headers="hd_h_niceng226er7.tab13_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Laser therapy</b> (n=10)</p>
|
|
<p>Active laser treatment (810nm wavelength, 50mW average page, pulse repetition rate of 1500Hz, pulse length of 1 microsecond, 6J per point, 3.4J/cm2, spot size 1.76cm2, 2 minutes per point). 3 times a week for 4 weeks.</p>
|
|
<p><b>Sham electrotherapy</b> (n=10)</p>
|
|
<p>Placebo laser</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>No additional information.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab13_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Temporomandibular joint osteoarthritis</b>
|
|
</p>
|
|
<p>Age range: 35-60 years</p>
|
|
<p>N = 20</p>
|
|
<p>Definition: People with limited mandibular movements, and suffered from arthralgia and crepitation, especially in the late afternoon or evening, based on the Research Diagnostic Criteria for Temporomandibular Disorders and confirmed through cone beam-computed tomography images taken from the TMJs</p>
|
|
<p>Severity: Not stated</p>
|
|
<p>Duration of symptoms: Not stated</p>
|
|
<p>Presence of multimorbidities: Not stated/unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab13_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain at ≤3 months</td><td headers="hd_h_niceng226er7.tab13_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab13_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Mahler 2019<a class="bibr" href="#niceng226er7.s1.1.ref148" rid="niceng226er7.s1.1.ref148"><sup>148</sup></a></td><td headers="hd_h_niceng226er7.tab13_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Laser therapy</b> (n=27)</p>
|
|
<p>Laser therapy consisting of a total dose of 6 Gray, applied in 6 fractions of 1 Gray, delivered every other weekday over 2 weeks.</p>
|
|
<p><b>Sham electrotherapy</b> (n=28)</p>
|
|
<p>Sham laser delivering 0 Gray</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>No additional information</p>
|
|
</td><td headers="hd_h_niceng226er7.tab13_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 65 (10) years</p>
|
|
<p>N = 55</p>
|
|
<p>Definition: American College of Rheumatology knee osteoarthritis criteria</p>
|
|
<p>Severity: The majority had a Kellgren Lawrence score of at least 2</p>
|
|
<p>Duration of symptoms: The majority had symptoms for less than or equal to 5 years</p>
|
|
<p>Presence of multimorbidities: Low morbidity score</p>
|
|
</td><td headers="hd_h_niceng226er7.tab13_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Quality of life at ≤3 months</p>
|
|
<p>Pain at ≤3 months</p>
|
|
<p>Physical function at ≤3 months</p>
|
|
<p>Mild adverse events at ≤3 months</p>
|
|
<p>Moderate/major adverse events at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab13_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab13_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Marquina 2012<a class="bibr" href="#niceng226er7.s1.1.ref150" rid="niceng226er7.s1.1.ref150"><sup>150</sup></a></td><td headers="hd_h_niceng226er7.tab13_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Laser therapy</b> (n=27)</p>
|
|
<p>Laser treatment (905nm, 50000mW peak power, up to 100mW average power, 200ns pulse width, up to 10000Hz frequency) and four 660nm visible red laser diodes (25 mW average power). Delivered as 3 treatments per week over 4 weeks</p>
|
|
<p><b>Sham electrotherapy</b> (n=28)</p>
|
|
<p>Sham laser with no near-IR optical output and instead only using visible red laser diodes.</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>No additional information</p>
|
|
</td><td headers="hd_h_niceng226er7.tab13_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Age (range): 25-80 years</p>
|
|
<p>N = 126</p>
|
|
<p>Definition: People with chronic knee pain</p>
|
|
<p>Severity: Not stated</p>
|
|
<p>Duration of symptoms: Not stated</p>
|
|
<p>Presence of multimorbidities: Not stated/unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab13_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain at ≤3 months</td><td headers="hd_h_niceng226er7.tab13_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab13_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Shen 2009<a class="bibr" href="#niceng226er7.s1.1.ref193" rid="niceng226er7.s1.1.ref193"><sup>193</sup></a></td><td headers="hd_h_niceng226er7.tab13_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Laser therapy</b> (n=20)</p>
|
|
<p>Laser acupuncture (two lasers, one 0.65-0.66 micrometer with an output power of 36mW, the other a 10.6 micrometer carbon dioxide laser with an output power of 200mW, pulse frequency of 20Hz, duty factor of 50%) given for 20 minutes three times a week for 4 weeks</p>
|
|
<p><b>Sham electrotherapy</b> (n=20)</p>
|
|
<p>Placebo laser</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>No additional information</p>
|
|
</td><td headers="hd_h_niceng226er7.tab13_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 58.3 (7.4) years</p>
|
|
<p>N = 40</p>
|
|
<p>Definition: Diagnosis of osteoarthritis, radiographic evidence of at least one osteophyte at the tibiofemoral joint, Kellgren-Lawrence grade at least 2, moderate or greater clinically significant knee pain on most days during the previous month</p>
|
|
<p>Severity: Kellgren Lawrence grade of at least 2</p>
|
|
<p>Duration of symptoms (mean [SD]): 5.2 (6.6) years</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab13_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at ≤3 months</p>
|
|
<p>Physical function at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab13_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab13_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Yurtkuran 2007<a class="bibr" href="#niceng226er7.s1.1.ref229" rid="niceng226er7.s1.1.ref229"><sup>229</sup></a></td><td headers="hd_h_niceng226er7.tab13_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Laser therapy</b> (n=28)</p>
|
|
<p>Laser acupuncture (infrared 27 GaAs diode laser, output power 4mW, 10mW/cm2 power density, 0.4cm2 spot size, 120s treatment time, 0.48J dose per session). This was delivered in pulses (1 pulse per 200nanoseconds). Delivered 5 times per week over 2 weeks.</p>
|
|
<p><b>Sham electrotherapy</b> (n=27)</p>
|
|
<p>Placebo laser</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>All people received exercise, consisting of 10 sets of isometric contraction to quadriceps muscle and active range of motion exercises (20 repetitions) for knee. They were instructed not to use any analgesic or non-steroidal anti-inflammatory drugs during the follow-up period</p>
|
|
</td><td headers="hd_h_niceng226er7.tab13_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 52.6 (7.0) years</p>
|
|
<p>N = 55</p>
|
|
<p>Definition: People with knee osteoarthritis diagnosed according to the American College of Rheumatology criteria, with Kellgren Lawrence grade 2-3 knee osteoarthritis and an average pain intensity of 40 or more on a 100mm visual analogue scale for the last month before baseline assessment</p>
|
|
<p>Severity: Kellgren Lawrence grade 2-3</p>
|
|
<p>Duration of symptoms (mean [SD]): 64.0 (55.0) months</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab13_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Quality of life at ≤3 months</p>
|
|
<p>Pain at ≤3 months</p>
|
|
<p>Physical function at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab13_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab14"><div id="niceng226er7.tab14" class="table"><h3><span class="label">Table 14</span><span class="title">Summary of studies included in the laser therapy compared to no treatment comparison</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab14/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab14_lrgtbl__"><table><thead><tr><th id="hd_h_niceng226er7.tab14_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study</th><th id="hd_h_niceng226er7.tab14_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention and comparison</th><th id="hd_h_niceng226er7.tab14_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><th id="hd_h_niceng226er7.tab14_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes</th><th id="hd_h_niceng226er7.tab14_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comments</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab14_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Alayat 2017<a class="bibr" href="#niceng226er7.s1.1.ref8" rid="niceng226er7.s1.1.ref8"><sup>8</sup></a></td><td headers="hd_h_niceng226er7.tab14_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Laser therapy</b> (n=25)</p>
|
|
<p>High-intensity laser therapy using a pulsed Nd:YAG laser (wavelength 1064nm, average power 10.5W, fluency 510-1780mJ/cm2, pulsed duration <120µs, probe diameter of 0.5cm, spot size of 0.2cm2) with glucosamine sulfate, chondroitin sulfate and exercise. Laser given twice a week for 6 weeks.</p>
|
|
<p><b>No treatment</b> (n=25)</p>
|
|
<p>Exercise, glucosamine sulfate and chondroitin sulfate only</p>
|
|
<p>A third group (n=25) was reported but not included in the analysis as it did not fulfil the inclusion criteria.</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>Hot packs were allowed after exercise in cases of muscle soreness or pain.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab14_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 53.9 (4.5) years</p>
|
|
<p>N = 75</p>
|
|
<p>Definition: People with a degenerative osteoarthritic knee of grade 3 or less based on the Kellgren and Lawrence classification</p>
|
|
<p>Severity: Kellgren Lawrence grades 3 or less</p>
|
|
<p>Duration of symptoms: Not stated</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab14_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at ≤3 months</p>
|
|
<p>Physical function at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab14_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab14_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">De matos brunelli braghin 2018<a class="bibr" href="#niceng226er7.s1.1.ref64" rid="niceng226er7.s1.1.ref64"><sup>64</sup></a></td><td headers="hd_h_niceng226er7.tab14_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Laser therapy (no additional treatment)</b> (n=15)</p>
|
|
<p>Low level laser therapy (wavelength 808nm, 0.028cm2 spot area, 100mW power output, fluence of 200J/cm2, energy per point of 5.6J) for 2 months.</p>
|
|
<p><b>Laser therapy (with additional treatment)</b> (n=15)</p>
|
|
<p>Low level laser therapy (wavelength 808nm, 0.028cm2 spot area, 100mW power output, fluence of 200J/cm2, energy per point of 5.6J) for 2 months and exercise therapy.</p>
|
|
<p><b>No treatment (no additional treatment)</b> (n=15)</p>
|
|
<p>No treatment</p>
|
|
<p><b>No treatment (with additional treatment)</b> (n=15)</p>
|
|
<p>Exercise therapy only</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>No additional information</p>
|
|
</td><td headers="hd_h_niceng226er7.tab14_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 60.5 (8.0) years</p>
|
|
<p>N = 60</p>
|
|
<p>Definition: Knee osteoarthritis with a radiographic diagnosis (Kellgren Lawrence grade 1-3)</p>
|
|
<p>Severity: Kellgren Lawrence grade 1-3</p>
|
|
<p>Duration of symptoms: Not stated</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab14_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at ≤3 months</p>
|
|
<p>Physical function at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab14_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">In the final analysis, the two laser therapy groups were pooled and the two no treatment groups were pooled.</td></tr><tr><td headers="hd_h_niceng226er7.tab14_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">De Paula Gomes 2020<a class="bibr" href="#niceng226er7.s1.1.ref66" rid="niceng226er7.s1.1.ref66"><sup>66</sup></a></td><td headers="hd_h_niceng226er7.tab14_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Interferential therapy</b> (n=20)</p>
|
|
<p>The sessions were held three times a week, over 8 weeks (24 sessions), on alternate days, lasting approximately 90 minutes each treatment session.</p>
|
|
<p>Interferential therapy (n=20)</p>
|
|
<p>ICT was performed using a premodulated tetrapolar method with a carrier frequency of 4KHz, 1/1s sweep mode, 75 Hz frequency modulation amplitude, 25Hz delta frequency modulation amplitude, and automatic vector mode for 40 minutes.</p>
|
|
<p><b>Short wave therapy</b> (n=20)</p>
|
|
<p>a thermopulse (Ibramed, Amparo, Sao Paolo, Brazil) device set to continuous mode, 27.12MHz frequency and 150W input was used for 20 minutes, and the intensity was defined based on each participant reporting a warm sensation (one sensation, described as soft but pleasant heat).</p>
|
|
<p><b>Laser therapy</b> (n=20)</p>
|
|
<p>Prior to the exercise protocol, participants in the exercise and photobiomodulation (PHOTO) group underwent photobiomodulation therapy using a laserpulse device (Ibramed, Amparo, SP, Brazil). The power of each infrared laser was as follows: wavelength of 904nm, frequency of 9500Hz, pulse duration of 60ns, peak power of 70W, average power of 0.04W, energy density of 6J/cm² applied on eight points, with a total dose of 48J/cm², each session.</p>
|
|
<p><b>Sham electrotherapy</b> (n=20)</p>
|
|
<p><b>No treatment</b> (n=20)</p>
|
|
<p>Exercise therapy only (supervised strength exercises)</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>None of the participants undertook any form of physical therapy, in addition to the one stipulate. In addition they did not use intra-articular, anti-inflammatory or chondroprotective corticosteroids. The use of medications for concomitant diseases was not controlled.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab14_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): Exercise group: 67.85 (4.49) years, exercise+placebo group: 69.4 (4.45) years, exercise+ICT group: 71.85 (2.62) years, exercise+SDT group: 68.45 (4.62) years, exercise+PHOTO group: 65.75 (4.48) years</p>
|
|
<p>N = 100</p>
|
|
<p>Definition: Unilateral knee OA according to American College of Rheumatology criteria, made through examination and the written opinion of a specialist in rheumatic disease.</p>
|
|
<p>Severity (NRS pain score): Exercise group: 6.55 (1.09), exercise+placebo group: 6.50 (0.68), exercise+ICT group: 6.65 (0.98), exercise+SDT group: 6.40 (0.99), exercise+PHOTO group: 6.70 (0.86)</p>
|
|
<p>Duration of symptoms: Not stated/unclear</p>
|
|
<p>Presence of multi-morbidities: Not stated/unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab14_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at ≤3 months</p>
|
|
<p>Physical function at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab14_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab14_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Hinman 2014<a class="bibr" href="#niceng226er7.s1.1.ref97" rid="niceng226er7.s1.1.ref97"><sup>97</sup></a></td><td headers="hd_h_niceng226er7.tab14_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Laser therapy</b> (n=71)</p>
|
|
<p>Laser acupuncture (measured output 10mW, energy output 0.2J/point) given over 12 weeks</p>
|
|
<p><b>Sham electrotherapy</b> (n=70)</p>
|
|
<p>Placebo laser</p>
|
|
<p><b>No treatment</b> (n=71)</p>
|
|
<p>A fourth group (n=70) was not included as it did not fulfil the inclusion criteria for this review.</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>No additional information</p>
|
|
</td><td headers="hd_h_niceng226er7.tab14_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 63.6 (8.4) years</p>
|
|
<p>N = 282</p>
|
|
<p>Definition: Knee pain of longer than 3 months duration, knee pain on most days with average severity of 4 or more out of 10 on a numeric rating scale, and had morning stiffness lasting less than 30 minutes (consistent with a clinical diagnosis of osteoarthritis)</p>
|
|
<p>Severity: Not stated</p>
|
|
<p>Duration of symptoms: Median 5-<10 years</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab14_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Quality of life at ≤3 months and >3 months</p>
|
|
<p>Pain at ≤3 months and >3 months</p>
|
|
<p>Physical function at ≤3 months and >3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab14_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab15"><div id="niceng226er7.tab15" class="table"><h3><span class="label">Table 15</span><span class="title">Summary of studies included in the transcutaneous electrical nerve stimulation compared to pulsed short-wave therapy comparison</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab15/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab15_lrgtbl__"><table><thead><tr><th id="hd_h_niceng226er7.tab15_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study</th><th id="hd_h_niceng226er7.tab15_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention and comparison</th><th id="hd_h_niceng226er7.tab15_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><th id="hd_h_niceng226er7.tab15_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes</th><th id="hd_h_niceng226er7.tab15_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comments</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab15_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Atamaz 2012<a class="bibr" href="#niceng226er7.s1.1.ref22" rid="niceng226er7.s1.1.ref22"><sup>22</sup></a></td><td headers="hd_h_niceng226er7.tab15_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Transcutaneous electrical nerve stimulation</b> (n=37)</p>
|
|
<p>TENS (frequency 80Hz, 10-30mA intensity) for 20 minutes three times a week for 3 weeks</p>
|
|
<p><b>Interferential therapy</b> (n=31)</p>
|
|
<p>Interferential currents (frequency 100Hz generated by 4kHz sinusoidal waves) for 3 weeks</p>
|
|
<p><b>Pulsed short-wave therapy</b> (n=32)</p>
|
|
<p>Pulsed short-wave diathermy (10cm diameter condenser plate, frequency 27.12mHz, input 300W, mean output 3.2W) for 3 weeks</p>
|
|
<p><b>Sham electrotherapy (TENS)</b> (n=37)</p>
|
|
<p>Sham TENS</p>
|
|
<p><b>Sham electrotherapy (interferential therapy)</b> (n=35)</p>
|
|
<p>Sham interferential therapy</p>
|
|
<p><b>Sham electrotherapy (pulsed short-wave therapy)</b> (n=31)</p>
|
|
<p>Sham pulsed short-wave therapy</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>All people had an exercise program conducted in groups of 4-5 people three times a week for 3 weeks involving stretching, isometric quadriceps exercises and chair lift/minisquats. This was supplemented with additional instruction for home exercise. All people also attended an education program consisting of one 1 hour session discussing the functional anatomy of the knee, ergonomic principles, and understanding of osteoarthritis.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab15_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 61.5 (7.5) years</p>
|
|
<p>N = 203</p>
|
|
<p>Definition: People with knee osteoarthritis according to the American College of Rheumatology criteria with radiologically confirmation with a Kellgren Lawrence grade of 2 or 3</p>
|
|
<p>Severity: Kellgren Lawrence grade 2-3</p>
|
|
<p>Duration of symptoms (mean [SD]): 43.7 (49.1) months.</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab15_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at ≤3 months and >3 months</p>
|
|
<p>Physical function at ≤3 months and >3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab15_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab15_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cetin 2008<a class="bibr" href="#niceng226er7.s1.1.ref44" rid="niceng226er7.s1.1.ref44"><sup>44</sup></a></td><td headers="hd_h_niceng226er7.tab15_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Pulsed short-wave therapy</b> (n=20)</p>
|
|
<p>Short-wave diathermy, hot packs and isokinetic exercise using a frequency of 27.12 MHz for 15 minutes per knee 3 times a week for 8 weeks</p>
|
|
<p><b>Transcutaneous electrical nerve stimulation</b> (n=20)</p>
|
|
<p>TENS, hot packs and isokinetic exercise. Unit set to 60-100Hz, pulse duration set to 60ms for 24 sessions, 3 times a week for 8 weeks.</p>
|
|
<p><b>Ultrasound</b> (n=20)</p>
|
|
<p>Ultrasound, hot packs and isokinetic exercise. 1MHz ultrasound head, intensity of 1.5W/cm2, 3 times a week for 8 weeks</p>
|
|
<p><b>No treatment</b> (n=20)</p>
|
|
<p>Hot pack and isokinetic exercise only</p>
|
|
<p>A fifth group (n=20) was reported by not included as it did not fulfil the inclusion criteria</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>After application of physical agents, each person underwent individual warm up exercises on a stationary bike set for 20 cycles/min for 5 mins before undergoing muscle-strengthening exercises. People were instructed to continue taking any current medications and not to start any new therapies for knee osteoarthritis during the 8 week studies.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab15_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 59.8 (9.2) years</p>
|
|
<p>N = 100</p>
|
|
<p>Definition: Defined by the American College of Rheumatology with radiographic confirmation</p>
|
|
<p>Severity: Radiographic grade 1-4, median grade 3</p>
|
|
<p>Duration of symptoms: Not stated</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab15_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain at ≤3 months</td><td headers="hd_h_niceng226er7.tab15_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab16"><div id="niceng226er7.tab16" class="table"><h3><span class="label">Table 16</span><span class="title">Summary of studies included in the transcutaneous electrical nerve stimulation compared to interferential therapy comparison</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab16/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab16_lrgtbl__"><table><thead><tr><th id="hd_h_niceng226er7.tab16_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study</th><th id="hd_h_niceng226er7.tab16_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention and comparison</th><th id="hd_h_niceng226er7.tab16_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><th id="hd_h_niceng226er7.tab16_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes</th><th id="hd_h_niceng226er7.tab16_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comments</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab16_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Atamaz 2012<a class="bibr" href="#niceng226er7.s1.1.ref22" rid="niceng226er7.s1.1.ref22"><sup>22</sup></a></td><td headers="hd_h_niceng226er7.tab16_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Transcutaneous electrical nerve stimulation</b> (n=37)</p>
|
|
<p>TENS (frequency 80Hz, 10-30mA intensity) for 20 minutes three times a week for 3 weeks</p>
|
|
<p><b>Interferential therapy</b> (n=31)</p>
|
|
<p>Interferential currents (frequency 100Hz generated by 4kHz sinusoidal waves) for 3 weeks</p>
|
|
<p><b>Pulsed short-wave therapy</b> (n=32)</p>
|
|
<p>Pulsed short-wave diathermy (10cm diameter condenser plate, frequency 27.12mHz, input 300W, mean output 3.2W) for 3 weeks</p>
|
|
<p><b>Sham electrotherapy (TENS)</b> (n=37)</p>
|
|
<p>Sham TENS</p>
|
|
<p><b>Sham electrotherapy (interferential therapy)</b> (n=35)</p>
|
|
<p>Sham interferential therapy</p>
|
|
<p><b>Sham electrotherapy (pulsed short-wave therapy)</b> (n=31)</p>
|
|
<p>Sham pulsed short-wave therapy</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>All people had an exercise program conducted in groups of 4-5 people three times a week for 3 weeks involving stretching, isometric quadriceps exercises and chair lift/minisquats. This was supplemented with additional instruction for home exercise. All people also attended an education program consisting of one 1 hour session discussing the functional anatomy of the knee, ergonomic principles, and understanding of osteoarthritis.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab16_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 61.5 (7.5) years</p>
|
|
<p>N = 203</p>
|
|
<p>Definition: People with knee osteoarthritis according to the American College of Rheumatology criteria with radiologically confirmation with a Kellgren Lawrence grade of 2 or 3</p>
|
|
<p>Severity: Kellgren Lawrence grade 2-3</p>
|
|
<p>Duration of symptoms (mean [SD]): 43.7 (49.1) months.</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab16_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at ≤3 months and >3 months</p>
|
|
<p>Physical function at ≤3 months and >3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab16_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab16_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Burch 2008<a class="bibr" href="#niceng226er7.s1.1.ref38" rid="niceng226er7.s1.1.ref38"><sup>38</sup></a></td><td headers="hd_h_niceng226er7.tab16_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Interferential therapy</b> (n=57)</p>
|
|
<p>Interferential therapy with patterned stimulation (15 minutes, base frequency 500Hz, premodulated beat frequency sweeping between 1 and 150Hz, patterned muscle stimulation delivered as 50hz impulses for 200ms every 1500ms with a biphasic square waveform with a fixed amplitude of 50mA, stimulation intensity pulse width ranging from 3.39 to 102.2 microseconds) for 8 weeks</p>
|
|
<p><b>Transcutaneous electrical nerve stimulation</b> (n=59)</p>
|
|
<p>Low current TENS for 35 minutes (biphasic square wave, 0.2Hz frequency, fixed amplitude of 60mA, pulse width adjusted to provide a net output of 73nC, delivered across 300microseconds, peak output 0.5mA) for 1 session daily over 8 weeks</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>Stable doses of medications were permitted.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab16_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 61.7 (11.0) years</p>
|
|
<p>N = 116</p>
|
|
<p>Definition: Evidence of osteoarthritis in more than one joint based on a physician’s assessment of patient-reported symptoms and a differential diagnosis of radiographic evidence</p>
|
|
<p>Severity: Not stated</p>
|
|
<p>Duration of symptoms (mean [SD]): 8.3 (7.9) years</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab16_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at ≤3 months</p>
|
|
<p>Physical function at ≤3 months</p>
|
|
<p>Mild adverse events at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab16_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab17"><div id="niceng226er7.tab17" class="table"><h3><span class="label">Table 17</span><span class="title">Summary of studies included in transcutaneous electrical nerve stimulation compared to sham electrotherapy comparison</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab17/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab17_lrgtbl__"><table><thead><tr><th id="hd_h_niceng226er7.tab17_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study</th><th id="hd_h_niceng226er7.tab17_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention and comparison</th><th id="hd_h_niceng226er7.tab17_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><th id="hd_h_niceng226er7.tab17_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes</th><th id="hd_h_niceng226er7.tab17_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comments</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab17_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Altay 2010<a class="bibr" href="#niceng226er7.s1.1.ref17" rid="niceng226er7.s1.1.ref17"><sup>17</sup></a></td><td headers="hd_h_niceng226er7.tab17_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Transcutaneous electrical nerve stimulation</b> (n=20)</p>
|
|
<p>TENS using two electrodes applied to painful areas on the knee (frequency 100Hz, pulse time 200, current strength 2035mA) for 40 minutes a day for 3 weeks</p>
|
|
<p><b>Sham electrotherapy</b> (n=20)</p>
|
|
<p>Sham TENS device (switched on but delivered no current)</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>All people received an exercise program for 30 minutes and hot packs for 15 minutes in a day for 3 weeks.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab17_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 59.5 (9.0) years</p>
|
|
<p>N = 20</p>
|
|
<p>Definition: Primary knee osteoarthritis according to the American college of Rheumatology criteria confirmed with standing anteroposterior and lateral radiographs of both knees</p>
|
|
<p>Severity: Kellgren Lawrence grade <4</p>
|
|
<p>Duration of symptoms (mean [SD]): 7.9 (5.9) years</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab17_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life at ≤3 months</td><td headers="hd_h_niceng226er7.tab17_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab17_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Atamaz 2012<a class="bibr" href="#niceng226er7.s1.1.ref22" rid="niceng226er7.s1.1.ref22"><sup>22</sup></a></td><td headers="hd_h_niceng226er7.tab17_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Transcutaneous electrical nerve stimulation</b> (n=37)</p>
|
|
<p>TENS (frequency 80Hz, 10-30mA intensity) for 20 minutes three times a week for 3 weeks</p>
|
|
<p><b>Interferential therapy</b> (n=31)</p>
|
|
<p>Interferential currents (frequency 100Hz generated by 4kHz sinusoidal waves) for 3 weeks</p>
|
|
<p><b>Pulsed short-wave therapy</b> (n=32)</p>
|
|
<p>Pulsed short-wave diathermy (10cm diameter condenser plate, frequency 27.12mHz, input 300W, mean output 3.2W) for 3 weeks</p>
|
|
<p><b>Sham electrotherapy (TENS)</b> (n=37)</p>
|
|
<p>Sham TENS</p>
|
|
<p><b>Sham electrotherapy (interferential therapy)</b> (n=35)</p>
|
|
<p>Sham interferential therapy</p>
|
|
<p><b>Sham electrotherapy (pulsed short-wave therapy)</b> (n=31)</p>
|
|
<p>Sham pulsed short-wave therapy</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>All people had an exercise program conducted in groups of 4-5 people three times a week for 3 weeks involving stretching, isometric quadriceps exercises and chair lift/minisquats. This was supplemented with additional instruction for home exercise. All people also attended an education program consisting of one 1 hour session discussing the functional anatomy of the knee, ergonomic principles, and understanding of osteoarthritis.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab17_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 61.5 (7.5) years</p>
|
|
<p>N = 203</p>
|
|
<p>Definition: People with knee osteoarthritis according to the American College of Rheumatology criteria with radiologically confirmation with a Kellgren Lawrence grade of 2 or 3</p>
|
|
<p>Severity: Kellgren Lawrence grade 2-3</p>
|
|
<p>Duration of symptoms (mean [SD]): 43.7 (49.1) months.</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab17_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at ≤3 months and >3 months</p>
|
|
<p>Physical function at ≤3 months and >3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab17_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab17_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Inal 2016<a class="bibr" href="#niceng226er7.s1.1.ref107" rid="niceng226er7.s1.1.ref107"><sup>107</sup></a></td><td headers="hd_h_niceng226er7.tab17_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Transcutaneous electrical nerve stimulation</b> (n=60)</p>
|
|
<p>TENS over 10 sessions (5 sessions per week). This was achieved in two doses, 4Hz and 100Hz.</p>
|
|
<p><b>Sham electrotherapy</b> (n=30)</p>
|
|
<p>Sham TENS</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>All people had physical therapy in the inpatient clinic and were educated primarily about the harmful movements and conditions for her knees. This included hot pack, therapeutic ultrasonography, TENS and exercise programs. Hot packs were applied during 20 minutes to both knees of the people. Therapeutic ultrasound was performed separately to both knees during 5 minutes with a stimulation of 1.5W/cm². Exercise programs consisted of three sessions of range of motion, quadriceps isometric and isotonic exercises in a day with 20 repetition of each exercise in each session. After ten sessions of physical therapy in the hospital the people were discharged with a home exercise program.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab17_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SE): Placebo = 64.6 (1.88) years, 4Hz TENS = 64.4 (1.70) years, 100Hz TENS = 64.1 (0.99) years.</p>
|
|
<p>N = 90</p>
|
|
<p>Definition: Symptomatic knee osteoarthritis according to the American College of Rheumatology criteria</p>
|
|
<p>Severity: Radiographic grade 2-4, median grade 3</p>
|
|
<p>Duration of symptoms (median [range]): Placebo = 48 (24-120) months, 4Hz TENS = 48 (16.5-120), 100Hz TENS = 30 (12-75)</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab17_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at ≤3 months</p>
|
|
<p>Physical function at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab17_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab17_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Law 2004<a class="bibr" href="#niceng226er7.s1.1.ref132" rid="niceng226er7.s1.1.ref132"><sup>132</sup></a></td><td headers="hd_h_niceng226er7.tab17_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Transcutaneous electrical nerve stimulation</b> (n=38)</p>
|
|
<p>TENS for 40 minutes (frequency 2Hz, pulse width 200microseconds, alternating frequencies of 2Hz and 100Hz). The current was adjusted from 25mA to 35mA. Conducted over 2 weeks.</p>
|
|
<p><b>Sham electrotherapy</b> (n=10)</p>
|
|
<p>Sham TENS</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>No additional information</p>
|
|
</td><td headers="hd_h_niceng226er7.tab17_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 82.5 (6.3) years</p>
|
|
<p>N = 48</p>
|
|
<p>Definition: Osteoarthritis of the knee with at least grade 2 changes on their x-rays</p>
|
|
<p>Severity: Osteoarthritis grade 2 radiographic changes</p>
|
|
<p>Duration of symptoms (mean [SD]): 8.7 (9.7) years</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab17_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain at ≤3 months</td><td headers="hd_h_niceng226er7.tab17_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab17_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Palmer 2014<a class="bibr" href="#niceng226er7.s1.1.ref169" rid="niceng226er7.s1.1.ref169"><sup>169</sup></a></td><td headers="hd_h_niceng226er7.tab17_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Transcutaneous electrical nerve stimulation</b> (n=73)</p>
|
|
<p>TENS delivered through a continuous mode (program A: 110Hz, 50 microseconds), delivered with asymmetric and biphasic pulses</p>
|
|
<p><b>Sham electrotherapy</b> (n=74)</p>
|
|
<p>Sham TENS (same device type but released no current)</p>
|
|
<p>A third group (n=77) was reported but not included as it did not fulfil the inclusion criteria.</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>All people received a knee exercise and education program. This was a 6 week program involving a group of up to 12 people attending for 1 hour (30 minutes of education and 30 minutes of group exercise) on 6 consecutive weeks. The education program aimed to enhance people’s ability to self-manage their condition. The education program included information on setting personal objectives, pacing, managing flares, diet, medical management of osteoarthritis, local community exercise opportunities and long-term exercise adherence. The exercise component included a 5 minute warm up followed by a circuit of exercises aimed at improving lower extremity strength, proprioception and function. Each exercise had specific ideas for progression that people advanced as able to over the 6 weeks. All people were taught home exercises during the second session and advised to perform them daily. These included step ups, sit to stand, balancing on one leg, and heel to toe walking. This was supported by a booklet containing written advice on the topics covered in the education session, details of the home exercises and tools to aid goal setting</p>
|
|
</td><td headers="hd_h_niceng226er7.tab17_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 61.4 (10.5) years</p>
|
|
<p>N = 224</p>
|
|
<p>Definition: Knee osteoarthritis confirmed by the American College of Rheumatology clinical criteria (including knee pain accompanied by at least 3 out of 6 signs and symptoms [age >50 years, stiffness <30 minutes, crepitus, body tenderness, bony enlargement and no palpable warmth)</p>
|
|
<p>Severity: Not stated</p>
|
|
<p>Duration of symptoms (mean [SD]): 4.0 (8.7) years</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab17_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at ≤3 months and >3 months</p>
|
|
<p>Physical function at ≤3 months and >3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab17_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab17_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pietrosimone 2011<a class="bibr" href="#niceng226er7.s1.1.ref178" rid="niceng226er7.s1.1.ref178"><sup>178</sup></a></p>
|
|
<p>Subsidiary study: Pietrosimone 2010<a class="bibr" href="#niceng226er7.s1.1.ref176" rid="niceng226er7.s1.1.ref176"><sup>176</sup></a></p>
|
|
</td><td headers="hd_h_niceng226er7.tab17_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Transcutaneous electrical nerve stimulation</b> (n=12)</p>
|
|
<p>TENS as a 150Hz biphasic pulsatile current, with a phase duration of 150microseconds. People were allowed to increase or decrease the amplitude from 1 to 60mA.</p>
|
|
<p><b>Sham electrotherapy</b> (n=12)</p>
|
|
<p>Sham TENS</p>
|
|
<p><b>No treatment</b> (n=12)</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>Therapeutic exercise was available to all participants including quadriceps strengthening lower extremity exercises 3 times a week for 4 weeks, for a total of 12 sessions.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab17_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Age not stated</p>
|
|
<p>N = 36</p>
|
|
<p>Definition: People with a clinical diagnosis of tibiofemoral osteoarthritis with a quadriceps CAR of less than 0.90 and a Kellgren Lawrence score between 1-4</p>
|
|
<p>Severity: Kellgren Lawrence score 1-4, median grade 3</p>
|
|
<p>Duration of symptoms: Not stated</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab17_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at ≤3 months</p>
|
|
<p>Physical function at ≤3 months</p>
|
|
<p>Mild adverse events at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab17_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab17_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pietrosimone 2020<a class="bibr" href="#niceng226er7.s1.1.ref175" rid="niceng226er7.s1.1.ref175"><sup>175</sup></a></td><td headers="hd_h_niceng226er7.tab17_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Transcutaneous electrical nerve stimulation</b> (n=32)</p>
|
|
<p>Participants were instructed to utilise the TENS or sham TENS units during all TE sessions and during activities of daily living. The stimulator units were set to deliver a continuous TENS biphasic pulsatile current at 150Hz, with a phase duration of 150µs. maintain an arbitrary intensity level of 4.</p>
|
|
<p><b>Sham electrotherapy</b> (n=29)</p>
|
|
<p>The sham TENS units provided a low-level sensory stimulation for 30s and then were programmed to automatically decrease the electrical current over approx. 10s until no electricity was emitted.</p>
|
|
<p><b>No treatment</b> (n=29)</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>10 sessions of therapeutic exercise (TE) over a 28 day period</p>
|
|
</td><td headers="hd_h_niceng226er7.tab17_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): TENS group: 60.8 (7.3) years, sham TENS group: 62.5 (7.7) years, exercise group: 63 (7.4) years</p>
|
|
<p>N = 90</p>
|
|
<p>Definition: Radiographic and clinical diagnosis of knee osteoarthritis</p>
|
|
<p>Severity:</p>
|
|
<p>Kellgren-Lawrence grade 2: TENS group: 9, sham: 7, exercise: 9</p>
|
|
<p>Kellgren-Lawrence grade 3: TENS group: 18, sham: 17, exercise: 14</p>
|
|
<p>Kellgren-Lawrence grade 4: TENS group: 5, sham: 5, exercise: 6</p>
|
|
<p>Duration of symptoms (years): not reported</p>
|
|
<p>Presence of multi-morbidities: Not stated/unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab17_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at ≤3 months</p>
|
|
<p>Physical function at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab17_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab18"><div id="niceng226er7.tab18" class="table"><h3><span class="label">Table 18</span><span class="title">Summary of studies included in the transcutaneous electrical nerve stimulation compared to no treatment comparison</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab18/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab18_lrgtbl__"><table><thead><tr><th id="hd_h_niceng226er7.tab18_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study</th><th id="hd_h_niceng226er7.tab18_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention and comparison</th><th id="hd_h_niceng226er7.tab18_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><th id="hd_h_niceng226er7.tab18_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes</th><th id="hd_h_niceng226er7.tab18_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comments</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab18_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cetin 2008<a class="bibr" href="#niceng226er7.s1.1.ref44" rid="niceng226er7.s1.1.ref44"><sup>44</sup></a></td><td headers="hd_h_niceng226er7.tab18_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Pulsed short-wave therapy</b> (n=20)</p>
|
|
<p>Short-wave diathermy, hot packs and isokinetic exercise using a frequency of 27.12 MHz for 15 minutes per knee 3 times a week for 8 weeks</p>
|
|
<p><b>Transcutaneous electrical nerve stimulation</b> (n=20)</p>
|
|
<p>TENS, hot packs and isokinetic exercise. Unit set to 60-100Hz, pulse duration set to 60ms for 24 sessions, 3 times a week for 8 weeks.</p>
|
|
<p><b>Ultrasound</b> (n=20)</p>
|
|
<p>Ultrasound, hot packs and isokinetic exercise. 1MHz ultrasound head, intensity of 1.5W/cm2, 3 times a week for 8 weeks</p>
|
|
<p><b>No treatment</b> (n=20)</p>
|
|
<p>Hot pack and isokinetic exercise only</p>
|
|
<p>A fifth group (n=20) was reported by not included as it did not fulfil the inclusion criteria</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>After application of physical agents, each person underwent individual warm up exercises on a stationary bike set for 20 cycles/min for 5 mins before undergoing muscle-strengthening exercises. People were instructed to continue taking any current medications and not to start any new therapies for knee osteoarthritis during the 8 week studies.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab18_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 59.8 (9.2) years</p>
|
|
<p>N = 100</p>
|
|
<p>Definition: Defined by the American College of Rheumatology with radiographic confirmation</p>
|
|
<p>Severity: Radiographic grade 1-4, median grade 3</p>
|
|
<p>Duration of symptoms: Not stated</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab18_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain at ≤3 months</td><td headers="hd_h_niceng226er7.tab18_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab18_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Mascarin 2012<a class="bibr" href="#niceng226er7.s1.1.ref151" rid="niceng226er7.s1.1.ref151"><sup>151</sup></a></td><td headers="hd_h_niceng226er7.tab18_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Transcutaneous electrical nerve stimulation</b> (n=12)</p>
|
|
<p>TENS (100Hz frequency, pulse width 50 microseconds, modulation up to 50% of variation frequency, quadratic biphasic symmetrical pulse and a length of application of 20 minutes). 24 sessions delivered over 12 weeks.</p>
|
|
<p><b>Ultrasound</b> (n=12)</p>
|
|
<p>Ultrasound delivering continuous ultrasonic waves (1MHz frequency, 0.8W/cm power, 5cm diameter applicator, each session lasted 3-4 minutes, depending on the knee size due to oedema) 24 sessions delivered over 12 weeks.</p>
|
|
<p><b>No treatment</b> (n=16)</p>
|
|
<p>No electrotherapy</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>Kinesthetic exercise including stretching and isometric exercises for the entire lower limb conducted in supervised 20 minute sessions.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab18_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 62.1 (7.6) years</p>
|
|
<p>N = 40</p>
|
|
<p>Definition: People with knee osteoarthritis according to the American College of Rheumatology criteria</p>
|
|
<p>Severity: Not stated</p>
|
|
<p>Duration of symptoms (mean [SD]): 5.2 (5.5) years</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab18_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at ≤3 months</p>
|
|
<p>Physical function at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab18_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab18_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pietrosimone 2011<a class="bibr" href="#niceng226er7.s1.1.ref178" rid="niceng226er7.s1.1.ref178"><sup>178</sup></a></p>
|
|
<p>Subsidiary study: Pietrosimone 2010<a class="bibr" href="#niceng226er7.s1.1.ref176" rid="niceng226er7.s1.1.ref176"><sup>176</sup></a></p>
|
|
</td><td headers="hd_h_niceng226er7.tab18_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Transcutaneous electrical nerve stimulation</b> (n=12)</p>
|
|
<p>TENS as a 150Hz biphasic pulsatile current, with a phase duration of 150microseconds. People were allowed to increase or decrease the amplitude from 1 to 60mA.</p>
|
|
<p><b>Sham electrotherapy</b> (n=12)</p>
|
|
<p>Sham TENS</p>
|
|
<p><b>No treatment</b> (n=12)</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>Therapeutic exercise was available to all participants including quadriceps strengthening lower extremity exercises 3 times a week for 4 weeks, for a total of 12 sessions.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab18_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Age not stated</p>
|
|
<p>N = 36</p>
|
|
<p>Definition: People with a clinical diagnosis of tibiofemoral osteoarthritis with a quadriceps CAR of less than 0.90 and a Kellgren Lawrence score between 1-4</p>
|
|
<p>Severity: Kellgren Lawrence score 1-4, median grade 3</p>
|
|
<p>Duration of symptoms: Not stated</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab18_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at ≤3 months</p>
|
|
<p>Physical function at ≤3 months</p>
|
|
<p>Mild adverse events at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab18_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab18_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pietrosimone 2020<a class="bibr" href="#niceng226er7.s1.1.ref175" rid="niceng226er7.s1.1.ref175"><sup>175</sup></a></td><td headers="hd_h_niceng226er7.tab18_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Transcutaneous electrical nerve stimulation</b> (n=32)</p>
|
|
<p>Participants were instructed to utilise the TENS or sham TENS units during all TE sessions and during activities of daily living. The stimulator units were set to deliver a continuous TENS biphasic pulsatile current at 150Hz, with a phase duration of 150µs. maintain an arbitrary intensity level of 4.</p>
|
|
<p><b>Sham electrotherapy</b> (n=29)</p>
|
|
<p>The sham TENS units provided a low-level sensory stimulation for 30s and then were programmed to automatically decrease the electrical current over approx. 10s until no electricity was emitted.</p>
|
|
<p><b>No treatment</b> (n=29)</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>10 sessions of therapeutic exercise (TE) over a 28 day period</p>
|
|
</td><td headers="hd_h_niceng226er7.tab18_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): TENS group: 60.8 (7.3) years, sham TENS group: 62.5 (7.7) years, exercise group: 63 (7.4) years</p>
|
|
<p>N = 90</p>
|
|
<p>Definition: Radiographic and clinical diagnosis of knee osteoarthritis</p>
|
|
<p>Severity:</p>
|
|
<p>Kellgren-Lawrence grade 2: TENS group: 9, sham: 7, exercise: 9</p>
|
|
<p>Kellgren-Lawrence grade 3: TENS group: 18, sham: 17, exercise: 14</p>
|
|
<p>Kellgren-Lawrence grade 4: TENS group: 5, sham: 5, exercise: 6</p>
|
|
<p>Duration of symptoms (years): not reported</p>
|
|
<p>Presence of multi-morbidities: Not stated/unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab18_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at ≤3 months</p>
|
|
<p>Physical function at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab18_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab19"><div id="niceng226er7.tab19" class="table"><h3><span class="label">Table 19</span><span class="title">Summary of studies included in the ultrasound compared to pulsed short-wave therapy comparison</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab19/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab19_lrgtbl__"><table><thead><tr><th id="hd_h_niceng226er7.tab19_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study</th><th id="hd_h_niceng226er7.tab19_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention and comparison</th><th id="hd_h_niceng226er7.tab19_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><th id="hd_h_niceng226er7.tab19_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes</th><th id="hd_h_niceng226er7.tab19_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comments</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab19_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cetin 2008<a class="bibr" href="#niceng226er7.s1.1.ref44" rid="niceng226er7.s1.1.ref44"><sup>44</sup></a></td><td headers="hd_h_niceng226er7.tab19_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Pulsed short-wave therapy</b> (n=20)</p>
|
|
<p>Short-wave diathermy, hot packs and isokinetic exercise using a frequency of 27.12 MHz for 15 minutes per knee 3 times a week for 8 weeks</p>
|
|
<p><b>Transcutaneous electrical nerve stimulation</b> (n=20)</p>
|
|
<p>TENS, hot packs and isokinetic exercise. Unit set to 60-100Hz, pulse duration set to 60ms for 24 sessions, 3 times a week for 8 weeks.</p>
|
|
<p><b>Ultrasound</b> (n=20)</p>
|
|
<p>Ultrasound, hot packs and isokinetic exercise. 1MHz ultrasound head, intensity of 1.5W/cm2, 3 times a week for 8 weeks</p>
|
|
<p><b>No treatment</b> (n=20)</p>
|
|
<p>Hot pack and isokinetic exercise only</p>
|
|
<p>A fifth group (n=20) was reported by not included as it did not fulfil the inclusion criteria</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>After application of physical agents, each person underwent individual warm up exercises on a stationary bike set for 20 cycles/min for 5 mins before undergoing muscle-strengthening exercises. People were instructed to continue taking any current medications and not to start any new therapies for knee osteoarthritis during the 8 week studies.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab19_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 59.8 (9.2) years</p>
|
|
<p>N = 100</p>
|
|
<p>Definition: Defined by the American College of Rheumatology with radiographic confirmation</p>
|
|
<p>Severity: Radiographic grade 1-4, median grade 3</p>
|
|
<p>Duration of symptoms: Not stated</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab19_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain at ≤3 months</td><td headers="hd_h_niceng226er7.tab19_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab20"><div id="niceng226er7.tab20" class="table"><h3><span class="label">Table 20</span><span class="title">Summary of studies included in the ultrasound compared to neuromuscular electrical stimulation</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab20/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab20_lrgtbl__"><table><thead><tr><th id="hd_h_niceng226er7.tab20_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study</th><th id="hd_h_niceng226er7.tab20_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention and comparison</th><th id="hd_h_niceng226er7.tab20_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><th id="hd_h_niceng226er7.tab20_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes</th><th id="hd_h_niceng226er7.tab20_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comments</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab20_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Devrimsel 2019<a class="bibr" href="#niceng226er7.s1.1.ref69" rid="niceng226er7.s1.1.ref69"><sup>69</sup></a></td><td headers="hd_h_niceng226er7.tab20_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Ultrasound</b> (n=20)</p>
|
|
<p>Continuous ultrasound (1W/cm2, 1MHz, 5 minutes) applied with a 5cm diameter head bilaterally to each knee for 5 days a week for 3 weeks</p>
|
|
<p><b>Neuromuscular electrical stimulation</b> (n=30)</p>
|
|
<p>Neuromuscular electrical stimulat applied to the vastus lateralis and quadriceps femoris muscles (50Hz freqeucny, pulse duration of 250micrseconds, 10s time on, 30s time off) for 20 minutes/session, once daily, 5 days a week for 3 weeks.</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>People received hot pack, exercise and analgesic treatment (paracetamol 1500mg/day).</p>
|
|
</td><td headers="hd_h_niceng226er7.tab20_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 62.1 (7.8) years</p>
|
|
<p>N = 50</p>
|
|
<p>Definition: American College of Rheumatology knee osteoarthritis with grade 2-3 Kellgren Lawrence changes</p>
|
|
<p>Severity: Kellgren Lawrence (mean [SD]): 2.6 (0.5)</p>
|
|
<p>Duration of symptoms (mean [SD]): 6.4 (3.5) years</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab20_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at ≤3 months</p>
|
|
<p>Physical function at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab20_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab21"><div id="niceng226er7.tab21" class="table"><h3><span class="label">Table 21</span><span class="title">Summary of studies included in the ultrasound compared to transcutaneous electrical nerve stimulation</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab21/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab21_lrgtbl__"><table><thead><tr><th id="hd_h_niceng226er7.tab21_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study</th><th id="hd_h_niceng226er7.tab21_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention and comparison</th><th id="hd_h_niceng226er7.tab21_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><th id="hd_h_niceng226er7.tab21_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes</th><th id="hd_h_niceng226er7.tab21_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comments</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab21_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cetin 2008<a class="bibr" href="#niceng226er7.s1.1.ref44" rid="niceng226er7.s1.1.ref44"><sup>44</sup></a></td><td headers="hd_h_niceng226er7.tab21_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Pulsed short-wave therapy</b> (n=20)</p>
|
|
<p>Short-wave diathermy, hot packs and isokinetic exercise using a frequency of 27.12 MHz for 15 minutes per knee 3 times a week for 8 weeks</p>
|
|
<p><b>Transcutaneous electrical nerve stimulation</b> (n=20)</p>
|
|
<p>TENS, hot packs and isokinetic exercise. Unit set to 60-100Hz, pulse duration set to 60ms for 24 sessions, 3 times a week for 8 weeks.</p>
|
|
<p><b>Ultrasound</b> (n=20)</p>
|
|
<p>Ultrasound, hot packs and isokinetic exercise. 1MHz ultrasound head, intensity of 1.5W/cm2, 3 times a week for 8 weeks</p>
|
|
<p><b>No treatment</b> (n=20)</p>
|
|
<p>Hot pack and isokinetic exercise only</p>
|
|
<p>A fifth group (n=20) was reported by not included as it did not fulfil the inclusion criteria</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>After application of physical agents, each person underwent individual warm up exercises on a stationary bike set for 20 cycles/min for 5 mins before undergoing muscle-strengthening exercises. People were instructed to continue taking any current medications and not to start any new therapies for knee osteoarthritis during the 8 week studies.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab21_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 59.8 (9.2) years</p>
|
|
<p>N = 100</p>
|
|
<p>Definition: Defined by the American College of Rheumatology with radiographic confirmation</p>
|
|
<p>Severity: Radiographic grade 1-4, median grade 3</p>
|
|
<p>Duration of symptoms: Not stated</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab21_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain at ≤3 months</td><td headers="hd_h_niceng226er7.tab21_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab21_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Mascarin 2012<a class="bibr" href="#niceng226er7.s1.1.ref151" rid="niceng226er7.s1.1.ref151"><sup>151</sup></a></td><td headers="hd_h_niceng226er7.tab21_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Transcutaneous electrical nerve stimulation</b> (n=12)</p>
|
|
<p>TENS (100Hz frequency, pulse width 50 microseconds, modulation up to 50% of variation frequency, quadratic biphasic symmetrical pulse and a length of application of 20 minutes). 24 sessions delivered over 12 weeks.</p>
|
|
<p>Ultrasound (n=12)</p>
|
|
<p>Ultrasound delivering continuous ultrasonic waves (1MHz frequency, 0.8W/cm power, 5cm diameter applicator, each session lasted 3-4 minutes, depending on the knee size due to oedema) 24 sessions delivered over 12 weeks.</p>
|
|
<p><b>No treatment</b> (n=16)</p>
|
|
<p>No electrotherapy</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>Kinesthetic exercise including stretching and isometric exercises for the entire lower limb conducted in supervised 20 minute sessions.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab21_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 62.1 (7.6) years</p>
|
|
<p>N = 40</p>
|
|
<p>Definition: People with knee osteoarthritis according to the American College of Rheumatology criteria</p>
|
|
<p>Severity: Not stated</p>
|
|
<p>Duration of symptoms (mean [SD]): 5.2 (5.5) years</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab21_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at ≤3 months</p>
|
|
<p>Physical function at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab21_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab22"><div id="niceng226er7.tab22" class="table"><h3><span class="label">Table 22</span><span class="title">Summary of studies included in the ultrasound compared to sham electrotherapy comparison</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab22/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab22_lrgtbl__"><table><thead><tr><th id="hd_h_niceng226er7.tab22_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study</th><th id="hd_h_niceng226er7.tab22_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention and comparison</th><th id="hd_h_niceng226er7.tab22_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><th id="hd_h_niceng226er7.tab22_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes</th><th id="hd_h_niceng226er7.tab22_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comments</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab22_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cakir 2014<a class="bibr" href="#niceng226er7.s1.1.ref40" rid="niceng226er7.s1.1.ref40"><sup>40</sup></a></td><td headers="hd_h_niceng226er7.tab22_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Ultrasound</b> (n=40)</p>
|
|
<p>Continuous or pulsed ultrasound using a 5cm2 head ultrasound device (Continuous ultrasound was administered at the frequency of 1MHz with an intensity of 1W/cm². Pulse ultrasound was used for same frequency and intensity on 1:4 pulse ratios) 5 times a week for 2 weeks</p>
|
|
<p><b>Sham electrotherapy</b> (n=20)</p>
|
|
<p>Sham ultrasound (same device, but the power switch was off)</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>Paracetamol up to 2000mg/day was allowed. Other drugs for systemic diseases were not stopped</p>
|
|
</td><td headers="hd_h_niceng226er7.tab22_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 57.4 (8.9) years</p>
|
|
<p>N = 60</p>
|
|
<p>Definition: Diagnosed knee osteoarthritis according to the American College of Rheumatology, confirmed with radiologically grade 2-3 Kellgren Lawrence changes</p>
|
|
<p>Severity: Kellgren Lawrence grade 2-3</p>
|
|
<p>Duration of symptoms (mean [SD]): 4.5 (3.7) years</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab22_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at ≤3 months and >3 months</p>
|
|
<p>Physical function at ≤3 months and >3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab22_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab22_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Draper 2018<a class="bibr" href="#niceng226er7.s1.1.ref71" rid="niceng226er7.s1.1.ref71"><sup>71</sup></a></td><td headers="hd_h_niceng226er7.tab22_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Ultrasound</b> (n=55)</p>
|
|
<p>Low-intensity ultrasound treatment (3MHz continuous wave mode, 1.3W output power, 132mW/cm2 intensity, 18,720J total acoustic dose) for 6 weeks. Self-administered 4 hours per day, 7 days a week.</p>
|
|
<p><b>Sham electrotherapy</b> (n=35)</p>
|
|
<p>Sham ultrasound (same device, but transducers deactivated)</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>People were permitted to continue use of pain medications as long as those medication were maintained at a stable dose throughout the trial. Co-interventions were not assessed in this study</p>
|
|
</td><td headers="hd_h_niceng226er7.tab22_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 52.6 (9.0) years</p>
|
|
<p>N = 90</p>
|
|
<p>Definition: Moderate to severe knee pain negatively affecting their life with radiographically-confirmed mild to moderate changes</p>
|
|
<p>Severity: Kellgren Lawrence grade 1-2</p>
|
|
<p>Duration of symptoms: Not stated</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab22_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at ≤3 months</p>
|
|
<p>Physical function at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab22_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab22_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Jia 2016<a class="bibr" href="#niceng226er7.s1.1.ref115" rid="niceng226er7.s1.1.ref115"><sup>115</sup></a></td><td headers="hd_h_niceng226er7.tab22_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Ultrasound</b> (n=53)</p>
|
|
<p>Ultrasound for 20 minutes once daily for a total treatment duration of 10 days in low intensity mode (ultrasonic transducer diameter of 25mm, a radius of curvature of 28mm, a frequency of 0.6MHz, a pulse repetition frequency of 300Hz, a spatial and temporal average intensity of 120mW/cm², and a duty cycle of 20%).</p>
|
|
<p><b>Sham electrotherapy</b> (n=53)</p>
|
|
<p>Sham ultrasound</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>All people received diclofenac sodium (oral sustained release, 75mg) once daily for the 10 day period</p>
|
|
</td><td headers="hd_h_niceng226er7.tab22_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 62.4 (10.1) years</p>
|
|
<p>N = 106</p>
|
|
<p>Definition: Knee osteoarthritis fulfilling the American College of Rheumatology classification criteria, Kellgren and Lawrence grade 2-3 with knee pain and limitation on most days within the past 6 months</p>
|
|
<p>Severity: Radiographic grade 2-3</p>
|
|
<p>Duration of symptoms (mean [SD]): 62.4 (10.1) months</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab22_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Quality of life at ≤3 months</p>
|
|
<p>Pain at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab22_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab22_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Karakas 2020<a class="bibr" href="#niceng226er7.s1.1.ref118" rid="niceng226er7.s1.1.ref118"><sup>118</sup></a></td><td headers="hd_h_niceng226er7.tab22_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Ultrasound</b> (n=48)</p>
|
|
<p>The pulsed ultrasound group received a total of 24 sessions of pulsed ultrasound treatment (1 MHz, 1w/cm², 1:4 ratio, 10 minutes) 3 sessions a week for 8 weeks.</p>
|
|
<p><b>Sham electrotherapy</b> (n=48)</p>
|
|
<p>Sham ultrasound (no further details) given as per the active treatment group.</p>
|
|
<p>
|
|
<b>Concomitant treatment:</b>
|
|
</p>
|
|
<p>Both groups were given a standard home exercise programme consisting of knee joint range of motion and isometric strengthening. The home exercise programme was given to each patient before starting the treatment. In addition, when they came to the treatment, whether they exercise or not was constantly checked. In both groups, patients were only allowed to take paracetamol for pain. The use of any other analgesics was avoided during the treatment and until the end of the 4 weeks following the completion of the US therapy.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab22_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): US group: 59.10 (7.45) years, sham group: 60.75 (7.46) years</p>
|
|
<p>N = 96</p>
|
|
<p>Definition: American College of Rheumatology criteria and stage 1-3 Kellgren-Lawrence stage.</p>
|
|
<p>Severity (WOMAC pain at baseline): 8.92 (3.64) vs 8.25 (3.12)</p>
|
|
<p>Duration of pain: not reported</p>
|
|
<p>Presence of multi-morbidities: Not stated/unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab22_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at ≤3 months</p>
|
|
<p>Physical function at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab22_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab22_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Kiraly 2021<a class="bibr" href="#niceng226er7.s1.1.ref124" rid="niceng226er7.s1.1.ref124"><sup>124</sup></a></td><td headers="hd_h_niceng226er7.tab22_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Combination therapy</b> (n=15)</p>
|
|
<p>Participants received combined UST and TENS therapy for 10 minutes per day (continuous US: 0.5 W/cm2 intensity, 3MHs carrier frequency; TENS: 100 Hz frequency, 100µs impulse, constant frequency).</p>
|
|
<p><b>Ultrasound</b> (n=38)</p>
|
|
<p>Combination of people receiving continuous and pulse ultrasound. Participants received continuous ultrasound therapy (UST) with moving head in three fields: 1) inguinal; 2) gluteal; and 3) trochanteric for 3 minutes per field, altogether for 9 minutes every working day for 2 weeks, on a total of 10 occasions (calibrated BTL-4825S Premium device, head size: 5cm, 3 MHz frequency, 1.5 W/cm2 intensity). Participants received pulsed UST (1.5 W/cm2 intensity, 3 MHz frequency, 50% duty cycle).</p>
|
|
<p><b>Sham therapy</b> (n=18)</p>
|
|
<p>Participants received sham UST (the device was switched off).</p>
|
|
<p>
|
|
<b>Concomitant treatment:</b>
|
|
</p>
|
|
<p>Participants in each group received conventional treatment (i.e. physical exercise, massage and balneotherapy) every working day for two weeks, on a total of 10 occasions. Exercises included standardised hip exercises. Swedish massage techniques were used during the massage therapy, and the balneotherapy was performed in thermal water at 34 degrees C. Participants were permitted to take analgesics or anti-rheumatic drugs during the study-these medications were recorded on their documents. They were not permitted to receive any additional therapy during the 3 months follow-up period.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab22_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Hip osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age: 65 years</p>
|
|
<p>N = 71</p>
|
|
<p>Definition: clinically and radiologically moderate hip osteoarthritis (Kellgren Lawrence II-III stage) as defined by American College of Rheumatology</p>
|
|
<p>Severity (resting VAS pain at baseline): continuous US group: 64.38 (12.45), pulsed US group: 63.88 (14.47), combination group: 61.33 (17.78), placebo group: 62.94 (9.37)</p>
|
|
<p>Duration of symptoms: at least 8 weeks prior to the start of the study</p>
|
|
<p>Presence of multi-morbidities: continuous US group: 10/21, pulsed US group: 13/17, combination group: 6/15, placebo group: 12/18</p>
|
|
</td><td headers="hd_h_niceng226er7.tab22_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Quality of life at ≤3 months</p>
|
|
<p>Pain at ≤3 months</p>
|
|
<p>Mild adverse events at ≤3 months</p>
|
|
<p>Moderate/major adverse events at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab22_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab22_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Koybasi 2010<a class="bibr" href="#niceng226er7.s1.1.ref126" rid="niceng226er7.s1.1.ref126"><sup>126</sup></a></td><td headers="hd_h_niceng226er7.tab22_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Ultrasound</b> (n=15)</p>
|
|
<p>Ultrasound and conventional physical therapy (frequency 1mHz, continuous mode, intensity 1W/cm2, head size 5cm2) applied for 5 minutes in each of the four fields. Given five times weekly for 2 weeks.</p>
|
|
<p><b>Sham electrotherapy</b> (n=15)</p>
|
|
<p>Sham ultrasound</p>
|
|
<p><b>No treatment</b> (n=15)</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>Hot packs were applied on the hip joint for 20 minutes before the therapies. In all groups, the people performed strengthening exercises for the hip muscles and lengthening exercises for the ligaments around the hip joint, for a duration of 20 minutes, directed by an experienced physiotherapist. People were instructed to complete exercise three times a week, with ten repetitions for each exercise (strengthening exercises).</p>
|
|
</td><td headers="hd_h_niceng226er7.tab22_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Hip osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 65.3 (6.7) years</p>
|
|
<p>N = 45</p>
|
|
<p>Definition: Hip pain for more than 3 months and having Kellgren Lawrence scores of 2-3 on radiologic evaluation. Diagnosis based on the American College of Rheumatology criteria, verified through history and physical examination.</p>
|
|
<p>Severity: Kellgren Lawrence grade 2-3, median grade 2</p>
|
|
<p>Duration of symptoms (mean [SD]): 2.5 (1.7) years</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab22_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Quality of life at ≤3 months</p>
|
|
<p>Pain at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab22_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab22_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Loyola-sanchez 2012<a class="bibr" href="#niceng226er7.s1.1.ref142" rid="niceng226er7.s1.1.ref142"><sup>142</sup></a></td><td headers="hd_h_niceng226er7.tab22_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Ultrasound</b> (n=14)</p>
|
|
<p>Ultrasound for 24 sessions with 3 session per week for 8 weeks (1MHz ultrasound device, sound-head area of 5cm2, beam nonuniformity ratio of 5:1, therapeutic dose of approximately 112.5J/cm2. Pulsed therapy delivered for 9.5 minutes with a peak intensity of 1W/cm2 at 20% duty cycle, to achieve a spatial average temporal intensity of 0.2W/cm2).</p>
|
|
<p><b>Sham electrotherapy</b> (n=13)</p>
|
|
<p>Sham ultrasound (identical device but no sound-head crystal)</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>No additional information</p>
|
|
</td><td headers="hd_h_niceng226er7.tab22_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 61.9 (10.5) years</p>
|
|
<p>N = 27</p>
|
|
<p>Definition: People who fulfilled the American College of Rheumatology clinical and radiological diagnostic criteria for knee osteoarthritis and presented with OARSI atlas classification grades 1 or 2 tibiofemoral compartment joint space narrowing</p>
|
|
<p>Severity: OARSI atlas grade 1-2, median grade 2</p>
|
|
<p>Duration of symptoms: Not stated</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab22_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at ≤3 months</p>
|
|
<p>Physical function at ≤3 months</p>
|
|
<p>Mild adverse events at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab22_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab22_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Ozgonenel 2009<a class="bibr" href="#niceng226er7.s1.1.ref166" rid="niceng226er7.s1.1.ref166"><sup>166</sup></a></td><td headers="hd_h_niceng226er7.tab22_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Ultrasound</b> (n=34)</p>
|
|
<p>Ultrasound applied to a treatment area of 25cm2. Continuous ultrasonic waves with 1mHz frequency, 1W/cm2 power applied with a 3cm diameter applicator for 5 minutes each session, once a day for 10 days</p>
|
|
<p><b>Sham electrotherapy</b> (n=33)</p>
|
|
<p>Sham ultrasound (applicator was disconnected)</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>No additional information</p>
|
|
</td><td headers="hd_h_niceng226er7.tab22_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 54.9 (7.6) years</p>
|
|
<p>N = 67</p>
|
|
<p>Definition: Clinical and radiological criteria defined by the American College of Rheumatology for knee osteoarthritis</p>
|
|
<p>Severity: Kellgren Lawrence grade 2-3, median grade 3</p>
|
|
<p>Duration of symptoms: Not stated</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab22_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at ≤3 months</p>
|
|
<p>Physical function at ≤3 months</p>
|
|
<p>Mild adverse events at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab22_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab22_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Ozgonenel 2018<a class="bibr" href="#niceng226er7.s1.1.ref167" rid="niceng226er7.s1.1.ref167"><sup>167</sup></a></td><td headers="hd_h_niceng226er7.tab22_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Ultrasound</b> (n=15)</p>
|
|
<p>Ultrasound delivered as continuous ultrasonic waves with 1MHz frequency, 1W/cm2 power applied with a 4cm diameter applicator for 5 minutes over 2 weeks</p>
|
|
<p><b>Sham electrotherapy</b> (n=18)</p>
|
|
<p>Sham ultrasound (applicator was disconnected)</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>No additional information</p>
|
|
</td><td headers="hd_h_niceng226er7.tab22_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 54.8 (14.8) years</p>
|
|
<p>N = 33</p>
|
|
<p>Definition: Clinical and radiological criteria defined by the American College of Rheumatology for knee osteoarthritis</p>
|
|
<p>Severity: Kellgren Lawrence grade 3</p>
|
|
<p>Duration of symptoms: At least 6 months</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab22_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain at ≤3 months</td><td headers="hd_h_niceng226er7.tab22_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab22_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Tascioglu 2010<a class="bibr" href="#niceng226er7.s1.1.ref205" rid="niceng226er7.s1.1.ref205"><sup>205</sup></a></td><td headers="hd_h_niceng226er7.tab22_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Ultrasound</b> (n=60)</p>
|
|
<p>Continuous or pulsed ultrasound. Continuous ultrasonic waves of 1MHz frequency, 2W/cm2, 5cm diameter applicator, 5 minutes per session. Pulsed ultrasound group used the same parameters, but with a pulsed mode duty cycle of 1:4.</p>
|
|
<p><b>Sham electrotherapy</b> (n=30)</p>
|
|
<p>Sham ultrasound (applicator delivered no output)</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>No additional information</p>
|
|
</td><td headers="hd_h_niceng226er7.tab22_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 60.5 (3.2) years</p>
|
|
<p>N = 90</p>
|
|
<p>Definition: People with idiopathic knee osteoarthritis according to the American College of Rheumatology criteria</p>
|
|
<p>Severity: Kellgren Lawrence grade 2-3, median grade 2</p>
|
|
<p>Duration of symptoms (mean [SD]): 6.5 (1.8) years</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab22_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at ≤3 months</p>
|
|
<p>Mild adverse events at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab22_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab22_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Ulus 2012<a class="bibr" href="#niceng226er7.s1.1.ref213" rid="niceng226er7.s1.1.ref213"><sup>213</sup></a></td><td headers="hd_h_niceng226er7.tab22_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Ultrasound</b> (n=20)</p>
|
|
<p>Therapeutic ultrasound delivered with continuous ultrasonic waves of 1MHz frequency and intensity of 1W/cm2 applied with a 5cm diameter applicator for 10 minutes per session. Treatment 5 times weekly for 3 weeks.</p>
|
|
<p><b>Sham electrotherapy</b> (n=20)</p>
|
|
<p>Sham ultrasound (applicator disconnected from the back of the machine)</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>All people received 20 minutes of hot packs, 10 minutes of interferential current and 15 minutes of quadriceps isometric exercise of both knees. Non-steroid anti-inflammatory drugs and antidepressant drugs were not permitted throughout the physical therapy sessions; analgesics whenever needed and other medication for comorbid diseases were permitted during the study period.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab22_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 60.5 (9.5) years</p>
|
|
<p>N = 40</p>
|
|
<p>Definition: People with bilateral knee osteoarthritis diagnosed in accordance with the American College of Rheumatology criteria</p>
|
|
<p>Severity: Kellgren and Lawrence grade 2-3, median grade 3</p>
|
|
<p>Duration of symptoms (mean [SD]): 106.4 (105.1) months</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab22_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at ≤3 months</p>
|
|
<p>Physical function at ≤3 months</p>
|
|
<p>Psychological distress at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab22_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab22_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Yegin 2017<a class="bibr" href="#niceng226er7.s1.1.ref224" rid="niceng226er7.s1.1.ref224"><sup>224</sup></a></td><td headers="hd_h_niceng226er7.tab22_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Ultrasound</b> (n=32)</p>
|
|
<p>Ultrasound applied to both knees for 10 sessions over 2 weeks (continuous, 1W/cm2, 1MHz)</p>
|
|
<p><b>Sham electrotherapy</b> (n=33)</p>
|
|
<p>Sham ultrasound (device switched off)</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>The use of analgesics except paracetamol was avoided during the treatment and until the end of the first month following completion of ultrasound treatment.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab22_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Age range: 40-70 years</p>
|
|
<p>N = 62</p>
|
|
<p>Definition: Primary knee osteoarthritis according to the American Rheumatology Association with a minimum of stage 2 knee osteoarthritis on x-rays taken during the last 12 months according to the Kellgren Lawrence grading scale</p>
|
|
<p>Severity: At least Kellgren Lawrence grade 2</p>
|
|
<p>Duration of symptoms: Not stated</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab22_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at ≤3 months</p>
|
|
<p>Physical function at ≤3 months</p>
|
|
<p>Psychological distress at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab22_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab22_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Yildiz 2015<a class="bibr" href="#niceng226er7.s1.1.ref225" rid="niceng226er7.s1.1.ref225"><sup>225</sup></a></td><td headers="hd_h_niceng226er7.tab22_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Ultrasound</b> (n=60)</p>
|
|
<p>Continuous or pulsed ultrasound. Continuous (frequency 1Mhz, intensity 1.5W/cm2, duration 5 minutes) or pulsed (frequency 1MHz, intensity 1.5W/cm2, mode: 1/5, duration 5 minutes) given for 5 days a week for 2 weeks by the same 5cm2 head</p>
|
|
<p><b>Sham electrotherapy</b> (n=30)</p>
|
|
<p>Sham ultrasound (device switched off)</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>All people were given a home exercise program and were instructed to perform exercises, including quadriceps isometric exercises and strengthening exercises, for 10 repetitions of the set, 3 times a day for 8 weeks from the beginning of the treatment. People were informed that they could take 500mg of paracetamol up to 3 times a day in case of pain during treatment.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab22_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean (SD): 56.2 (6.9) years</p>
|
|
<p>N = 90</p>
|
|
<p>Definition: Bilateral stage 2-3 primary knee osteoarthritis according to Kellgren-Lawrence criteria</p>
|
|
<p>Severity: Kellgren Lawrence grade 2-3, median grade 3</p>
|
|
<p>Duration of symptoms (mean [SD]): 4.0 (3.2) years</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab22_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at ≤3 months</p>
|
|
<p>Mild adverse events at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab22_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab23"><div id="niceng226er7.tab23" class="table"><h3><span class="label">Table 23</span><span class="title">Summary of studies included in the ultrasound compared to no treatment comparison</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab23/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab23_lrgtbl__"><table><thead><tr><th id="hd_h_niceng226er7.tab23_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study</th><th id="hd_h_niceng226er7.tab23_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention and comparison</th><th id="hd_h_niceng226er7.tab23_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><th id="hd_h_niceng226er7.tab23_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes</th><th id="hd_h_niceng226er7.tab23_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comments</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab23_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Alfredo 2020<a class="bibr" href="#niceng226er7.s1.1.ref12" rid="niceng226er7.s1.1.ref12"><sup>12</sup></a></td><td headers="hd_h_niceng226er7.tab23_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Ultrasound</b> (n=80)</p>
|
|
<p>Continuous/ pulsed ultrasound. The continuous ultrasound parameters were as follows: a frequency of 1 MHz, an intensity of 1.5 W/cm2 (spatial average, temporal average (SATA)), a duty cycle of 100% and an application time of 5 minutes on the medial side and 5 minutes on the lateral side of the knee. The pulsed ultrasound parameters were as follows: a frequency of 1 MHz, an intensity of 2.5 W/cm2 (SATA), a pulsed mode of 25% and an application time of 5 minutes on the medial side and 5 minutes on the lateral side of the knee.</p>
|
|
<p><b>No treatment</b> (n=20)</p>
|
|
<p>Exercise only. Three 45 minute sessions per week.</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>Participants were instructed not to use analgesic medications other than paracetamol (500mg/day) or anti-inflammatory drugs during the study and not to perform any other type of physical exercise in addition to the treatment.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab23_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Age (range): 50-75 years</p>
|
|
<p>N = 100</p>
|
|
<p>Definition: American College of Rheumatology criteria</p>
|
|
<p>Severity (Kellgren-Lawrence): Grade 2-4</p>
|
|
<p>Duration of symptoms: not reported</p>
|
|
<p>Presence of multi-morbidities: Not stated/unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab23_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at ≤3 months</p>
|
|
<p>Physical function at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab23_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pulsed and continuous ultrasound groups combined (4 groups)</td></tr><tr><td headers="hd_h_niceng226er7.tab23_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cetin 2008<a class="bibr" href="#niceng226er7.s1.1.ref44" rid="niceng226er7.s1.1.ref44"><sup>44</sup></a></td><td headers="hd_h_niceng226er7.tab23_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Pulsed short-wave therapy</b> (n=20)</p>
|
|
<p>Short-wave diathermy, hot packs and isokinetic exercise using a frequency of 27.12 MHz for 15 minutes per knee 3 times a week for 8 weeks</p>
|
|
<p><b>Transcutaneous electrical nerve stimulation</b> (n=20)</p>
|
|
<p>TENS, hot packs and isokinetic exercise. Unit set to 60-100Hz, pulse duration set to 60ms for 24 sessions, 3 times a week for 8 weeks.</p>
|
|
<p><b>Ultrasound</b> (n=20)</p>
|
|
<p>Ultrasound, hot packs and isokinetic exercise. 1MHz ultrasound head, intensity of 1.5W/cm2, 3 times a week for 8 weeks</p>
|
|
<p><b>No treatment</b> (n=20)</p>
|
|
<p>Hot pack and isokinetic exercise only</p>
|
|
<p>A fifth group (n=20) was reported by not included as it did not fulfil the inclusion criteria</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>After application of physical agents, each person underwent individual warm up exercises on a stationary bike set for 20 cycles/min for 5 mins before undergoing muscle-strengthening exercises. People were instructed to continue taking any current medications and not to start any new therapies for knee osteoarthritis during the 8 week studies.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab23_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 59.8 (9.2) years</p>
|
|
<p>N = 100</p>
|
|
<p>Definition: Defined by the American College of Rheumatology with radiographic confirmation</p>
|
|
<p>Severity: Radiographic grade 1-4, median grade 3</p>
|
|
<p>Duration of symptoms: Not stated</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab23_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain at ≤3 months</td><td headers="hd_h_niceng226er7.tab23_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab23_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Huang 2005<a class="bibr" href="#niceng226er7.s1.1.ref101" rid="niceng226er7.s1.1.ref101"><sup>101</sup></a></td><td headers="hd_h_niceng226er7.tab23_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Ultrasound</b> (n=60)</p>
|
|
<p>Continuous or pulsed ultrasound given 3 times weekly for 8 weeks. The continuous ultrasound included a duty cycle of 100%, with frequency of 1MHz and a spatial and temporal peak intensity of 1.5W/cm². The US probe was applied for 5 minutes to each treated region (a total treated area of approximately 25cm²). The pulsed sonication included a frequency of 1MHz and a spatial and temporal peak intensity of 2.5W/cm², and pulsed at a duty cycle of 25%. Given 3 times weekly over 8 weeks.</p>
|
|
<p><b>No treatment</b> (n=30)</p>
|
|
<p>Isokinetic exercise only.</p>
|
|
<p>A third group (n=30) was reported by not included as it did not fulfil the inclusion criteria.</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>All groups received 20 minutes of hot packs and 5 minutes of passive ROM exercise on an electric stationary bike (20 cycles/min) of both knees before undergoing muscle strengthening exercises.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab23_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 62.0 (8.4) years</p>
|
|
<p>N = 120</p>
|
|
<p>Definition: Bilateral moderate knee osteoarthritis with periarticular soft tissue pain, as identified by painful sensations during palpation or passive stretching of the arthritic knee under orthopedic examination. The locations of soft tissue pain were confirmed by the findings of musculoskeletal ultrasound images.</p>
|
|
<p>Severity: Altman grade 2</p>
|
|
<p>Duration of symptoms: 6 months - 11 years.</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab23_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain at ≤3 months and >3 months</td><td headers="hd_h_niceng226er7.tab23_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">In Forest plots this study is referred to as Huang 2005B</td></tr><tr><td headers="hd_h_niceng226er7.tab23_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Huang 2005<a class="bibr" href="#niceng226er7.s1.1.ref102" rid="niceng226er7.s1.1.ref102"><sup>102</sup></a></td><td headers="hd_h_niceng226er7.tab23_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Ultrasound</b> (n=60)</p>
|
|
<p>Isokinetic exercise with pulsed ultrasound. Ultrasound treatment given as a frequency of 1MHz and a spatial and temporal peak intensity of 2.5 W/cm², and pulsed at a duty cycle of 25%. Sonication was performed 3 times a week for 8 weeks</p>
|
|
<p><b>No treatment</b> (n=35)</p>
|
|
<p>Isokinetic exercise only.</p>
|
|
<p>A third group (n=35) and forth group (n=35) were reported by not included as it did not fulfil the inclusion criteria.</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>No additional information</p>
|
|
</td><td headers="hd_h_niceng226er7.tab23_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 65.0 (6.4) years</p>
|
|
<p>N = 140</p>
|
|
<p>Definition: People with bilateral moderate knee osteoarthritis</p>
|
|
<p>Severity: Altman grade 2</p>
|
|
<p>Duration of symptoms: 5 months - 12 years</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab23_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain at ≤3 months and >3 months</td><td headers="hd_h_niceng226er7.tab23_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">In Forest plots this study is referred to as Huang 2005A</td></tr><tr><td headers="hd_h_niceng226er7.tab23_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Mascarin 2012<a class="bibr" href="#niceng226er7.s1.1.ref151" rid="niceng226er7.s1.1.ref151"><sup>151</sup></a></td><td headers="hd_h_niceng226er7.tab23_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Transcutaneous electrical nerve stimulation</b> (n=12)</p>
|
|
<p>TENS (100Hz frequency, pulse width 50 microseconds, modulation up to 50% of variation frequency, quadratic biphasic symmetrical pulse and a length of application of 20 minutes). 24 sessions delivered over 12 weeks.</p>
|
|
<p><b>Ultrasound</b> (n=12)</p>
|
|
<p>Ultrasound delivering continuous ultrasonic waves (1MHz frequency, 0.8W/cm power, 5cm diameter applicator, each session lasted 3-4 minutes, depending on the knee size due to oedema) 24 sessions delivered over 12 weeks.</p>
|
|
<p><b>No treatment</b> (n=16)</p>
|
|
<p>No electrotherapy</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>Kinesthetic exercise including stretching and isometric exercises for the entire lower limb conducted in supervised 20 minute sessions.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab23_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 62.1 (7.6) years</p>
|
|
<p>N = 40</p>
|
|
<p>Definition: People with knee osteoarthritis according to the American College of Rheumatology criteria</p>
|
|
<p>Severity: Not stated</p>
|
|
<p>Duration of symptoms (mean [SD]): 5.2 (5.5) years</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab23_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at ≤3 months</p>
|
|
<p>Physical function at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab23_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab24"><div id="niceng226er7.tab24" class="table"><h3><span class="label">Table 24</span><span class="title">Summary of studies included in the combination therapy compared to interferential therapy comparison</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab24/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab24_lrgtbl__"><table><thead><tr><th id="hd_h_niceng226er7.tab24_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study</th><th id="hd_h_niceng226er7.tab24_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention and comparison</th><th id="hd_h_niceng226er7.tab24_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><th id="hd_h_niceng226er7.tab24_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes</th><th id="hd_h_niceng226er7.tab24_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comments</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab24_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Alqualo-Costa 2020<a class="bibr" href="#niceng226er7.s1.1.ref15" rid="niceng226er7.s1.1.ref15"><sup>15</sup></a></td><td headers="hd_h_niceng226er7.tab24_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Interferential therapy</b> (n=42)</p>
|
|
<p>Interferential current (IFC) three times a week for 4 week (12 sessions). Duration of each session ranged from 40 to 50 minutes. Parameters were used as follows: carrier current frequency of 4000Hz; amplitude-modulated frequency of 50Hz; sweep frequency of 50Hz; swing pattern of 1:1 second, and the current amplitude was increased until the patient reported strong but comfortable and non-painful stimulation paraesthesia.</p>
|
|
<p><b>Laser therapy</b> (n=42)</p>
|
|
<p>Three times a week for 4 week (12 sessions). Duration of each session ranged from 40 to 50 minutes, and used a probe with a wavelength of 904nm, with a dose of 3J per point, totalling 9 points, total energy of 27J per session, peak power of 70W, pulse repetition frequency of 9500Hz, pulse duration of 60ns, average power of 40mW, application time of 75 seconds per point, and beam cross-sectional area of 0.5cm².</p>
|
|
<p><b>Combination therapy</b> (n=42)</p>
|
|
<p>IFC plus PBM (interferential current plus photobiomodulation). Three times a week for 4 weeks (12 sessions).</p>
|
|
<p><b>Sham electrotherapy</b> (n=42)</p>
|
|
<p>Sham IFC and PBM.</p>
|
|
<p>Three times a week for 4 week (12 sessions).</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>No analgesics 4 hours before the intervention.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab24_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): IFC group: 64.5 (7.8) years, PBM group: 61.3 (9.4) years, IFC+PBM group: 65.7 (10.1) years, placebo group: 65.3 (8.5) years</p>
|
|
<p>N = 168</p>
|
|
<p>Definition:</p>
|
|
<p>American College of Rheumatology criteria</p>
|
|
<p>Severity (Kellgren-Lawrence):</p>
|
|
<p>(Score 2): IFC group: 24, PBM group: 23, IFC+PBM group: 27, placebo group: 24</p>
|
|
<p>(Score 3): IFC group: 17, PBM group: 19, IFC+PBM group: 15, placebo group: 18</p>
|
|
<p>(Score 4): IFC group: 1, PBM group: 1, IFC+PBM group: 0, placebo group: 0</p>
|
|
<p>Duration of symptoms: not reported</p>
|
|
<p>Presence of multi-morbidities: Not stated/unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab24_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain at ≤3 months and >3 months</td><td headers="hd_h_niceng226er7.tab24_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab25"><div id="niceng226er7.tab25" class="table"><h3><span class="label">Table 25</span><span class="title">Summary of studies included in the combination therapy compared to neuromuscular electrical stimulation comparison</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab25/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab25_lrgtbl__"><table><thead><tr><th id="hd_h_niceng226er7.tab25_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study</th><th id="hd_h_niceng226er7.tab25_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention and comparison</th><th id="hd_h_niceng226er7.tab25_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><th id="hd_h_niceng226er7.tab25_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes</th><th id="hd_h_niceng226er7.tab25_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comments</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab25_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Melo mde 2015<a class="bibr" href="#niceng226er7.s1.1.ref152" rid="niceng226er7.s1.1.ref152"><sup>152</sup></a></td><td headers="hd_h_niceng226er7.tab25_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Combination therapy</b> (n=15)</p>
|
|
<p>Laser and neuromuscular electrical stimulation (combination of the same protocols for the other two) delivered over 8 weeks.</p>
|
|
<p><b>Laser therapy</b> (n=15)</p>
|
|
<p>Low level laser therapy delivered as 30 seconds per point, 6J energy per point (36J in total) for 4 weeks, then a reduction of the dose by 30% for the remaining 4 weeks</p>
|
|
<p><b>Neuromuscular electrical stimulation</b> (n=15)</p>
|
|
<p>Neuromuscular electrical stimulation sessions twice a week, at 48 hour intervals, over an 8 week period with a progressive increase in intensity and volume.</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>Kinesthetic exercise including stretching and isometric exercises for the entire lower limb conducted in supervised 20 minute sessions.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab25_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 68.8 (5.1) years</p>
|
|
<p>N = 45</p>
|
|
<p>Definition: Grade 2 or 3 knee osteoarthritis diagnosed by a traumatology-orthopaedic physician according to the criteria proposed by Kellgren and Lawrence</p>
|
|
<p>Severity: Kellgren-Lawrence grade 2-3</p>
|
|
<p>Duration of symptoms: Not stated</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab25_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain at ≤3 months</td><td headers="hd_h_niceng226er7.tab25_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab26"><div id="niceng226er7.tab26" class="table"><h3><span class="label">Table 26</span><span class="title">Summary of studies included in the combination therapy compared to laser therapy comparison</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab26/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab26_lrgtbl__"><table><thead><tr><th id="hd_h_niceng226er7.tab26_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study</th><th id="hd_h_niceng226er7.tab26_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention and comparison</th><th id="hd_h_niceng226er7.tab26_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><th id="hd_h_niceng226er7.tab26_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes</th><th id="hd_h_niceng226er7.tab26_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comments</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab26_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Alqualo-Costa 2020<a class="bibr" href="#niceng226er7.s1.1.ref15" rid="niceng226er7.s1.1.ref15"><sup>15</sup></a></td><td headers="hd_h_niceng226er7.tab26_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Interferential therapy</b> (n=42)</p>
|
|
<p>Interferential current (IFC) three times a week for 4 week (12 sessions). Duration of each session ranged from 40 to 50 minutes. Parameters were used as follows: carrier current frequency of 4000Hz; amplitude-modulated frequency of 50Hz; sweep frequency of 50Hz; swing pattern of 1:1 second, and the current amplitude was increased until the patient reported strong but comfortable and non-painful stimulation paraesthesia.</p>
|
|
<p><b>Laser therapy</b> (n=42)</p>
|
|
<p>Three times a week for 4 week (12 sessions). Duration of each session ranged from 40 to 50 minutes, and used a probe with a wavelength of 904nm, with a dose of 3J per point, totalling 9 points, total energy of 27J per session, peak power of 70W, pulse repetition frequency of 9500Hz, pulse duration of 60ns, average power of 40mW, application time of 75 seconds per point, and beam cross-sectional area of 0.5cm².</p>
|
|
<p><b>Combination therapy</b> (n=42)</p>
|
|
<p>IFC plus PBM (interferential current plus photobiomodulation). Three times a week for 4 weeks (12 sessions).</p>
|
|
<p><b>Sham electrotherapy</b> (n=42)</p>
|
|
<p>Sham IFC and PBM.</p>
|
|
<p>Three times a week for 4 week (12 sessions).</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>No analgesics 4 hours before the intervention.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab26_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): IFC group: 64.5 (7.8) years, PBM group: 61.3 (9.4) years, IFC+PBM group: 65.7 (10.1) years, placebo group: 65.3 (8.5) years</p>
|
|
<p>N = 168</p>
|
|
<p>Definition: American College of Rheumatology criteria</p>
|
|
<p>Severity (Kellgren-Lawrence):</p>
|
|
<p>(Score 2): IFC group: 24, PBM group: 23, IFC+PBM group: 27, placebo group: 24</p>
|
|
<p>(Score 3): IFC group: 17, PBM group: 19, IFC+PBM group: 15, placebo group: 18</p>
|
|
<p>(Score 4): IFC group: 1, PBM group: 1, IFC+PBM group: 0, placebo group: 0</p>
|
|
<p>Duration of symptoms: not reported</p>
|
|
<p>Presence of multi-morbidities: Not stated/unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab26_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain at ≤3 months and >3 months</td><td headers="hd_h_niceng226er7.tab26_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab26_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Melo mde 2015<a class="bibr" href="#niceng226er7.s1.1.ref152" rid="niceng226er7.s1.1.ref152"><sup>152</sup></a></td><td headers="hd_h_niceng226er7.tab26_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Combination therapy</b> (n=15)</p>
|
|
<p>Laser and neuromuscular electrical stimulation (combination of the same protocols for the other two) delivered over 8 weeks.</p>
|
|
<p><b>Laser therapy</b> (n=15)</p>
|
|
<p>Low level laser therapy delivered as 30 seconds per point, 6J energy per point (36J in total) for 4 weeks, then a reduction of the dose by 30% for the remaining 4 weeks</p>
|
|
<p><b>Neuromuscular electrical stimulation</b> (n=15)</p>
|
|
<p>Neuromuscular electrical stimulation sessions twice a week, at 48 hour intervals, over an 8 week period with a progressive increase in intensity and volume.</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>Kinesthetic exercise including stretching and isometric exercises for the entire lower limb conducted in supervised 20 minute sessions.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab26_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 68.8 (5.1) years</p>
|
|
<p>N = 45</p>
|
|
<p>Definition: Grade 2 or 3 knee osteoarthritis diagnosed by a traumatology-orthopaedic physician according to the criteria proposed by Kellgren and Lawrence</p>
|
|
<p>Severity: Kellgren-Lawrence grade 2-3</p>
|
|
<p>Duration of symptoms: Not stated</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab26_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain at ≤3 months</td><td headers="hd_h_niceng226er7.tab26_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab27"><div id="niceng226er7.tab27" class="table"><h3><span class="label">Table 27</span><span class="title">Summary of studies included in the combination therapy compared to transcutaneous electrical nerve stimulation comparison</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab27/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab27_lrgtbl__"><table><thead><tr><th id="hd_h_niceng226er7.tab27_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study</th><th id="hd_h_niceng226er7.tab27_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention and comparison</th><th id="hd_h_niceng226er7.tab27_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><th id="hd_h_niceng226er7.tab27_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes</th><th id="hd_h_niceng226er7.tab27_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comments</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab27_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Kim 2019<a class="bibr" href="#niceng226er7.s1.1.ref121" rid="niceng226er7.s1.1.ref121"><sup>121</sup></a></td><td headers="hd_h_niceng226er7.tab27_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Combination therapy</b> (n=20)</p>
|
|
<p>LIPUS combined with TENS therapy. Performed using CARESTAR (GENEMEDI CO, Ltd, South Korea). CARESTAR consisted of two 2.8 diameter applicators and gave LIPUS energy and TENS in 1s shifts. Therefore, 50%of the stimulation was offered by LIPUS and the remaining 50% was provided by TENS. The LIPUS signal is transmitted at a frequency of 1MHz, with an intensity of 0.1 W/cm². The effective radiating area was 3.3cm². The duty cycle of pulsed ultrasonic waves was 40%. The TENS setting was in a conventional mode, with a frequency of 80Hz and a pulse duration of 50-100µs.</p>
|
|
<p><b>Transcutaneous electrical nerve stimulation</b> (n=20)</p>
|
|
<p>TENS alone. A commercially available TENS machine (Chil-Sung, Co, Ltd, South Korea) was used for stimulation. The TENS setting was in a conventional mode, with a frequency of 100Hz and a pulse duration of 50-100µs.</p>
|
|
<p>
|
|
<b>Concomitant treatment:</b>
|
|
</p>
|
|
<p>Participants were only allowed to take their pain medication which was started at least 2 months before the screening. They were not allowed to change the dose or type of pain medication or start any other types of treatment for knee OA during the trial. In addition, participants were requested not to change their physical exercise level.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab27_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 57.6 (8.26) years</p>
|
|
<p>N = 40</p>
|
|
<p>Definition: Kellgren-Lawrence grade I to IV by standing posteroanterior X-ray in 15 degree knee flexion were eligible.</p>
|
|
<p>Severity (WOMAC pain at baseline): 8.63 (3.09) vs 7.53 (3.67)</p>
|
|
<p>Duration of symptoms (SD): 64.84 (62.70) vs 62.74 (65.58) months</p>
|
|
<p>Presence of multimorbidities: Not stated/unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab27_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Quality of life at ≤3 months</p>
|
|
<p>Pain at ≤3 months</p>
|
|
<p>Physical function at ≤3 months</p>
|
|
<p>Mild adverse events at ≤3 months</p>
|
|
<p>Moderate/major adverse events at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab27_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab28"><div id="niceng226er7.tab28" class="table"><h3><span class="label">Table 28</span><span class="title">Summary of studies included in the combination therapy compared to ultrasound comparison</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab28/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab28_lrgtbl__"><table><thead><tr><th id="hd_h_niceng226er7.tab28_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study</th><th id="hd_h_niceng226er7.tab28_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention and comparison</th><th id="hd_h_niceng226er7.tab28_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><th id="hd_h_niceng226er7.tab28_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes</th><th id="hd_h_niceng226er7.tab28_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comments</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab28_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Kiraly 2021<a class="bibr" href="#niceng226er7.s1.1.ref124" rid="niceng226er7.s1.1.ref124"><sup>124</sup></a></td><td headers="hd_h_niceng226er7.tab28_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Combination therapy</b> (n=15)</p>
|
|
<p>Participants received combined UST and TENS therapy for 10 minutes per day (continuous US: 0.5 W/cm2 intensity, 3MHs carrier frequency; TENS: 100 Hz frequency, 100µs impulse, constant frequency).</p>
|
|
<p><b>Ultrasound</b> (n=38)</p>
|
|
<p>Combination of people receiving continuous and pulse ultrasound. Participants received continuous ultrasound therapy (UST) with moving head in three fields: 1) inguinal; 2) gluteal; and 3) trochanteric for 3 minutes per field, altogether for 9 minutes every working day for 2 weeks, on a total of 10 occasions (calibrated BTL-4825S Premium device, head size: 5cm, 3 MHz frequency, 1.5 W/cm2 intensity). Participants received pulsed UST (1.5 W/cm2 intensity, 3 MHz frequency, 50% duty cycle).</p>
|
|
<p><b>Sham ultrasound</b> (n=18)</p>
|
|
<p>Participants received sham UST (the device was switched off).</p>
|
|
<p>
|
|
<b>Concomitant treatment:</b>
|
|
</p>
|
|
<p>Participants in each group received conventional treatment (i.e. physical exercise, massage and balneotherapy) every working day for two weeks, on a total of 10 occasions. Exercises included standardised hip exercises. Swedish massage techniques were used during the massage therapy, and the balneotherapy was performed in thermal water at 34 degrees C. Participants were permitted to take analgesics or anti-rheumatic drugs during the study-these medications were recorded on their documents. They were not permitted to receive any additional therapy during the 3 months follow-up period.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab28_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Hip osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age: 65 years</p>
|
|
<p>N = 71</p>
|
|
<p>Definition: clinically and radiologically moderate hip osteoarthritis (Kellgren-Lawrence II-III stage) as defined by American College of Rheumatology criteria</p>
|
|
<p>Severity (resting VAS pain at baseline): continuous US group: 64.38 (12.45), pulsed US group: 63.88 (14.47), combination group: 61.33 (17.78), placebo group: 62.94 (9.37)</p>
|
|
<p>Duration of symptoms: at least 8 weeks prior to the start of the study</p>
|
|
<p>Presence of multi-morbidities: continuous US group: 10/21, pulsed US group: 13/17, combination group: 6/15, placebo group: 12/18</p>
|
|
</td><td headers="hd_h_niceng226er7.tab28_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Quality of life at ≤3 months</p>
|
|
<p>Pain at ≤3 months</p>
|
|
<p>Mild adverse events at ≤3 months</p>
|
|
<p>Moderate/major adverse events at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab28_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab28_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sangtong 2019<a class="bibr" href="#niceng226er7.s1.1.ref190" rid="niceng226er7.s1.1.ref190"><sup>190</sup></a></td><td headers="hd_h_niceng226er7.tab28_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Combination therapy</b> (n=74)</p>
|
|
<p>Ultrasound and TENS. Ultrasound (frequency 1MHz, power 1W/cm2) for 10 minutes during each weekday over a 2 week period. TENS (symmetrical biphasic waveform, frequency 32-50Hz, pulse width 80 microseconds) for the same amount of time and the same number of days.</p>
|
|
<p><b>Ultrasound</b> (n=74)</p>
|
|
<p>Ultrasound only. Ultrasound (frequency 1MHz, power 1W/cm2) for 10 minutes during each weekday over a 2 week period.</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>People were asked to not accept pain medication or physical therapy from other clinics or hospitals for the duration of the study. People in both groups received informational brochures specific to knee osteoarthritis, including risk factors for osteoarthritis and how to properly use the affected knee during activities of daily living. Examples of provided information included reducing body weight, avoidance of knee flexion position >90 degrees, avoidance of unnecessary stair use and emphasis of the importance of knee strengthening exercises. People who were taking NSAIDs were asked to discontinue them one week before entering the study. People with intolerable pain were prescribed ibuprofen 1200mg/day as rescue medication for pain.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab28_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 63.0 (7.8) years</p>
|
|
<p>N = 148</p>
|
|
<p>Definition: People with symptomatic knee osteoarthritis fulfilling the American College of Rheumatology criteria</p>
|
|
<p>Severity: Not stated</p>
|
|
<p>Duration of symptoms (median [range]): 12-24 (1-240)</p>
|
|
<p>Presence of multimorbidities: Not stated/Unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab28_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at ≤3 months</p>
|
|
<p>Mild adverse events at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab28_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab29"><div id="niceng226er7.tab29" class="table"><h3><span class="label">Table 29</span><span class="title">Summary of studies included in the combination therapy compared to sham treatment comparison</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab29/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab29_lrgtbl__"><table><thead><tr><th id="hd_h_niceng226er7.tab29_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study</th><th id="hd_h_niceng226er7.tab29_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention and comparison</th><th id="hd_h_niceng226er7.tab29_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><th id="hd_h_niceng226er7.tab29_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes</th><th id="hd_h_niceng226er7.tab29_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comments</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab29_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Alqualo-Costa 2020<a class="bibr" href="#niceng226er7.s1.1.ref15" rid="niceng226er7.s1.1.ref15"><sup>15</sup></a></td><td headers="hd_h_niceng226er7.tab29_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Interferential therapy</b> (n=42)</p>
|
|
<p>Interferential current (IFC) three times a week for 4 week (12 sessions). Duration of each session ranged from 40 to 50 minutes. Parameters were used as follows: carrier current frequency of 4000Hz; amplitude-modulated frequency of 50Hz; sweep frequency of 50Hz; swing pattern of 1:1 second, and the current amplitude was increased until the patient reported strong but comfortable and non-painful stimulation paraesthesia.</p>
|
|
<p><b>Laser therapy</b> (n=42)</p>
|
|
<p>Three times a week for 4 week (12 sessions). Duration of each session ranged from 40 to 50 minutes, and used a probe with a wavelength of 904nm, with a dose of 3J per point, totalling 9 points, total energy of 27J per session, peak power of 70W, pulse repetition frequency of 9500Hz, pulse duration of 60ns, average power of 40mW, application time of 75 seconds per point, and beam cross-sectional area of 0.5cm².</p>
|
|
<p><b>Combination therapy</b> (n=42)</p>
|
|
<p>IFC plus PBM (interferential current plus photobiomodulation). Three times a week for 4 weeks (12 sessions).</p>
|
|
<p><b>Sham electrotherapy</b> (n=42)</p>
|
|
<p>Sham IFC and PBM.</p>
|
|
<p>Three times a week for 4 week (12 sessions).</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>No analgesics 4 hours before the intervention.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab29_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): IFC group: 64.5 (7.8) years, PBM group: 61.3 (9.4) years, IFC+PBM group: 65.7 (10.1) years, placebo group: 65.3 (8.5) years</p>
|
|
<p>N = 168</p>
|
|
<p>Definition:</p>
|
|
<p>American College of Rheumatology criteria</p>
|
|
<p>Severity (Kellgren-Lawrence):</p>
|
|
<p>(Score 2): IFC group: 24, PBM group: 23, IFC+PBM group: 27, placebo group: 24</p>
|
|
<p>(Score 3): IFC group: 17, PBM group: 19, IFC+PBM group: 15, placebo group: 18</p>
|
|
<p>(Score 4): IFC group: 1, PBM group: 1, IFC+PBM group: 0, placebo group: 0</p>
|
|
<p>Duration of symptoms: not reported</p>
|
|
<p>Presence of multi-morbidities: Not stated/unclear</p>
|
|
</td><td headers="hd_h_niceng226er7.tab29_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain at ≤3 months and >3 months</td><td headers="hd_h_niceng226er7.tab29_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng226er7.tab29_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Kiraly 2021<a class="bibr" href="#niceng226er7.s1.1.ref124" rid="niceng226er7.s1.1.ref124"><sup>124</sup></a></td><td headers="hd_h_niceng226er7.tab29_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Combination therapy</b> (n=15)</p>
|
|
<p>Participants received combined UST and TENS therapy for 10 minutes per day (continuous US: 0.5 W/cm2 intensity, 3MHs carrier frequency; TENS: 100 Hz frequency, 100µs impulse, constant frequency).</p>
|
|
<p><b>Ultrasound</b> (n=38)</p>
|
|
<p>Combination of people receiving continuous and pulse ultrasound. Participants received continuous ultrasound therapy (UST) with moving head in three fields: 1) inguinal; 2) gluteal; and 3) trochanteric for 3 minutes per field, altogether for 9 minutes every working day for 2 weeks, on a total of 10 occasions (calibrated BTL-4825S Premium device, head size: 5cm, 3 MHz frequency, 1.5 W/cm2 intensity). Participants received pulsed UST (1.5 W/cm2 intensity, 3 MHz frequency, 50% duty cycle).</p>
|
|
<p><b>Sham therapy</b> (n=18)</p>
|
|
<p>Participants received sham UST (the device was switched off).</p>
|
|
<p>
|
|
<b>Concomitant treatment:</b>
|
|
</p>
|
|
<p>Participants in each group received conventional treatment (i.e. physical exercise, massage and balneotherapy) every working day for two weeks, on a total of 10 occasions. Exercises included standardised hip exercises. Swedish massage techniques were used during the massage therapy, and the balneotherapy was performed in thermal water at 34 degrees C. Participants were permitted to take analgesics or anti-rheumatic drugs during the study-these medications were recorded on their documents. They were not permitted to receive any additional therapy during the 3 months follow-up period.</p>
|
|
</td><td headers="hd_h_niceng226er7.tab29_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Hip osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age: 65 years</p>
|
|
<p>N = 71</p>
|
|
<p>Definition: clinically and radiologically moderate hip osteoarthritis (Kellgren-Lawrence II-III stage) as defined by American College of Rheumatology criteria</p>
|
|
<p>Severity (resting VAS pain at baseline): continuous US group: 64.38 (12.45), pulsed US group: 63.88 (14.47), combination group: 61.33 (17.78), placebo group: 62.94 (9.37)</p>
|
|
<p>Duration of symptoms: at least 8 weeks prior to the start of the study</p>
|
|
<p>Presence of multi-morbidities: continuous US group: 10/21, pulsed US group: 13/17, combination group: 6/15, placebo group: 12/18</p>
|
|
</td><td headers="hd_h_niceng226er7.tab29_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Quality of life at ≤3 months</p>
|
|
<p>Pain at ≤3 months</p>
|
|
<p>Mild adverse events at ≤3 months</p>
|
|
<p>Moderate/major adverse events at ≤3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab29_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab30"><div id="niceng226er7.tab30" class="table"><h3><span class="label">Table 30</span><span class="title">Summary of studies included in the combination therapy compared to no treatment comparison</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab30/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab30_lrgtbl__"><table><tbody><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Altas 2020<a class="bibr" href="#niceng226er7.s1.1.ref16" rid="niceng226er7.s1.1.ref16"><sup>16</sup></a></td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Combination therapy plus exercise</b> (n=20)</p>
|
|
<p>Ten therapy sessions using hot pack, TENS and US.</p>
|
|
<p>Both groups received the same home-based exercise program as in 30 sessions with 10 reps a day for three times a week.</p>
|
|
<p><b>No treatment</b> (n=20)</p>
|
|
<p>Home based exercise, as above.</p>
|
|
<p>
|
|
<b>Concomitant treatment:</b>
|
|
</p>
|
|
<p>All patients were allowed to use paracetamol at a dose ≤3000mg/day for pain during the assessment. However, they were instructed not to use any other analgesics except for paracetamol. In addition, all patients were allowed to use other medications for their concomitant systemic diseases.</p>
|
|
</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): 56.6 (8.9) years</p>
|
|
<p>N=40</p>
|
|
<p>Definition (intervention versus control):</p>
|
|
<p>Severity (K-L grade 2): combination therapy group: 10, exercise group: 13</p>
|
|
<p>Severity (K-L grade 3): combination therapy group: 10, exercise group: 7</p>
|
|
<p>Duration (years): 3.13 (1.3), range 1-5 years</p>
|
|
</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Quality of life at ≤3 months</p>
|
|
<p>Pain at ≤3 months</p>
|
|
<p>Psychological distress at ≤3 months</p>
|
|
</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Eftekharsadat 2019<a class="bibr" href="#niceng226er7.s1.1.ref74" rid="niceng226er7.s1.1.ref74"><sup>74</sup></a></td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Extracorporeal shockwave therapy</b> (n= 25)</p>
|
|
<p>ESWT. Participants received 5 sessions of shock wave therapy through 3 weeks Then, radial ESWT was used with shockwaves of 2000 pulses/session with an energy flux density of 0.18mJ/mm², the energy level of 2-4, a frequency of 10-16Hz, and pulse rate of 160/ minute were generally applied each session.</p>
|
|
<p><b>Combination therapy</b> (n=25)</p>
|
|
<p>Participants received 10 sessions (3 sessions, weekly) of physical therapy including hot pack, TENS and ultrasound (US, HP: 74.5 degrees C, 20 minutes on the affected knee, TENS: pulse duration 20-100 microseconds, 50% duty cycle, current amplitude, maximum tolerated tingling, frequency <200pps, US: frequency of 1 MHz, the intensity of 2.5 W/cm², and duty cycle of 25%, and the probe of US was applied for 10 minutes.</p>
|
|
<p><b>No treatment</b> (n=25)</p>
|
|
<p>The exercise programme was applied to all 3 groups. It consisted of the isometric strengthening of the quadriceps muscle in the form of 3 submaximal isometric contractions with gradually increasing intensity combined with weight- bearing water and land based exercises. Additionally, participants were advised to only use acetaminophen for pain relief in the event of severe pain and activities of daily living modifications (e.g. weight loss and the avoidance of heavy lifting, long-distance walking, and high-impact exercises) were taught as well.</p>
|
|
<p>
|
|
<b>Concomitant therapy:</b>
|
|
</p>
|
|
<p>None of the participants undertook any form of physical therapy, in addition to the ones stipulated. In addition, they did not use intra-articular, anti-inflammatory or chondroprotective corticosteroids. The use of medications for concomitant diseases was not controlled</p>
|
|
</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Knee osteoarthritis</b>
|
|
</p>
|
|
<p>Mean age (SD): ESWT group: 58.00 (5.97) years, PT group: 55.76 (6.06) years, exercise group: 58.16 (7.20) years</p>
|
|
<p>N = 75</p>
|
|
<p>Definition: American College of Rheumatology criteria</p>
|
|
<p>Severity:(VAS score at baseline): ESWT group: 7.00 (1.63), combination group: 7.16 (1.37), exercise group: 6.32(1.44)</p>
|
|
<p>Duration of symptoms: Not stated/unclear</p>
|
|
<p>Presence of multi-morbidities: Not stated/unclear</p>
|
|
</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Pain at ≤3 months</p>
|
|
<p>Physical function at ≤3 months</p>
|
|
</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The combination therapy and extracorporeal shockwave therapy arms were not compared to each other as the combination therapy did not include the extracorporeal shockwave therapy as a component.</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab31"><div id="niceng226er7.tab31" class="table"><h3><span class="label">Table 31</span><span class="title">Summary matrix for all interventions at ≤3 months</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab31/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab31_lrgtbl__"><table><thead><tr><th id="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Intervention</th><th id="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Control</th><th id="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Quality of life at ≤3 months</th><th id="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Pain at ≤3 months</th><th id="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Physical function at ≤3 months</th><th id="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Psychological distress at ≤3 months</th><th id="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Osteoarthritis flares at ≤3 months</th><th id="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Mild adverse events at ≤3 months</th><th id="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Moderate/major adverse events at ≤3 months</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="9" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Pulsed short-wave therapy</b>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Interferential therapy</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (2 studies)</p>
|
|
<p>N = 103</p>
|
|
<p>Moderate</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (2 studies)</p>
|
|
<p>N = 103</p>
|
|
<p>Moderate</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Neuromuscular electrical stimulation</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Extracorporeal shockwave therapy</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Laser therapy</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 40</p>
|
|
<p>Low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 40</p>
|
|
<p>Moderate</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Transcutaneous electrical nerve stimulation</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (2 studies)</p>
|
|
<p>N = 109</p>
|
|
<p>Low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 69</p>
|
|
<p>Low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Ultrasound</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 40</p>
|
|
<p>Very low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Combination therapy</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sham electrotherapy</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>3 GRADE Outcomes (5 studies)</p>
|
|
<p>N = 301</p>
|
|
<p>High-Low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>2 GRADE Outcomes (13 studies)</p>
|
|
<p>N = 691</p>
|
|
<p>Very low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>2 GRADE Outcomes (9 studies)</p>
|
|
<p>N = 548</p>
|
|
<p>Low-Very low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 60</p>
|
|
<p>Low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (5 studies)</p>
|
|
<p>N = 339</p>
|
|
<p>Very low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 83</p>
|
|
<p>Moderate</p>
|
|
</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No treatment</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>6 GRADE Outcomes (2 studies)</p>
|
|
<p>N = 131</p>
|
|
<p>Very low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>3 GRADE Outcomes (5 studies)</p>
|
|
<p>N = 302</p>
|
|
<p>Moderate-Very low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>2 GRADE Outcomes (3 studies)</p>
|
|
<p>N = 171</p>
|
|
<p>Low-Very low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>2 GRADE Outcomes (2 studies)</p>
|
|
<p>N = 100</p>
|
|
<p>Very Low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Interferential therapy</b>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pulsed short-wave therapy</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (2 studies)</p>
|
|
<p>N = 103</p>
|
|
<p>Moderate</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (2 studies)</p>
|
|
<p>N = 103</p>
|
|
<p>Moderate</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Neuromuscular electrical stimulation</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Extracorporeal shockwave therapy</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Laser therapy</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (2 studies)</p>
|
|
<p>N = 124</p>
|
|
<p>Moderate</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 40</p>
|
|
<p>Low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Transcutaneous electrical nerve stimulation</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 68</p>
|
|
<p>Low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 68</p>
|
|
<p>Low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 116</p>
|
|
<p>Low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Ultrasound</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Combination therapy</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 84</p>
|
|
<p>Moderate</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sham electrotherapy</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>2 GRADE Outcomes (4 studies)</p>
|
|
<p>N = 250</p>
|
|
<p>Moderate-Very low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (2 studies)</p>
|
|
<p>N = 126</p>
|
|
<p>Very low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No treatment</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 40</p>
|
|
<p>Moderate</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 40</p>
|
|
<p>Low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Neuromuscular electrical stimulation</b>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pulsed short-wave therapy</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Interferential therapy</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Extracorporeal shockwave therapy</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Laser therapy</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 30</p>
|
|
<p>Low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Transcutaneous electrical nerve stimulation</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Ultrasound</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 60</p>
|
|
<p>Low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 60</p>
|
|
<p>Low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Combination therapy</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 29</p>
|
|
<p>Low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sham electrotherapy</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No treatment</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>8 GRADE Outcomes (2 study)</p>
|
|
<p>N = 54</p>
|
|
<p>Very low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>2 GRADE Outcome (6 studies)</p>
|
|
<p>N = 284</p>
|
|
<p>Moderate-Very low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>2 GRADE Outcomes (4 studies)</p>
|
|
<p>N = 184</p>
|
|
<p>Very low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 100</p>
|
|
<p>Low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Extracorporeal shockwave therapy</b>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pulsed short-wave therapy</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Interferential therapy</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Neuromuscular electrical stimulation</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Laser therapy</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Transcutaneous electrical nerve stimulation</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Ultrasound</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Combination therapy</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sham electrotherapy</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>2 GRADE Outcomes (5 studies)</p>
|
|
<p>N = 307</p>
|
|
<p>High-Very low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (2 studies)</p>
|
|
<p>N = 200</p>
|
|
<p>High</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 70</p>
|
|
<p>Moderate</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 63</p>
|
|
<p>Low</p>
|
|
</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No treatment</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (2 studies)</p>
|
|
<p>N = 73</p>
|
|
<p>Low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 45</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Laser therapy</b>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pulsed short-wave therapy</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 40</p>
|
|
<p>Low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 40</p>
|
|
<p>Moderate</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Interferential therapy</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (2 studies)</p>
|
|
<p>N = 124</p>
|
|
<p>Moderate</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 40</p>
|
|
<p>Low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Neuromuscular electrical stimulation</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 30</p>
|
|
<p>Low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Electrocorporeal shockwave therapy</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Transcutaneous electrical nerve stimulation</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Ultrasound</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Combination therapy</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (2 studies)</p>
|
|
<p>N = 113</p>
|
|
<p>Low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sham electrotherapy</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>5 GRADE Outcomes (4 studies)</p>
|
|
<p>N = 305</p>
|
|
<p>High-Moderate</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>2 GRADE Outcomes (18 studies)</p>
|
|
<p>N = 1150</p>
|
|
<p>Very low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>2 GRADE Outcomes (10 studies)</p>
|
|
<p>N = 591</p>
|
|
<p>High-Very low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (4 studies)</p>
|
|
<p>N = 227</p>
|
|
<p>Very low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 55</p>
|
|
<p>Moderate</p>
|
|
</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No treatment</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>2 GRADE Outcomes (1 study)</p>
|
|
<p>N = 134</p>
|
|
<p>Low-Very low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (4 studies)</p>
|
|
<p>N = 279</p>
|
|
<p>Very low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (4 studies)</p>
|
|
<p>N = 279</p>
|
|
<p>Very low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Transcutaneous electrical nerve stimulation</b>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pulsed short-wave therapy</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (2 studies)</p>
|
|
<p>N = 109</p>
|
|
<p>Low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 69</p>
|
|
<p>Low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Interferential therapy</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (2 studies)</p>
|
|
<p>N = 173</p>
|
|
<p>Very low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (2 studies)</p>
|
|
<p>N = 173</p>
|
|
<p>Very low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 116</p>
|
|
<p>Low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Neuromuscular electrical stimulation</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Electrocorporeal shockwave therapy</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Laser therapy</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Ultrasound</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>2 GRADE Outcomes (1 study)</p>
|
|
<p>N = 64</p>
|
|
<p>Low-Very low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 24</p>
|
|
<p>Low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Combination therapy</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 38</p>
|
|
<p>Very low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 38</p>
|
|
<p>Moderate</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 38</p>
|
|
<p>Moderate</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 40</p>
|
|
<p>Low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 40</p>
|
|
<p>Low</p>
|
|
</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sham electrotherapy</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>5 GRADE Outcomes (1 study)</p>
|
|
<p>N = 40</p>
|
|
<p>Low-Very low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>2 GRADE Outcomes (6 studies)</p>
|
|
<p>N = 435</p>
|
|
<p>Low-Very low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>2 GRADE Outcomes (5 studies)</p>
|
|
<p>N = 387</p>
|
|
<p>Low-Very low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 24</p>
|
|
<p>Very low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No treatment</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>2 GRADE Outcomes (4 studies)</p>
|
|
<p>N = 151</p>
|
|
<p>Very low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (3 studies)</p>
|
|
<p>N = 111</p>
|
|
<p>Very low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 24</p>
|
|
<p>Very low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Ultrasound</b>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pulsed short-wave therapy</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 40</p>
|
|
<p>Very low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Interferential therapy</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Neuromuscular electrical stimulation</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 60</p>
|
|
<p>Very low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 60</p>
|
|
<p>Very low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Electrocorporeal shockwave therapy</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Laser therapy</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Transcutaneous electrical nerve stimulation</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>2 GRADE Outcomes (2 studies)</p>
|
|
<p>N = 64</p>
|
|
<p>Low-Very low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 24</p>
|
|
<p>Low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Combination therapy</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>2 GRADE Outcomes (1 study)</p>
|
|
<p>N = 53</p>
|
|
<p>Low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (2 studies)</p>
|
|
<p>N = 201</p>
|
|
<p>Very low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (2 studies)</p>
|
|
<p>N = 185</p>
|
|
<p>Very low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 53</p>
|
|
<p>Low</p>
|
|
</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sham electrotherapy</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>10 GRADE Outcomes (4 studies)</p>
|
|
<p>N = 245</p>
|
|
<p>High-Very low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>2 GRADE Outcomes (13 studies)</p>
|
|
<p>N = 799</p>
|
|
<p>Very low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>2 GRADE Outcomes (7 studies)</p>
|
|
<p>N = 411</p>
|
|
<p>Low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>2 GRADE Outcomes (1 study)</p>
|
|
<p>N = 40</p>
|
|
<p>Low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (5 studies)</p>
|
|
<p>N = 330</p>
|
|
<p>Very low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 56</p>
|
|
<p>Low</p>
|
|
</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No treatment</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>2 GRADE Outcomes (1 study)</p>
|
|
<p>N = 30</p>
|
|
<p>Very low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>2 GRADE Outcomes (6 studies)</p>
|
|
<p>N = 358</p>
|
|
<p>Very low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (2 study)</p>
|
|
<p>N = 128</p>
|
|
<p>Very low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Combination therapy</b>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pulsed short-wave therapy</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Interferential therapy</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 84</p>
|
|
<p>Moderate</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Neuromuscular electrical stimulation</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 29</p>
|
|
<p>Low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Electrocorporeal shockwave therapy</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Laser therapy</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (2 studies)</p>
|
|
<p>N = 113</p>
|
|
<p>Low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Transcutaneous electrical nerve stimulation</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 38</p>
|
|
<p>Very low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 38</p>
|
|
<p>Moderate</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 38</p>
|
|
<p>Moderate</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 40</p>
|
|
<p>Low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 40</p>
|
|
<p>Low</p>
|
|
</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Ultrasound</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>2 GRADE Outcomes (1 study)</p>
|
|
<p>N = 53</p>
|
|
<p>Low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (2 studies)</p>
|
|
<p>N = 201</p>
|
|
<p>Very low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (2 studies)</p>
|
|
<p>N = 185</p>
|
|
<p>Very low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 53</p>
|
|
<p>Low</p>
|
|
</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sham electrotherapy</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>2 GRADE Outcomes (1 study)</p>
|
|
<p>N = 33</p>
|
|
<p>Low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (2 studies)</p>
|
|
<p>N = 117</p>
|
|
<p>Moderate</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 33</p>
|
|
<p>Low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 33</p>
|
|
<p>Low</p>
|
|
</td></tr><tr><td headers="hd_h_niceng226er7.tab31_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab31_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No treatment</td><td headers="hd_h_niceng226er7.tab31_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>8 GRADE Outcomes (1 study)</p>
|
|
<p>N = 40</p>
|
|
<p>Low-Very low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (2 studies)</p>
|
|
<p>N = 84</p>
|
|
<p>Very low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 44</p>
|
|
<p>Low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 40</p>
|
|
<p>Very low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab31_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab31_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab32"><div id="niceng226er7.tab32" class="table"><h3><span class="label">Table 32</span><span class="title">Summary matrix for all interventions at >3 months</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab32/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab32_lrgtbl__"><table><thead><tr><th id="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Intervention</th><th id="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Control</th><th id="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Quality of life at >3 months</th><th id="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Pain at >3 months</th><th id="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Physical function at >3 months</th><th id="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Psychological distress at >3 months</th><th id="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Osteoarthritis flares at >3 months</th><th id="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Mild adverse events at >3 months</th><th id="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Moderate/major adverse events at >3 months</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="9" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Pulsed short-wave therapy</b>
|
|
</td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Interferential therapy</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 63</p>
|
|
<p>Low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 63</p>
|
|
<p>Low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Neuromuscular electrical stimulation</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Extracorporeal shockwave therapy</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Laser therapy</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Transcutaneous electrical nerve stimulation</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (2 studies)</p>
|
|
<p>N = 69</p>
|
|
<p>Low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 69</p>
|
|
<p>Low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Ultrasound</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Combination therapy</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sham electrotherapy</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>3 GRADE Outcomes (2 studies)</p>
|
|
<p>N = 121</p>
|
|
<p>High-Very low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>2 GRADE Outcomes (3 studies)</p>
|
|
<p>N = 184</p>
|
|
<p>High-Low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>2 GRADE Outcomes (3 studies)</p>
|
|
<p>N = 184</p>
|
|
<p>High-Low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No treatment</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>5 GRADE Outcomes (1 study)</p>
|
|
<p>N = 40</p>
|
|
<p>Very low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 40</p>
|
|
<p>Very low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 40</p>
|
|
<p>Very low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 40</p>
|
|
<p>Very low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Interferential therapy</b>
|
|
</td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pulsed short-wave therapy</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 63</p>
|
|
<p>Low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 63</p>
|
|
<p>Low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Neuromuscular electrical stimulation</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Extracorporeal shockwave therapy</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Laser therapy</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 84</p>
|
|
<p>Moderate</p>
|
|
</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Transcutaneous electrical nerve stimulation</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 68</p>
|
|
<p>Low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 68</p>
|
|
<p>Low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Ultrasound</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Combination therapy</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 84</p>
|
|
<p>Moderate</p>
|
|
</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sham electrotherapy</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>2 GRADE Outcomes (2 studies)</p>
|
|
<p>N = 150</p>
|
|
<p>Moderate-Low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 66</p>
|
|
<p>Low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No treatment</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Neuromuscular electrical stimulation</b>
|
|
</td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pulsed short-wave therapy</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Interferential therapy</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Extracorporeal shockwave therapy</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Laser therapy</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Transcutaneous electrical nerve stimulation</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Ultrasound</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Combination therapy</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sham electrotherapy</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No treatment</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>2 GRADE Outcomes (2 studies)</p>
|
|
<p>N = 74</p>
|
|
<p>Very low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 30</p>
|
|
<p>Very low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Extracorporeal shockwave therapy</b>
|
|
</td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pulsed short-wave therapy</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Interferential therapy</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Neuromuscular electrical stimulation</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Laser therapy</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Transcutaneous electrical nerve stimulation</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Ultrasound</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Combination therapy</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sham electrotherapy</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No treatment</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Laser therapy</b>
|
|
</td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pulsed short-wave therapy</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Interferential therapy</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 84</p>
|
|
<p>Moderate</p>
|
|
</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Neuromuscular electrical stimulation</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Electrocorporeal shockwave therapy</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Transcutaneous electrical nerve stimulation</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Ultrasound</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Combination therapy</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 84</p>
|
|
<p>Moderate</p>
|
|
</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sham electrotherapy</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>2 GRADE Outcomes (1 study)</p>
|
|
<p>N = 123</p>
|
|
<p>Moderate</p>
|
|
</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>2 GRADE Outcomes (4 studies)</p>
|
|
<p>N = 319</p>
|
|
<p>High-Moderate</p>
|
|
</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>2 GRADE Outcomes (3 studies)</p>
|
|
<p>N = 235</p>
|
|
<p>High-Moderate</p>
|
|
</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 66</p>
|
|
<p>Very low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No treatment</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>2 GRADE Outcomes (1 study)</p>
|
|
<p>N = 120</p>
|
|
<p>Low-Very low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 120</p>
|
|
<p>Low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 120</p>
|
|
<p>Low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Transcutaneous electrical nerve stimulation</b>
|
|
</td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pulsed short-wave therapy</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (2 studies)</p>
|
|
<p>N = 69</p>
|
|
<p>Low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 69</p>
|
|
<p>Low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Interferential therapy</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 68</p>
|
|
<p>Low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 68</p>
|
|
<p>Low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Neuromuscular electrical stimulation</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Electrocorporeal shockwave therapy</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Laser therapy</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Ultrasound</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Combination therapy</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sham electrotherapy</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (2 studies)</p>
|
|
<p>N = 221</p>
|
|
<p>Very low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (2 studies)</p>
|
|
<p>N = 221</p>
|
|
<p>Moderate</p>
|
|
</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No treatment</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Ultrasound</b>
|
|
</td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pulsed short-wave therapy</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Interferential therapy</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Neuromuscular electrical stimulation</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Electrocorporeal shockwave therapy</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Laser therapy</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Transcutaneous electrical nerve stimulation</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Combination therapy</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sham electrotherapy</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 60</p>
|
|
<p>Low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 60</p>
|
|
<p>Low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No treatment</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (2 studies)</p>
|
|
<p>N = 160</p>
|
|
<p>Very low</p>
|
|
</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Combination therapy</b>
|
|
</td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pulsed short-wave therapy</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Interferential therapy</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 84</p>
|
|
<p>Moderate</p>
|
|
</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Neuromuscular electrical stimulation</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Electrocorporeal shockwave therapy</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Laser therapy</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 84</p>
|
|
<p>Moderate</p>
|
|
</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Transcutaneous electrical nerve stimulation</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Ultrasound</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sham electrotherapy</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1 GRADE Outcome (1 study)</p>
|
|
<p>N = 84</p>
|
|
<p>High</p>
|
|
</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr><tr><td headers="hd_h_niceng226er7.tab32_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab32_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No treatment</td><td headers="hd_h_niceng226er7.tab32_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td><td headers="hd_h_niceng226er7.tab32_1_1_1_9" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No evidence identified</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab33"><div id="niceng226er7.tab33" class="table"><h3><span class="label">Table 33</span><span class="title">Clinical evidence summary: pulsed short-wave therapy compared to sham electrotherapy</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab33/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab33_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng226er7.tab33_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab33_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_niceng226er7.tab33_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab33_1_1_1_2" style="text-align:left;vertical-align:bottom;">№ of participants (studies) Follow up</th><th id="hd_h_niceng226er7.tab33_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab33_1_1_1_3" style="text-align:left;vertical-align:bottom;">Certainty of the evidence (GRADE)</th><th id="hd_h_niceng226er7.tab33_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab33_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95% CI)</th><th id="hd_h_niceng226er7.tab33_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Anticipated absolute effects</th><th id="hd_h_niceng226er7.tab33_1_1_1_6" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab33_1_1_1_6" style="text-align:left;vertical-align:bottom;">Comments</th></tr><tr><th headers="hd_h_niceng226er7.tab33_1_1_1_5" id="hd_h_niceng226er7.tab33_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk with sham electrotherapy</th><th headers="hd_h_niceng226er7.tab33_1_1_1_5" id="hd_h_niceng226er7.tab33_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk difference with pulsed short-wave therapy</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab33_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (EQ-5D, KOOS, AIMS, 0-100, high is good, change score and final values) at ≤3 months</td><td headers="hd_h_niceng226er7.tab33_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>178</p>
|
|
<p>(3 RCTs)</p>
|
|
<p>follow up: mean 4 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab33_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab33_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab33_1_1_1_5 hd_h_niceng226er7.tab33_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 27.0</td><td headers="hd_h_niceng226er7.tab33_1_1_1_5 hd_h_niceng226er7.tab33_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>2.73 higher</b></p>
|
|
<p>(3.37 lower to 8.83 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab33_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 9 (0.5 × median baseline SD)</td></tr><tr><td headers="hd_h_niceng226er7.tab33_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (SF-36 physical component, 0-100, high is good, final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab33_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>63</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 4 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab33_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁⨁◯</p>
|
|
<p>MODERATE<sup>c</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab33_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab33_1_1_1_5 hd_h_niceng226er7.tab33_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 53.1</td><td headers="hd_h_niceng226er7.tab33_1_1_1_5 hd_h_niceng226er7.tab33_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>2.7 higher</b></p>
|
|
<p>(0.34 lower to 5.74 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab33_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 2 (established value)</td></tr><tr><td headers="hd_h_niceng226er7.tab33_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (SF-36 mental component, 0-100, high is good, final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab33_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>60</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 4 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab33_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁⨁⨁</p>
|
|
<p>HIGH</p>
|
|
</td><td headers="hd_h_niceng226er7.tab33_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab33_1_1_1_5 hd_h_niceng226er7.tab33_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 43.6</td><td headers="hd_h_niceng226er7.tab33_1_1_1_5 hd_h_niceng226er7.tab33_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>0.2 higher</b></p>
|
|
<p>(1.92 lower to 2.32 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab33_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 3 (established value)</td></tr><tr><td headers="hd_h_niceng226er7.tab33_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (KOOS, 0-100, high is good, final value) at >3 months</td><td headers="hd_h_niceng226er7.tab33_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>51</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 12 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab33_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab33_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab33_1_1_1_5 hd_h_niceng226er7.tab33_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 33</td><td headers="hd_h_niceng226er7.tab33_1_1_1_5 hd_h_niceng226er7.tab33_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>3.4 higher</b></p>
|
|
<p>(5.26 lower to 12.06 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab33_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab33_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (SF-36 physical component, 0-100, high is good, change score) at >3 months</td><td headers="hd_h_niceng226er7.tab33_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>70</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 26 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab33_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁⨁◯</p>
|
|
<p>MODERATE<sup>c</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab33_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab33_1_1_1_5 hd_h_niceng226er7.tab33_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 2.6</td><td headers="hd_h_niceng226er7.tab33_1_1_1_5 hd_h_niceng226er7.tab33_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>1.6 lower</b></p>
|
|
<p>(4.64 lower to 1.44 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab33_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 2 (established value)</td></tr><tr><td headers="hd_h_niceng226er7.tab33_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (SF-36 mental component, 0-100, high is good, change score) at >3 months</td><td headers="hd_h_niceng226er7.tab33_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>70</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 26 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab33_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁⨁⨁</p>
|
|
<p>HIGH</p>
|
|
</td><td headers="hd_h_niceng226er7.tab33_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab33_1_1_1_5 hd_h_niceng226er7.tab33_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 2.4</td><td headers="hd_h_niceng226er7.tab33_1_1_1_5 hd_h_niceng226er7.tab33_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>1.2 lower</b></p>
|
|
<p>(5.3 lower to 2.9 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab33_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 3 (established value)</td></tr><tr><td headers="hd_h_niceng226er7.tab33_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (WOMAC [different scale ranges], high is poor, change scores) at ≤3 months</td><td headers="hd_h_niceng226er7.tab33_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>247</p>
|
|
<p>(4 RCTs)</p>
|
|
<p>follow up: mean 8 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab33_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup><sup>,</sup><sup>c</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab33_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab33_1_1_1_5 hd_h_niceng226er7.tab33_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab33_1_1_1_5 hd_h_niceng226er7.tab33_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>SMD <b>0.36 SD lower</b></p>
|
|
<p>(0.97 lower to 0.26 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab33_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab33_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (KOOS, WOMAC, VAS, NRS [different scale ranges], high is poor, final values) at ≤3 months</td><td headers="hd_h_niceng226er7.tab33_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>444</p>
|
|
<p>(9 RCTs)</p>
|
|
<p>follow up: mean 6 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab33_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup><sup>,</sup><sup>c</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab33_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab33_1_1_1_5 hd_h_niceng226er7.tab33_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab33_1_1_1_5 hd_h_niceng226er7.tab33_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>SMD <b>0.67 SD lower</b></p>
|
|
<p>(1.12 lower to 0.21 lower)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab33_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab33_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (WOMAC [different scale ranges], high is poor, change scores) at >3 months</td><td headers="hd_h_niceng226er7.tab33_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>133</p>
|
|
<p>(2 RCTs)</p>
|
|
<p>follow up: mean 26 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab33_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁⨁⨁</p>
|
|
<p>HIGH</p>
|
|
</td><td headers="hd_h_niceng226er7.tab33_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab33_1_1_1_5 hd_h_niceng226er7.tab33_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab33_1_1_1_5 hd_h_niceng226er7.tab33_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>SMD <b>0.01 SD higher</b></p>
|
|
<p>(0.49 lower to 0.5 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab33_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab33_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (KOOS, 0-100, high is good, final value) at >3 months</td><td headers="hd_h_niceng226er7.tab33_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>51</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 52 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab33_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW<sup>a</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab33_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab33_1_1_1_5 hd_h_niceng226er7.tab33_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean pain was 33</td><td headers="hd_h_niceng226er7.tab33_1_1_1_5 hd_h_niceng226er7.tab33_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>24.6 higher</b></p>
|
|
<p>(16.63 higher to 32.57 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab33_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab33_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Physical function (WOMAC [different scale ranges], high is poor, change scores) at ≤3 months</td><td headers="hd_h_niceng226er7.tab33_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>245</p>
|
|
<p>(4 RCTs)</p>
|
|
<p>follow up: mean 8 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab33_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW<sup>b</sup><sup>,</sup><sup>c</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab33_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab33_1_1_1_5 hd_h_niceng226er7.tab33_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab33_1_1_1_5 hd_h_niceng226er7.tab33_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>SMD <b>0.51 SD lower</b></p>
|
|
<p>(0.89 lower to 0.12 lower)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab33_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab33_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Physical function (KOOS, WOMAC [different scale ranges], high is poor, final values) at ≤3 months</td><td headers="hd_h_niceng226er7.tab33_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>303</p>
|
|
<p>(5 RCTs)</p>
|
|
<p>follow up: mean 6 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab33_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup><sup>,</sup><sup>c</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab33_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab33_1_1_1_5 hd_h_niceng226er7.tab33_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab33_1_1_1_5 hd_h_niceng226er7.tab33_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>SMD <b>0.52 SD lower</b></p>
|
|
<p>(0.97 lower to 0.06 lower)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab33_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab33_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Physical function (WOMAC [different scale ranges], high is poor, change scores) at >3 months</td><td headers="hd_h_niceng226er7.tab33_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>133</p>
|
|
<p>(2 RCTs)</p>
|
|
<p>follow up: 26 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab33_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁⨁⨁</p>
|
|
<p>HIGH</p>
|
|
</td><td headers="hd_h_niceng226er7.tab33_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab33_1_1_1_5 hd_h_niceng226er7.tab33_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab33_1_1_1_5 hd_h_niceng226er7.tab33_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>SMD <b>0.06 SD higher</b></p>
|
|
<p>(0.28 lower to 0.4 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab33_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab33_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Physical function (KOOS, 0-100, high is good, final value) at >3 months</td><td headers="hd_h_niceng226er7.tab33_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>51</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 12 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab33_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>c</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab33_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab33_1_1_1_5 hd_h_niceng226er7.tab33_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean physical function was 41.6</td><td headers="hd_h_niceng226er7.tab33_1_1_1_5 hd_h_niceng226er7.tab33_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>19 higher</b></p>
|
|
<p>(8.09 higher to 29.91 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab33_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab33_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Psychological distress (GHQ, 0-90, high is poor, final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab33_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>60</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 12 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab33_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>c</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab33_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab33_1_1_1_5 hd_h_niceng226er7.tab33_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean psychological distress was 26.79</td><td headers="hd_h_niceng226er7.tab33_1_1_1_5 hd_h_niceng226er7.tab33_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>3.48 higher</b></p>
|
|
<p>(3.98 lower to 10.94 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab33_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab33_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Mild adverse events at ≤3 months</td><td headers="hd_h_niceng226er7.tab33_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>339</p>
|
|
<p>(5 RCTs)</p>
|
|
<p>follow up: mean 7 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab33_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>d</sup><sup>,</sup><sup>e</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab33_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>RD 0.03</p>
|
|
<p>(−0.05 to 0.11)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab33_1_1_1_5 hd_h_niceng226er7.tab33_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">148 per 1,000</td><td headers="hd_h_niceng226er7.tab33_1_1_1_5 hd_h_niceng226er7.tab33_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>30 fewer per 1,000</b>
|
|
</p>
|
|
<p>(110 fewer to 50 more)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab33_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Precision calculated through Optimal Information Size (OIS) due to zero events in some studies (0.8-0.9 = serious, <0.8 = very serious).</td></tr><tr><td headers="hd_h_niceng226er7.tab33_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Moderate/major adverse events at ≤3 months</td><td headers="hd_h_niceng226er7.tab33_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>83</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 12 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab33_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>MODERATE<sup>a</sup><sup>,</sup><sup>e</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab33_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>RD 0.00</p>
|
|
<p>(−0.05 to 0.05)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab33_1_1_1_5 hd_h_niceng226er7.tab33_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">0 per 1,000</td><td headers="hd_h_niceng226er7.tab33_1_1_1_5 hd_h_niceng226er7.tab33_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>0 fewer per 1,000</b>
|
|
</p>
|
|
<p>(50 fewer to 50 more)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab33_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sample size used to determine precision: 75-150 = serious imprecision, <75 = very serious imprecision.</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng226er7.tab33_1"><p class="no_margin">Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="niceng226er7.tab33_2"><p class="no_margin">Downgraded by 1 or 2 increments because heterogeneity, unexplained by subgroup analysis</p></div></dd></dl><dl class="bkr_refwrap"><dt>c</dt><dd><div id="niceng226er7.tab33_3"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl><dl class="bkr_refwrap"><dt>d</dt><dd><div id="niceng226er7.tab33_4"><p class="no_margin">Downgraded for heterogeneity due to conflicting number of events in different studies (zero events in one or more studies)</p></div></dd></dl><dl class="bkr_refwrap"><dt>e</dt><dd><div id="niceng226er7.tab33_5"><p class="no_margin">Downgraded by 1 to 2 increments for imprecision due to zero events and small sample size</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab34"><div id="niceng226er7.tab34" class="table"><h3><span class="label">Table 34</span><span class="title">Clinical evidence summary: pulsed short-wave therapy compared to no treatment</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab34/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab34_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng226er7.tab34_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab34_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_niceng226er7.tab34_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab34_1_1_1_2" style="text-align:left;vertical-align:bottom;">№ of participants (studies) Follow up</th><th id="hd_h_niceng226er7.tab34_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab34_1_1_1_3" style="text-align:left;vertical-align:bottom;">Certainty of the evidence (GRADE)</th><th id="hd_h_niceng226er7.tab34_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab34_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95% CI)</th><th id="hd_h_niceng226er7.tab34_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Anticipated absolute effects</th><th id="hd_h_niceng226er7.tab34_1_1_1_6" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab34_1_1_1_6" style="text-align:left;vertical-align:bottom;">Comments</th></tr><tr><th headers="hd_h_niceng226er7.tab34_1_1_1_5" id="hd_h_niceng226er7.tab34_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk with no treatment</th><th headers="hd_h_niceng226er7.tab34_1_1_1_5" id="hd_h_niceng226er7.tab34_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk difference with pulsed short-wave therapy</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab34_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (KOOS, 0-100, high is good, final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab34_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>91</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 3 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
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<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab34_1_1_1_5 hd_h_niceng226er7.tab34_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 26.4</td><td headers="hd_h_niceng226er7.tab34_1_1_1_5 hd_h_niceng226er7.tab34_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>MD <b>11.8 higher</b></p>
|
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<p>(3.03 higher to 20.57 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab34_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (SF-36 physical function, 0-100, high is good, change score) at ≤3 months</td><td headers="hd_h_niceng226er7.tab34_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>40</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 4 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab34_1_1_1_5 hd_h_niceng226er7.tab34_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 19</td><td headers="hd_h_niceng226er7.tab34_1_1_1_5 hd_h_niceng226er7.tab34_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<p>MD <b>6.25 higher</b></p>
|
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<p>(5.77 lower to 18.27 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<p>MID = 3</p>
|
|
<p>(established value)</p>
|
|
</td></tr><tr><td headers="hd_h_niceng226er7.tab34_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (SF-36 bodily pain, 0-100, high is good, change score) at ≤3 months</td><td headers="hd_h_niceng226er7.tab34_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>40</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 4 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab34_1_1_1_5 hd_h_niceng226er7.tab34_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 28.35</td><td headers="hd_h_niceng226er7.tab34_1_1_1_5 hd_h_niceng226er7.tab34_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<p>MD <b>2.5 lower</b></p>
|
|
<p>(16.2 lower to 11.2 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MID = 3</p>
|
|
<p>(established value)</p>
|
|
</td></tr><tr><td headers="hd_h_niceng226er7.tab34_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (SF-36 vitality, 0-100, high is good, change score) at ≤3 months</td><td headers="hd_h_niceng226er7.tab34_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>40</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 4 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab34_1_1_1_5 hd_h_niceng226er7.tab34_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 7</td><td headers="hd_h_niceng226er7.tab34_1_1_1_5 hd_h_niceng226er7.tab34_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>0.5 lower</b></p>
|
|
<p>(8.4 lower to 7.4 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 2 (established value)</td></tr><tr><td headers="hd_h_niceng226er7.tab34_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (SF-36 general health, 0-100, high is good, change score) at ≤3 months</td><td headers="hd_h_niceng226er7.tab34_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>40</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 4 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab34_1_1_1_5 hd_h_niceng226er7.tab34_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 6.5</td><td headers="hd_h_niceng226er7.tab34_1_1_1_5 hd_h_niceng226er7.tab34_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>1 lower</b></p>
|
|
<p>(10.54 lower to 8.54 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 2 (established value)</td></tr><tr><td headers="hd_h_niceng226er7.tab34_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (SF-36 social function, 0-100, high is good, final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab34_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>40</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 4 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab34_1_1_1_5 hd_h_niceng226er7.tab34_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 59.4</td><td headers="hd_h_niceng226er7.tab34_1_1_1_5 hd_h_niceng226er7.tab34_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>8.25 higher</b></p>
|
|
<p>(2.99 lower to 19.49 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 3 (established value)</td></tr><tr><td headers="hd_h_niceng226er7.tab34_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (SF-36 physical function, 0-100, high is good, change score) at >3 months</td><td headers="hd_h_niceng226er7.tab34_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>40</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 16 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab34_1_1_1_5 hd_h_niceng226er7.tab34_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 17</td><td headers="hd_h_niceng226er7.tab34_1_1_1_5 hd_h_niceng226er7.tab34_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>7.25 higher</b></p>
|
|
<p>(5.07 lower to 19.57 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 3 (established value)</td></tr><tr><td headers="hd_h_niceng226er7.tab34_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (SF-36 bodily pain, 0-100, high is good, change score) at >3 months</td><td headers="hd_h_niceng226er7.tab34_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>40</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 16 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab34_1_1_1_5 hd_h_niceng226er7.tab34_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 28.45</td><td headers="hd_h_niceng226er7.tab34_1_1_1_5 hd_h_niceng226er7.tab34_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>12.4 lower</b></p>
|
|
<p>(29.24 lower to 4.44 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 3 (established value)</td></tr><tr><td headers="hd_h_niceng226er7.tab34_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (SF-36 vitality, 0-100, high is good, change score) at >3 months</td><td headers="hd_h_niceng226er7.tab34_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>40</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 16 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab34_1_1_1_5 hd_h_niceng226er7.tab34_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was −0.75</td><td headers="hd_h_niceng226er7.tab34_1_1_1_5 hd_h_niceng226er7.tab34_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>0.5 lower</b></p>
|
|
<p>(9.18 lower to 8.18 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 2 (established value)</td></tr><tr><td headers="hd_h_niceng226er7.tab34_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (SF-36 general health, 0-100, high is good, change score) at >3 months</td><td headers="hd_h_niceng226er7.tab34_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>40</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 16 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab34_1_1_1_5 hd_h_niceng226er7.tab34_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 5.75</td><td headers="hd_h_niceng226er7.tab34_1_1_1_5 hd_h_niceng226er7.tab34_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>4.75 lower</b></p>
|
|
<p>(15.36 lower to 5.86 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 2 (established value)</td></tr><tr><td headers="hd_h_niceng226er7.tab34_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (SF-36 social function, 0-100, high is good, final value) at >3 months</td><td headers="hd_h_niceng226er7.tab34_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>40</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 16 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab34_1_1_1_5 hd_h_niceng226er7.tab34_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 59.95</td><td headers="hd_h_niceng226er7.tab34_1_1_1_5 hd_h_niceng226er7.tab34_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>5.5 higher</b></p>
|
|
<p>(7.76 lower to 18.76 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 3 (established value)</td></tr><tr><td headers="hd_h_niceng226er7.tab34_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (WOMAC, VAS [different scale ranges], high is poor, change scores) at ≤3 months</td><td headers="hd_h_niceng226er7.tab34_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>80</p>
|
|
<p>(2 RCTs)</p>
|
|
<p>follow up: mean 6 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW<sup>a</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab34_1_1_1_5 hd_h_niceng226er7.tab34_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab34_1_1_1_5 hd_h_niceng226er7.tab34_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>SMD <b>0.07 SD lower</b></p>
|
|
<p>(0.5 lower to 0.37 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab34_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (KOOS, WOMAC [different scale ranges], high is poor, final values) at ≤3 months</td><td headers="hd_h_niceng226er7.tab34_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>131</p>
|
|
<p>(2 RCTs)</p>
|
|
<p>follow up: mean 6 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup><sup>,</sup><sup>c</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab34_1_1_1_5 hd_h_niceng226er7.tab34_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab34_1_1_1_5 hd_h_niceng226er7.tab34_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>SMD <b>0.28 SD higher</b></p>
|
|
<p>(2.28 lower to 2.84 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab34_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (WOMAC, 0-20, high is poor, change score) at >3 months</td><td headers="hd_h_niceng226er7.tab34_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>40</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 16 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab34_1_1_1_5 hd_h_niceng226er7.tab34_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean pain was −5</td><td headers="hd_h_niceng226er7.tab34_1_1_1_5 hd_h_niceng226er7.tab34_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>0.5 lower</b></p>
|
|
<p>(3.04 lower to 2.04 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab34_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Physical function (WOMAC, 0-68, high is poor, change score and final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab34_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>80</p>
|
|
<p>(2 RCTs)</p>
|
|
<p>follow up: mean 6 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab34_1_1_1_5 hd_h_niceng226er7.tab34_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean physical function was 27</td><td headers="hd_h_niceng226er7.tab34_1_1_1_5 hd_h_niceng226er7.tab34_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>2.2 lower</b></p>
|
|
<p>(4.05 lower to 0.35 lower)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 3.4 (0.5 × median baseline SD)</td></tr><tr><td headers="hd_h_niceng226er7.tab34_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Physical function (KOOS, 0-100, high is good, final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab34_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>91</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 3 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab34_1_1_1_5 hd_h_niceng226er7.tab34_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean physical function was 48.1</td><td headers="hd_h_niceng226er7.tab34_1_1_1_5 hd_h_niceng226er7.tab34_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>14.2 higher</b></p>
|
|
<p>(6.45 higher to 21.95 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab34_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Physical function (WOMAC, 0-68, high is poor, change score) at >3 months</td><td headers="hd_h_niceng226er7.tab34_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>40</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 16 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab34_1_1_1_5 hd_h_niceng226er7.tab34_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean physical function was −15.35</td><td headers="hd_h_niceng226er7.tab34_1_1_1_5 hd_h_niceng226er7.tab34_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>1.55 lower</b></p>
|
|
<p>(10 lower to 6.9 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab34_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Psychological distress (Beck depression score, 0-63, high is poor, change score) at ≤3 months</td><td headers="hd_h_niceng226er7.tab34_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>40</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 4 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab34_1_1_1_5 hd_h_niceng226er7.tab34_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean psychological distress was −2.3</td><td headers="hd_h_niceng226er7.tab34_1_1_1_5 hd_h_niceng226er7.tab34_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>0.15 lower</b></p>
|
|
<p>(2.33 lower to 2.03 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab34_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Psychological distress (GHQ, 0-90, high is poor, final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab34_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>60</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 12 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab34_1_1_1_5 hd_h_niceng226er7.tab34_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean psychological distress was 32</td><td headers="hd_h_niceng226er7.tab34_1_1_1_5 hd_h_niceng226er7.tab34_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>1.73 lower</b></p>
|
|
<p>(9.33 lower to 5.87 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab34_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Psychological distress (Beck depression score, 0-63, high is poor, change score) at >3 months</td><td headers="hd_h_niceng226er7.tab34_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>40</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 16 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab34_1_1_1_5 hd_h_niceng226er7.tab34_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean psychological distress was −1.25</td><td headers="hd_h_niceng226er7.tab34_1_1_1_5 hd_h_niceng226er7.tab34_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>0.1 higher</b></p>
|
|
<p>(2.61 lower to 2.81 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab34_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng226er7.tab34_1"><p class="no_margin">Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="niceng226er7.tab34_2"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl><dl class="bkr_refwrap"><dt>c</dt><dd><div id="niceng226er7.tab34_3"><p class="no_margin">Downgraded by 1 or 2 increments because heterogeneity, unexplained by subgroup analysis</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab35"><div id="niceng226er7.tab35" class="table"><h3><span class="label">Table 35</span><span class="title">Clinical evidence summary: interferential therapy compared to pulsed short-wave therapy</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab35/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab35_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng226er7.tab35_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab35_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_niceng226er7.tab35_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab35_1_1_1_2" style="text-align:left;vertical-align:bottom;">№ of participants (studies) Follow up</th><th id="hd_h_niceng226er7.tab35_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab35_1_1_1_3" style="text-align:left;vertical-align:bottom;">Certainty of the evidence (GRADE)</th><th id="hd_h_niceng226er7.tab35_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab35_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95% CI)</th><th id="hd_h_niceng226er7.tab35_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Anticipated absolute effects</th><th id="hd_h_niceng226er7.tab35_1_1_1_6" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab35_1_1_1_6" style="text-align:left;vertical-align:bottom;">Comments</th></tr><tr><th headers="hd_h_niceng226er7.tab35_1_1_1_5" id="hd_h_niceng226er7.tab35_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk with pulsed short-wave therapy</th><th headers="hd_h_niceng226er7.tab35_1_1_1_5" id="hd_h_niceng226er7.tab35_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk difference with interferential therapy</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab35_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (WOMAC, 0-20, high is poor, final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab35_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>103</p>
|
|
<p>(2 RCTs)</p>
|
|
<p>follow up: mean 10 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab35_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁⨁◯</p>
|
|
<p>MODERATE<sup>a</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab35_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab35_1_1_1_5 hd_h_niceng226er7.tab35_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean pain was 8.1</td><td headers="hd_h_niceng226er7.tab35_1_1_1_5 hd_h_niceng226er7.tab35_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>MD 0.52 lower</b>
|
|
</p>
|
|
<p>(1.25 lower to 0.21 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab35_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 1.4 (0.5 × median baseline SD)</td></tr><tr><td headers="hd_h_niceng226er7.tab35_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (WOMAC, 0-20, high is poor, final value) at >3 months</td><td headers="hd_h_niceng226er7.tab35_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>63</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 6 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab35_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab35_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab35_1_1_1_5 hd_h_niceng226er7.tab35_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean pain was 4.5</td><td headers="hd_h_niceng226er7.tab35_1_1_1_5 hd_h_niceng226er7.tab35_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>MD 1.1 lower</b>
|
|
</p>
|
|
<p>(2.93 lower to 0.73 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab35_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab35_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Physical function (WOMAC, 0-68, high is poor, final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab35_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>103</p>
|
|
<p>(2 RCTs)</p>
|
|
<p>follow up: mean 10 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab35_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁⨁◯</p>
|
|
<p>MODERATE<sup>a</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab35_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab35_1_1_1_5 hd_h_niceng226er7.tab35_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean physical function was 12.1</td><td headers="hd_h_niceng226er7.tab35_1_1_1_5 hd_h_niceng226er7.tab35_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>MD 0.88 lower</b>
|
|
</p>
|
|
<p>(2.6 lower to 0.84 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab35_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 3.6 (0.5 × median baseline SD)</td></tr><tr><td headers="hd_h_niceng226er7.tab35_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Physical function (WOMAC, 0-68, high is poor, final value) at >3 months</td><td headers="hd_h_niceng226er7.tab35_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>63</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 6 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab35_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab35_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab35_1_1_1_5 hd_h_niceng226er7.tab35_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean physical function was 9.9</td><td headers="hd_h_niceng226er7.tab35_1_1_1_5 hd_h_niceng226er7.tab35_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>MD 1.4 lower</b>
|
|
</p>
|
|
<p>(7.42 lower to 4.62 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab35_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng226er7.tab35_1"><p class="no_margin">Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="niceng226er7.tab35_2"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab36"><div id="niceng226er7.tab36" class="table"><h3><span class="label">Table 36</span><span class="title">Clinical evidence summary: interferential therapy compared to laser therapy</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab36/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab36_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng226er7.tab36_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab36_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_niceng226er7.tab36_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab36_1_1_1_2" style="text-align:left;vertical-align:bottom;">№ of participants (studies) Follow-up</th><th id="hd_h_niceng226er7.tab36_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab36_1_1_1_3" style="text-align:left;vertical-align:bottom;">Certainty of the evidence (GRADE)</th><th id="hd_h_niceng226er7.tab36_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab36_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95% CI)</th><th id="hd_h_niceng226er7.tab36_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Anticipated absolute effects</th><th id="hd_h_niceng226er7.tab36_1_1_1_6" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab36_1_1_1_6" style="text-align:left;vertical-align:bottom;">Comments</th></tr><tr><th headers="hd_h_niceng226er7.tab36_1_1_1_5" id="hd_h_niceng226er7.tab36_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk with laser therapy</th><th headers="hd_h_niceng226er7.tab36_1_1_1_5" id="hd_h_niceng226er7.tab36_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk difference with interferential therapy</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab36_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (WOMAC, NRS [different scale ranges], high is poor, final values) at ≤3 months</td><td headers="hd_h_niceng226er7.tab36_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>124</p>
|
|
<p>(2 RCTs)</p>
|
|
<p>follow-up: mean 10 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab36_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁⨁◯</p>
|
|
<p>MODERATE<sup>a</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab36_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab36_1_1_1_5 hd_h_niceng226er7.tab36_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab36_1_1_1_5 hd_h_niceng226er7.tab36_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>SMD <b>0.25 SD higher</b></p>
|
|
<p>(0.11 lower to 0.6 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab36_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab36_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (NRS, 0-10, high is poor, final value) at >3 months</td><td headers="hd_h_niceng226er7.tab36_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>84</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow-up: 6 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab36_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁⨁◯</p>
|
|
<p>MODERATE<sup>a</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab36_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab36_1_1_1_5 hd_h_niceng226er7.tab36_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean pain was 2.95</td><td headers="hd_h_niceng226er7.tab36_1_1_1_5 hd_h_niceng226er7.tab36_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>0.7 higher</b></p>
|
|
<p>(0.46 lower to 1.86 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab36_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab36_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Physical function (WOMAC, 0-68, high is poor, final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab36_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>40</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow-up: 8 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab36_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab36_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab36_1_1_1_5 hd_h_niceng226er7.tab36_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean physical function was 39.2</td><td headers="hd_h_niceng226er7.tab36_1_1_1_5 hd_h_niceng226er7.tab36_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>3 lower</b></p>
|
|
<p>(4.76 lower to 1.24 lower)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab36_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng226er7.tab36_1"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="niceng226er7.tab36_2"><p class="no_margin">Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab37"><div id="niceng226er7.tab37" class="table"><h3><span class="label">Table 37</span><span class="title">Clinical evidence summary: interferential therapy compared to sham electrotherapy</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab37/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab37_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng226er7.tab37_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab37_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_niceng226er7.tab37_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab37_1_1_1_2" style="text-align:left;vertical-align:bottom;">№ of participants (studies) Follow up</th><th id="hd_h_niceng226er7.tab37_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab37_1_1_1_3" style="text-align:left;vertical-align:bottom;">Certainty of the evidence (GRADE)</th><th id="hd_h_niceng226er7.tab37_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab37_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95% CI)</th><th id="hd_h_niceng226er7.tab37_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Anticipated absolute effects</th><th id="hd_h_niceng226er7.tab37_1_1_1_6" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab37_1_1_1_6" style="text-align:left;vertical-align:bottom;">Comments</th></tr><tr><th headers="hd_h_niceng226er7.tab37_1_1_1_5" id="hd_h_niceng226er7.tab37_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk with sham electrotherapy</th><th headers="hd_h_niceng226er7.tab37_1_1_1_5" id="hd_h_niceng226er7.tab37_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk difference with interferential therapy</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab37_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (WOMAC, 0-20, high is poor, change score and final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab37_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>166</p>
|
|
<p>(3 RCTs)</p>
|
|
<p>follow up: mean 11 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab37_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup><sup>,</sup><sup>c</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab37_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab37_1_1_1_5 hd_h_niceng226er7.tab37_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean pain was 10.2</td><td headers="hd_h_niceng226er7.tab37_1_1_1_5 hd_h_niceng226er7.tab37_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>2.84 lower</b></p>
|
|
<p>(9.07 lower to 3.39 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab37_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 1.1 (0.5 × median baseline SD)</td></tr><tr><td headers="hd_h_niceng226er7.tab37_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (NRS, 0-10, high is poor, final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab37_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>84</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 12 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab37_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁⨁◯</p>
|
|
<p>MODERATE<sup>c</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab37_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab37_1_1_1_5 hd_h_niceng226er7.tab37_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean pain was 3.85</td><td headers="hd_h_niceng226er7.tab37_1_1_1_5 hd_h_niceng226er7.tab37_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>0.3 lower</b></p>
|
|
<p>(1.55 lower to 0.95 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab37_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab37_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (WOMAC, 0-20, high is poor, change score) at >3 months</td><td headers="hd_h_niceng226er7.tab37_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>66</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 6 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab37_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW<sup>a</sup><sup>,</sup><sup>c</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab37_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab37_1_1_1_5 hd_h_niceng226er7.tab37_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean pain was −3.2</td><td headers="hd_h_niceng226er7.tab37_1_1_1_5 hd_h_niceng226er7.tab37_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>0.2 lower</b></p>
|
|
<p>(1.8 lower to 1.4 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab37_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab37_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (NRS, 0-10, high is poor, final value) at >3 months</td><td headers="hd_h_niceng226er7.tab37_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>84</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 6 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab37_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁⨁◯</p>
|
|
<p>MODERATE<sup>c</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab37_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab37_1_1_1_5 hd_h_niceng226er7.tab37_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean pain was 4.1</td><td headers="hd_h_niceng226er7.tab37_1_1_1_5 hd_h_niceng226er7.tab37_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>0.45 lower</b></p>
|
|
<p>(1.73 lower to 0.83 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab37_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab37_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Physical function (WOMAC, 0-68, high is poor, change score and final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab37_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>166</p>
|
|
<p>(3 RCTs)</p>
|
|
<p>follow up: mean 11 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab37_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup><sup>,</sup><sup>c</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab37_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab37_1_1_1_5 hd_h_niceng226er7.tab37_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean physical function was 36.7</td><td headers="hd_h_niceng226er7.tab37_1_1_1_5 hd_h_niceng226er7.tab37_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>10.88 lower</b></p>
|
|
<p>(28.56 lower to 6.8 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab37_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 3.1 (0.5 × median baseline SD)</td></tr><tr><td headers="hd_h_niceng226er7.tab37_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Physical function (WOMAC, 0-68, high is poor, change score) at >3 months</td><td headers="hd_h_niceng226er7.tab37_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>66</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 6 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab37_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW<sup>a</sup><sup>,</sup><sup>c</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab37_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab37_1_1_1_5 hd_h_niceng226er7.tab37_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean physical function was −11.5</td><td headers="hd_h_niceng226er7.tab37_1_1_1_5 hd_h_niceng226er7.tab37_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>3 higher</b></p>
|
|
<p>(1.94 lower to 7.94 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab37_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng226er7.tab37_1"><p class="no_margin">Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="niceng226er7.tab37_2"><p class="no_margin">Downgraded by 1 or 2 increments because heterogeneity, unexplained by subgroup analysis</p></div></dd></dl><dl class="bkr_refwrap"><dt>c</dt><dd><div id="niceng226er7.tab37_3"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab38"><div id="niceng226er7.tab38" class="table"><h3><span class="label">Table 38</span><span class="title">Clinical evidence summary: interferential therapy compared to no treatment</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab38/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab38_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng226er7.tab38_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab38_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_niceng226er7.tab38_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab38_1_1_1_2" style="text-align:left;vertical-align:bottom;">№ of participants (studies) Follow-up</th><th id="hd_h_niceng226er7.tab38_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab38_1_1_1_3" style="text-align:left;vertical-align:bottom;">Certainty of the evidence (GRADE)</th><th id="hd_h_niceng226er7.tab38_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab38_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95% CI)</th><th id="hd_h_niceng226er7.tab38_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Anticipated absolute effects</th><th id="hd_h_niceng226er7.tab38_1_1_1_6" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab38_1_1_1_6" style="text-align:left;vertical-align:bottom;">Comments</th></tr><tr><th headers="hd_h_niceng226er7.tab38_1_1_1_5" id="hd_h_niceng226er7.tab38_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk with no treatment</th><th headers="hd_h_niceng226er7.tab38_1_1_1_5" id="hd_h_niceng226er7.tab38_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk difference with interferential therapy</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab38_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (WOMAC, 0-20, high is poor, final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab38_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>40</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow-up: 8 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab38_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁⨁◯</p>
|
|
<p>MODERATE<sup>a</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab38_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab38_1_1_1_5 hd_h_niceng226er7.tab38_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean pain was 9</td><td headers="hd_h_niceng226er7.tab38_1_1_1_5 hd_h_niceng226er7.tab38_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>2 higher</b></p>
|
|
<p>(1.2 higher to 2.8 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab38_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab38_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Physical function (WOMAC, 0-68, high is poor, final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab38_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>40</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow-up: 8 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab38_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab38_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab38_1_1_1_5 hd_h_niceng226er7.tab38_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean physical function was 38.9</td><td headers="hd_h_niceng226er7.tab38_1_1_1_5 hd_h_niceng226er7.tab38_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>2.7 lower</b></p>
|
|
<p>(4.91 lower to 0.49 lower)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab38_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng226er7.tab38_1"><p class="no_margin">Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="niceng226er7.tab38_2"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab39"><div id="niceng226er7.tab39" class="table"><h3><span class="label">Table 39</span><span class="title">Clinical evidence summary: neuromuscular electrical stimulation compared to no treatment</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab39/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab39_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng226er7.tab39_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab39_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_niceng226er7.tab39_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab39_1_1_1_2" style="text-align:left;vertical-align:bottom;">№ of participants (studies) Follow up</th><th id="hd_h_niceng226er7.tab39_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab39_1_1_1_3" style="text-align:left;vertical-align:bottom;">Certainty of the evidence (GRADE)</th><th id="hd_h_niceng226er7.tab39_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab39_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95% CI)</th><th id="hd_h_niceng226er7.tab39_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Anticipated absolute effects</th><th id="hd_h_niceng226er7.tab39_1_1_1_6" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab39_1_1_1_6" style="text-align:left;vertical-align:bottom;">Comments</th></tr><tr><th headers="hd_h_niceng226er7.tab39_1_1_1_5" id="hd_h_niceng226er7.tab39_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk with no treatment</th><th headers="hd_h_niceng226er7.tab39_1_1_1_5" id="hd_h_niceng226er7.tab39_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk difference with neuromuscular electrical stimulation</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab39_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (SF-36 physical component, 0-100, high is good, final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab39_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>16</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 14 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab39_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab39_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab39_1_1_1_5 hd_h_niceng226er7.tab39_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 67.83</td><td headers="hd_h_niceng226er7.tab39_1_1_1_5 hd_h_niceng226er7.tab39_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>20.23 lower</b></p>
|
|
<p>(38.83 lower to 1.63 lower)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab39_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 2 (established value)</td></tr><tr><td headers="hd_h_niceng226er7.tab39_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (SF-36 mental component, 0-100, high is good, final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab39_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>16</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 14 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab39_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab39_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab39_1_1_1_5 hd_h_niceng226er7.tab39_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 70.5</td><td headers="hd_h_niceng226er7.tab39_1_1_1_5 hd_h_niceng226er7.tab39_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>5.1 lower</b></p>
|
|
<p>(24.75 lower to 14.55 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab39_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 3 (established value)</td></tr><tr><td headers="hd_h_niceng226er7.tab39_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (NHP pain, scale range unclear, high is poor, final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab39_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>38</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 2 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab39_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab39_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab39_1_1_1_5 hd_h_niceng226er7.tab39_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 51.11</td><td headers="hd_h_niceng226er7.tab39_1_1_1_5 hd_h_niceng226er7.tab39_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>13.35 lower</b></p>
|
|
<p>(31.41 lower to 4.71 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab39_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab39_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (NHP physical mobility, scale range unclear, high is poor, final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab39_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>38</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 2 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab39_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab39_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab39_1_1_1_5 hd_h_niceng226er7.tab39_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 33.53</td><td headers="hd_h_niceng226er7.tab39_1_1_1_5 hd_h_niceng226er7.tab39_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>4.67 higher</b></p>
|
|
<p>(10.03 lower to 19.37 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab39_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab39_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (NHP energy level, scale range unclear, high is poor, final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab39_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>38</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 2 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab39_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab39_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab39_1_1_1_5 hd_h_niceng226er7.tab39_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 56.84</td><td headers="hd_h_niceng226er7.tab39_1_1_1_5 hd_h_niceng226er7.tab39_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>20.23 lower</b></p>
|
|
<p>(45.51 lower to 5.05 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab39_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab39_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (NHP sleep, scale range unclear, high is poor, final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab39_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>38</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 2 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab39_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab39_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab39_1_1_1_5 hd_h_niceng226er7.tab39_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 34.23</td><td headers="hd_h_niceng226er7.tab39_1_1_1_5 hd_h_niceng226er7.tab39_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>2.17 lower</b></p>
|
|
<p>(21.98 lower to 17.64 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab39_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab39_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (NHP social isolation, scale range unclear, high is poor, final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab39_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>38</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 2 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab39_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab39_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab39_1_1_1_5 hd_h_niceng226er7.tab39_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 10.38</td><td headers="hd_h_niceng226er7.tab39_1_1_1_5 hd_h_niceng226er7.tab39_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>1.29 lower</b></p>
|
|
<p>(15.17 lower to 12.59 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab39_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab39_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (NHP total score, scale range unclear, high is poor, final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab39_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>38</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 2 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab39_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab39_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab39_1_1_1_5 hd_h_niceng226er7.tab39_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 213.07</td><td headers="hd_h_niceng226er7.tab39_1_1_1_5 hd_h_niceng226er7.tab39_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>45.49 lower</b></p>
|
|
<p>(125.53 lower to 34.55 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab39_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab39_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (WOMAC, [different scale ranges], high is poor, change scores) at ≤3 months</td><td headers="hd_h_niceng226er7.tab39_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>130</p>
|
|
<p>(2 RCTs)</p>
|
|
<p>follow up: 7 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab39_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁⨁◯</p>
|
|
<p>MODERATE<sup>a</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab39_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab39_1_1_1_5 hd_h_niceng226er7.tab39_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab39_1_1_1_5 hd_h_niceng226er7.tab39_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>SMD <b>0.12 SD higher</b></p>
|
|
<p>(0.22 lower to 0.47 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab39_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab39_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (WOMAC, VAS [different scale ranges], high is poor, final values) at ≤3 months</td><td headers="hd_h_niceng226er7.tab39_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>154</p>
|
|
<p>(4 RCTs)</p>
|
|
<p>follow up: mean 7 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab39_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab39_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab39_1_1_1_5 hd_h_niceng226er7.tab39_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab39_1_1_1_5 hd_h_niceng226er7.tab39_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>SMD <b>0.56 SD lower</b></p>
|
|
<p>(0.89 lower to 0.23 lower)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab39_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab39_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (WOMAC, 5-25, high is poor, change score) at >3 months</td><td headers="hd_h_niceng226er7.tab39_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>30</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 16 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab39_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab39_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab39_1_1_1_5 hd_h_niceng226er7.tab39_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean pain was 1.4</td><td headers="hd_h_niceng226er7.tab39_1_1_1_5 hd_h_niceng226er7.tab39_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>1.94 lower</b></p>
|
|
<p>(4.04 lower to 0.16 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab39_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab39_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (VAS, 0-10, high is poor, final value) at >3 months</td><td headers="hd_h_niceng226er7.tab39_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>44</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 18 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab39_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab39_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab39_1_1_1_5 hd_h_niceng226er7.tab39_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean pain was 5.3</td><td headers="hd_h_niceng226er7.tab39_1_1_1_5 hd_h_niceng226er7.tab39_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>1.9 lower</b></p>
|
|
<p>(3.29 lower to 0.51 lower)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab39_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab39_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Physical function (WOMAC [different scale ranges], high is poor, change scores) at ≤3 months</td><td headers="hd_h_niceng226er7.tab39_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>130</p>
|
|
<p>(2 RCTs)</p>
|
|
<p>follow up: 7 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab39_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup><sup>,</sup><sup>c</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab39_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab39_1_1_1_5 hd_h_niceng226er7.tab39_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab39_1_1_1_5 hd_h_niceng226er7.tab39_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>SMD <b>0.02 SD lower</b></p>
|
|
<p>(0.62 lower to 0.58 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab39_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab39_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Physical function (WOMAC, 0-68, high is poor, final values) at ≤3 months</td><td headers="hd_h_niceng226er7.tab39_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>54</p>
|
|
<p>(2 RCTs)</p>
|
|
<p>follow up: mean 7 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab39_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab39_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab39_1_1_1_5 hd_h_niceng226er7.tab39_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean physical function was 20.5</td><td headers="hd_h_niceng226er7.tab39_1_1_1_5 hd_h_niceng226er7.tab39_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>4.22 higher</b></p>
|
|
<p>(3.12 lower to 11.56 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab39_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 7.2 (0.5 × median baseline SD)</td></tr><tr><td headers="hd_h_niceng226er7.tab39_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Physical function (WOMAC, 17-85, high is poor, change score) at >3 months</td><td headers="hd_h_niceng226er7.tab39_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>30</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 16 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab39_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab39_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab39_1_1_1_5 hd_h_niceng226er7.tab39_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean physical function was 5</td><td headers="hd_h_niceng226er7.tab39_1_1_1_5 hd_h_niceng226er7.tab39_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>9.92 lower</b></p>
|
|
<p>(17.34 lower to 2.5 lower)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab39_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab39_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Mild adverse events at ≤3 months</td><td headers="hd_h_niceng226er7.tab39_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>100</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 8 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab39_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab39_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Peto OR 7.39</p>
|
|
<p>(0.15 to 372.38)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab39_1_1_1_5 hd_h_niceng226er7.tab39_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">0 per 1,000</td><td headers="hd_h_niceng226er7.tab39_1_1_1_5 hd_h_niceng226er7.tab39_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>20 more per 1,000</b>
|
|
</p>
|
|
<p>(30 fewer to 70 more)<sup>d</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab39_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID (precision) = Peto OR 0.8-1.25.</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng226er7.tab39_1"><p class="no_margin">Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="niceng226er7.tab39_2"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl><dl class="bkr_refwrap"><dt>c</dt><dd><div id="niceng226er7.tab39_3"><p class="no_margin">Downgraded by 1 or 2 increments because heterogeneity, unexplained by subgroup analysis</p></div></dd></dl><dl class="bkr_refwrap"><dt>d</dt><dd><div id="niceng226er7.tab39_4"><p class="no_margin">Absolute effect calculated by risk difference due to zero events in at least one arm of one study</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab40"><div id="niceng226er7.tab40" class="table"><h3><span class="label">Table 40</span><span class="title">Clinical evidence summary: extracorporeal shockwave therapy compared to sham electrotherapy</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab40/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab40_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng226er7.tab40_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab40_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_niceng226er7.tab40_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab40_1_1_1_2" style="text-align:left;vertical-align:bottom;">№ of participants (studies) Follow up</th><th id="hd_h_niceng226er7.tab40_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab40_1_1_1_3" style="text-align:left;vertical-align:bottom;">Certainty of the evidence (GRADE)</th><th id="hd_h_niceng226er7.tab40_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab40_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95% CI)</th><th id="hd_h_niceng226er7.tab40_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Anticipated absolute effects</th><th id="hd_h_niceng226er7.tab40_1_1_1_6" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab40_1_1_1_6" style="text-align:left;vertical-align:bottom;">Comments</th></tr><tr><th headers="hd_h_niceng226er7.tab40_1_1_1_5" id="hd_h_niceng226er7.tab40_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk with sham electrotherapy</th><th headers="hd_h_niceng226er7.tab40_1_1_1_5" id="hd_h_niceng226er7.tab40_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk difference with extracorporeal shockwave therapy</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab40_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (WOMAC, 0-20, high is poor, change score and final values) at ≤3 months</td><td headers="hd_h_niceng226er7.tab40_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>200</p>
|
|
<p>(3 RCTs)</p>
|
|
<p>follow up: mean 12 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab40_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁⨁◯</p>
|
|
<p>MODERATE<sup>a</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab40_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab40_1_1_1_5 hd_h_niceng226er7.tab40_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean pain was −4.3</td><td headers="hd_h_niceng226er7.tab40_1_1_1_5 hd_h_niceng226er7.tab40_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>2.99 lower</b></p>
|
|
<p>(3.57 lower to 2.42 lower)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab40_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 1.1 (0.5 × median baseline SD)</td></tr><tr><td headers="hd_h_niceng226er7.tab40_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (VAS, 0-10, high is poor, change score and final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab40_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>107</p>
|
|
<p>(2 RCTs)</p>
|
|
<p>follow up: mean 4 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab40_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>.</sup><sup>b</sup><sup>,</sup><sup>c</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab40_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab40_1_1_1_5 hd_h_niceng226er7.tab40_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean pain was 2.4</td><td headers="hd_h_niceng226er7.tab40_1_1_1_5 hd_h_niceng226er7.tab40_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>2.17 lower</b></p>
|
|
<p>(3.55 lower to 0.79 lower)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab40_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.95 (0.5 × median baseline SD)</td></tr><tr><td headers="hd_h_niceng226er7.tab40_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Physical function (WOMAC, 0-68, high is poor, change score and final values) at ≤3 months</td><td headers="hd_h_niceng226er7.tab40_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>200</p>
|
|
<p>(3 RCTs)</p>
|
|
<p>follow up: mean 12 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab40_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁⨁◯</p>
|
|
<p>MODERATE<sup>a</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab40_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab40_1_1_1_5 hd_h_niceng226er7.tab40_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean physical function was 14.2</td><td headers="hd_h_niceng226er7.tab40_1_1_1_5 hd_h_niceng226er7.tab40_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>9.06 lower</b></p>
|
|
<p>(11.11 lower to 7.02 lower)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab40_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 4.4 (0.5 × median baseline SD)</td></tr><tr><td headers="hd_h_niceng226er7.tab40_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Mild adverse events at ≤3 months</td><td headers="hd_h_niceng226er7.tab40_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>70</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 12 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab40_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁⨁◯</p>
|
|
<p>MODERATE<sup>c</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab40_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Peto OR 0.14</p>
|
|
<p>(0.01 to 2.27)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab40_1_1_1_5 hd_h_niceng226er7.tab40_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">56 per 1,000</td><td headers="hd_h_niceng226er7.tab40_1_1_1_5 hd_h_niceng226er7.tab40_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>60 fewer per 1,000</b>
|
|
</p>
|
|
<p>(150 fewer to 30 more)<sup>d</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab40_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID (precision) = Peto OR 0.8-1.25.</td></tr><tr><td headers="hd_h_niceng226er7.tab40_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Moderate/major adverse events at ≤3 months</td><td headers="hd_h_niceng226er7.tab40_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>63</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 12 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab40_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW<sup>e</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab40_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>RD 0.00</p>
|
|
<p>(−0.06 to 0.06)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab40_1_1_1_5 hd_h_niceng226er7.tab40_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">0 per 1,000</td><td headers="hd_h_niceng226er7.tab40_1_1_1_5 hd_h_niceng226er7.tab40_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>0 fewer per 1,000</b>
|
|
</p>
|
|
<p>(60 fewer to 60 more)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab40_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sample size used to determine precision: 75-150 = serious imprecision, <75 = very serious imprecision.</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng226er7.tab40_1"><p class="no_margin">Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="niceng226er7.tab40_2"><p class="no_margin">Downgraded by 1 or 2 increments because heterogeneity, unexplained by subgroup analysis</p></div></dd></dl><dl class="bkr_refwrap"><dt>c</dt><dd><div id="niceng226er7.tab40_3"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl><dl class="bkr_refwrap"><dt>d</dt><dd><div id="niceng226er7.tab40_4"><p class="no_margin">Absolute effect calculated by risk difference due to zero events in at least one arm of one study</p></div></dd></dl><dl class="bkr_refwrap"><dt>e</dt><dd><div id="niceng226er7.tab40_5"><p class="no_margin">Downgraded by 1 to 2 increments for imprecision due to zero events and small sample size</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab41"><div id="niceng226er7.tab41" class="table"><h3><span class="label">Table 41</span><span class="title">Clinical evidence summary: extracorporeal shockwave therapy compared to no treatment</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab41/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab41_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng226er7.tab41_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab41_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_niceng226er7.tab41_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab41_1_1_1_2" style="text-align:left;vertical-align:bottom;">№ of participants (studies) Follow-up</th><th id="hd_h_niceng226er7.tab41_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab41_1_1_1_3" style="text-align:left;vertical-align:bottom;">Certainty of the evidence (GRADE)</th><th id="hd_h_niceng226er7.tab41_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab41_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95% CI)</th><th id="hd_h_niceng226er7.tab41_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Anticipated absolute effects</th><th id="hd_h_niceng226er7.tab41_1_1_1_6" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab41_1_1_1_6" style="text-align:left;vertical-align:bottom;">Comments</th></tr><tr><th headers="hd_h_niceng226er7.tab41_1_1_1_5" id="hd_h_niceng226er7.tab41_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk with no treatment</th><th headers="hd_h_niceng226er7.tab41_1_1_1_5" id="hd_h_niceng226er7.tab41_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk difference with extracorporeal shockwave therapy</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab41_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (WOMAC, VAS [different scale ranges], high is poor, final values) at ≤3 months</td><td headers="hd_h_niceng226er7.tab41_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>73</p>
|
|
<p>(2 RCTs)</p>
|
|
<p>follow-up: mean 10 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab41_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab41_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab41_1_1_1_5 hd_h_niceng226er7.tab41_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab41_1_1_1_5 hd_h_niceng226er7.tab41_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>SMD <b>0.43 SD higher</b></p>
|
|
<p>(0.05 lower to 0.91 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab41_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab41_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Physical function (WOMAC, 0-68, high is poor, final score) at ≤3 months</td><td headers="hd_h_niceng226er7.tab41_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>45</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow-up: 7 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab41_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab41_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab41_1_1_1_5 hd_h_niceng226er7.tab41_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean physical function was 20</td><td headers="hd_h_niceng226er7.tab41_1_1_1_5 hd_h_niceng226er7.tab41_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>10.74 higher</b></p>
|
|
<p>(3.67 higher to 17.81 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab41_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng226er7.tab41_1"><p class="no_margin">Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="niceng226er7.tab41_2"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab42"><div id="niceng226er7.tab42" class="table"><h3><span class="label">Table 42</span><span class="title">Clinical evidence summary: laser therapy compared to pulsed short-wave therapy</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab42/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab42_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng226er7.tab42_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab42_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_niceng226er7.tab42_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab42_1_1_1_2" style="text-align:left;vertical-align:bottom;">№ of participants (studies) Follow-up</th><th id="hd_h_niceng226er7.tab42_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab42_1_1_1_3" style="text-align:left;vertical-align:bottom;">Certainty of the evidence (GRADE)</th><th id="hd_h_niceng226er7.tab42_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab42_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95% CI)</th><th id="hd_h_niceng226er7.tab42_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Anticipated absolute effects</th><th id="hd_h_niceng226er7.tab42_1_1_1_6" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab42_1_1_1_6" style="text-align:left;vertical-align:bottom;">Comments</th></tr><tr><th headers="hd_h_niceng226er7.tab42_1_1_1_5" id="hd_h_niceng226er7.tab42_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk with pulsed short-wave therapy</th><th headers="hd_h_niceng226er7.tab42_1_1_1_5" id="hd_h_niceng226er7.tab42_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk difference with laser therapy</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab42_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (WOMAC, 0-20, high is poor, final value) at <3 months</td><td headers="hd_h_niceng226er7.tab42_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>40</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow-up: 8 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab42_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab42_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab42_1_1_1_5 hd_h_niceng226er7.tab42_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean pain was 11.3</td><td headers="hd_h_niceng226er7.tab42_1_1_1_5 hd_h_niceng226er7.tab42_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>0.85 lower</b></p>
|
|
<p>(1.62 lower to 0.08 lower)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab42_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab42_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Physical function (WOMAC, 0-68, high is poor, final value) at <3 months</td><td headers="hd_h_niceng226er7.tab42_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>40</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow-up: 8 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab42_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁⨁◯</p>
|
|
<p>MODERATE<sup>a</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab42_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab42_1_1_1_5 hd_h_niceng226er7.tab42_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean physical function was 36</td><td headers="hd_h_niceng226er7.tab42_1_1_1_5 hd_h_niceng226er7.tab42_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>3.2 higher</b></p>
|
|
<p>(1.84 higher to 4.56 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab42_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng226er7.tab42_1"><p class="no_margin">Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="niceng226er7.tab42_2"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab43"><div id="niceng226er7.tab43" class="table"><h3><span class="label">Table 43</span><span class="title">Clinical evidence summary: laser therapy compared to neuromuscular electrical stimulation</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab43/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab43_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng226er7.tab43_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab43_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_niceng226er7.tab43_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab43_1_1_1_2" style="text-align:left;vertical-align:bottom;">№ of participants (studies) Follow up</th><th id="hd_h_niceng226er7.tab43_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab43_1_1_1_3" style="text-align:left;vertical-align:bottom;">Certainty of the evidence (GRADE)</th><th id="hd_h_niceng226er7.tab43_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab43_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95% CI)</th><th id="hd_h_niceng226er7.tab43_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Anticipated absolute effects</th><th id="hd_h_niceng226er7.tab43_1_1_1_6" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab43_1_1_1_6" style="text-align:left;vertical-align:bottom;">Comments</th></tr><tr><th headers="hd_h_niceng226er7.tab43_1_1_1_5" id="hd_h_niceng226er7.tab43_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk with neuromuscular electrical stimulation</th><th headers="hd_h_niceng226er7.tab43_1_1_1_5" id="hd_h_niceng226er7.tab43_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk difference with laser therapy</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab43_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (VAS, 0-10, high is poor, final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab43_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>30</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 12 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab43_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab43_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab43_1_1_1_5 hd_h_niceng226er7.tab43_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean pain was 0.9</td><td headers="hd_h_niceng226er7.tab43_1_1_1_5 hd_h_niceng226er7.tab43_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>0.7 higher</b></p>
|
|
<p>(0.22 higher to 1.18 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab43_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng226er7.tab43_1"><p class="no_margin">Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="niceng226er7.tab43_2"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab44"><div id="niceng226er7.tab44" class="table"><h3><span class="label">Table 44</span><span class="title">Clinical evidence summary: laser therapy compared to sham electrotherapy</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab44/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab44_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng226er7.tab44_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab44_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_niceng226er7.tab44_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab44_1_1_1_2" style="text-align:left;vertical-align:bottom;">№ of participants (studies) Follow up</th><th id="hd_h_niceng226er7.tab44_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab44_1_1_1_3" style="text-align:left;vertical-align:bottom;">Certainty of the evidence (GRADE)</th><th id="hd_h_niceng226er7.tab44_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab44_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95% CI)</th><th id="hd_h_niceng226er7.tab44_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Anticipated absolute effects</th><th id="hd_h_niceng226er7.tab44_1_1_1_6" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab44_1_1_1_6" style="text-align:left;vertical-align:bottom;">Comments</th></tr><tr><th headers="hd_h_niceng226er7.tab44_1_1_1_5" id="hd_h_niceng226er7.tab44_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk with sham electrotherapy</th><th headers="hd_h_niceng226er7.tab44_1_1_1_5" id="hd_h_niceng226er7.tab44_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk difference with laser therapy</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab44_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (KOOS, NHP [different scale ranges], high is good, final values) at ≤3 months</td><td headers="hd_h_niceng226er7.tab44_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>127</p>
|
|
<p>(2 RCTs)</p>
|
|
<p>follow up: mean 8 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab44_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁⨁⨁</p>
|
|
<p>HIGH</p>
|
|
</td><td headers="hd_h_niceng226er7.tab44_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab44_1_1_1_5 hd_h_niceng226er7.tab44_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab44_1_1_1_5 hd_h_niceng226er7.tab44_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>SMD <b>0.08 SD higher</b></p>
|
|
<p>(0.27 lower to 0.43 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab44_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab44_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (SF-36 physical component, 0-50, high is good, change score) at ≤3 months</td><td headers="hd_h_niceng226er7.tab44_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>55</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 12 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab44_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁⨁◯</p>
|
|
<p>MODERATE<sup>a</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab44_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab44_1_1_1_5 hd_h_niceng226er7.tab44_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 2.4</td><td headers="hd_h_niceng226er7.tab44_1_1_1_5 hd_h_niceng226er7.tab44_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>2.3 lower</b></p>
|
|
<p>(5.97 lower to 1.37 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab44_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab44_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (SF-36 mental component, 0-50, high is good, change score) at ≤3 months</td><td headers="hd_h_niceng226er7.tab44_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>55</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 12 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab44_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁⨁◯</p>
|
|
<p>MODERATE<sup>a</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab44_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab44_1_1_1_5 hd_h_niceng226er7.tab44_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was −4.2</td><td headers="hd_h_niceng226er7.tab44_1_1_1_5 hd_h_niceng226er7.tab44_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>5.1 higher</b></p>
|
|
<p>(0.03 lower to 10.23 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab44_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab44_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (SF-12 physical component, 0-100, high is good, final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab44_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>123</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 12 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab44_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁⨁◯</p>
|
|
<p>MODERATE<sup>c</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab44_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab44_1_1_1_5 hd_h_niceng226er7.tab44_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 40.2</td><td headers="hd_h_niceng226er7.tab44_1_1_1_5 hd_h_niceng226er7.tab44_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>0.8 lower</b></p>
|
|
<p>(4.28 lower to 2.68 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab44_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab44_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (SF-12 mental component, 0-100, high is good, final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab44_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>123</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 12 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab44_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁⨁◯</p>
|
|
<p>MODERATE<sup>c</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab44_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab44_1_1_1_5 hd_h_niceng226er7.tab44_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 53.2</td><td headers="hd_h_niceng226er7.tab44_1_1_1_5 hd_h_niceng226er7.tab44_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>0.2 lower</b></p>
|
|
<p>(3.8 lower to 3.4 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab44_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab44_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (SF-12 physical component, 0-100, high is good, final value) at >3 months</td><td headers="hd_h_niceng226er7.tab44_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>123</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 12 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab44_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁⨁◯</p>
|
|
<p>MODERATE<sup>c</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab44_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab44_1_1_1_5 hd_h_niceng226er7.tab44_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 38.2</td><td headers="hd_h_niceng226er7.tab44_1_1_1_5 hd_h_niceng226er7.tab44_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>0.6 higher</b></p>
|
|
<p>(3.18 lower to 4.38 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab44_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab44_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (SF-12 mental component, 0-100, high is good, final value) at >3 months</td><td headers="hd_h_niceng226er7.tab44_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>123</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 12 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab44_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁⨁◯</p>
|
|
<p>MODERATE<sup>c</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab44_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab44_1_1_1_5 hd_h_niceng226er7.tab44_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 52.8</td><td headers="hd_h_niceng226er7.tab44_1_1_1_5 hd_h_niceng226er7.tab44_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>0.7 lower</b></p>
|
|
<p>(4.25 lower to 2.85 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab44_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab44_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (WOMAC, AUSCAN, VAS [different scale ranges], high is poor, change scores) at ≤3 months</td><td headers="hd_h_niceng226er7.tab44_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>328</p>
|
|
<p>(4 RCTs)</p>
|
|
<p>follow up: mean 8 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab44_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>b</sup><sup>,</sup><sup>c</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab44_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab44_1_1_1_5 hd_h_niceng226er7.tab44_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab44_1_1_1_5 hd_h_niceng226er7.tab44_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>SMD <b>0.96 SD lower</b></p>
|
|
<p>(2.09 lower to 0.18 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab44_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab44_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (KOOS, WOMAC, VNPS, VAS [different scale ranges], high is poor, final values) at ≤3 months</td><td headers="hd_h_niceng226er7.tab44_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>822</p>
|
|
<p>(14 RCTs)</p>
|
|
<p>follow up: mean 8 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab44_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup><sup>,</sup><sup>c</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab44_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab44_1_1_1_5 hd_h_niceng226er7.tab44_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab44_1_1_1_5 hd_h_niceng226er7.tab44_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>SMD <b>0.31 SD lower</b></p>
|
|
<p>(0.55 lower to 0.06 lower)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab44_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab44_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (AUSCAN, 0-4, high is poor, change score) at >3 months</td><td headers="hd_h_niceng226er7.tab44_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>86</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 6 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab44_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁⨁⨁</p>
|
|
<p>HIGH</p>
|
|
</td><td headers="hd_h_niceng226er7.tab44_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab44_1_1_1_5 hd_h_niceng226er7.tab44_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean pain was −0.35</td><td headers="hd_h_niceng226er7.tab44_1_1_1_5 hd_h_niceng226er7.tab44_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>0.06 lower</b></p>
|
|
<p>(0.39 lower to 0.27 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab44_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab44_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (WOMAC, NRS [different scale ranges], high is poor, final values) at >3 months</td><td headers="hd_h_niceng226er7.tab44_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>233</p>
|
|
<p>(3 RCTs)</p>
|
|
<p>follow up: mean 8 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab44_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁⨁◯</p>
|
|
<p>MODERATE<sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab44_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab44_1_1_1_5 hd_h_niceng226er7.tab44_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean pain was −5.5</td><td headers="hd_h_niceng226er7.tab44_1_1_1_5 hd_h_niceng226er7.tab44_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>SMD <b>0.12 SD higher</b></p>
|
|
<p>(0.38 lower to 0.14 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab44_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab44_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Physical function (WOMAC, AUSCAN [different scale ranges], high is poor, change score) at ≤3 months</td><td headers="hd_h_niceng226er7.tab44_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>141</p>
|
|
<p>(2 RCTs)</p>
|
|
<p>follow up: mean 12 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab44_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁⨁⨁</p>
|
|
<p>HIGH</p>
|
|
</td><td headers="hd_h_niceng226er7.tab44_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab44_1_1_1_5 hd_h_niceng226er7.tab44_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab44_1_1_1_5 hd_h_niceng226er7.tab44_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>SMD <b>0.15 SD lower</b></p>
|
|
<p>(0.48 lower to 0.19 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab44_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab44_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Physical function (KOOS, WOMAC [different scale ranges], high is poor, final values) at ≤3 months</td><td headers="hd_h_niceng226er7.tab44_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>450</p>
|
|
<p>(8 RCTs)</p>
|
|
<p>follow up: mean 8 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab44_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup><sup>,</sup><sup>c</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab44_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab44_1_1_1_5 hd_h_niceng226er7.tab44_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab44_1_1_1_5 hd_h_niceng226er7.tab44_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>SMD <b>0.37 SD lower</b></p>
|
|
<p>(0.89 lower to 0.16 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab44_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab44_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Physical function (AUSCAN, 0-4, high is poor, change score) at >3 months</td><td headers="hd_h_niceng226er7.tab44_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>86</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 6 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab44_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁⨁◯</p>
|
|
<p>MODERATE<sup>a</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab44_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab44_1_1_1_5 hd_h_niceng226er7.tab44_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean physical function was −0.31</td><td headers="hd_h_niceng226er7.tab44_1_1_1_5 hd_h_niceng226er7.tab44_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>0.07 lower</b></p>
|
|
<p>(0.4 lower to 0.26 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab44_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab44_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Physical function (WOMAC, 0-68, high is poor, final value) at >3 months</td><td headers="hd_h_niceng226er7.tab44_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>149</p>
|
|
<p>(2 RCTs)</p>
|
|
<p>follow up: mean 9 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab44_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁⨁◯</p>
|
|
<p>MODERATE<sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab44_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab44_1_1_1_5 hd_h_niceng226er7.tab44_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean physical function was 22.2</td><td headers="hd_h_niceng226er7.tab44_1_1_1_5 hd_h_niceng226er7.tab44_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>0.13 higher</b></p>
|
|
<p>(4.33 lower to 4.59 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab44_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 5.9 (0.5 × median baseline SD)</td></tr><tr><td headers="hd_h_niceng226er7.tab44_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Mild adverse events at ≤3 months</td><td headers="hd_h_niceng226er7.tab44_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>227</p>
|
|
<p>(4 RCTs)</p>
|
|
<p>follow up: mean 8 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab44_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>c</sup><sup>,</sup><sup>d</sup><sup>,</sup><sup>e</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab44_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>RD 0.04</p>
|
|
<p>(−0.03 to 0.10)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab44_1_1_1_5 hd_h_niceng226er7.tab44_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">55 per 1,000</td><td headers="hd_h_niceng226er7.tab44_1_1_1_5 hd_h_niceng226er7.tab44_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>40 more per 1,000</b>
|
|
</p>
|
|
<p>(30 fewer to 100 more)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab44_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Precision calculated through Optimal Information Size (OIS) due to zero events in some studies (0.8-0.9 = serious, <0.8 = very serious).</td></tr><tr><td headers="hd_h_niceng226er7.tab44_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Mild adverse event at >3 months</td><td headers="hd_h_niceng226er7.tab44_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>66</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 6 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab44_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>e</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab44_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>RD 0.00</p>
|
|
<p>(−0.06 to 0.06)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab44_1_1_1_5 hd_h_niceng226er7.tab44_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">0 per 1,000</td><td headers="hd_h_niceng226er7.tab44_1_1_1_5 hd_h_niceng226er7.tab44_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>0 fewer per 1,000</b>
|
|
</p>
|
|
<p>(60 fewer to 60 more)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab44_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sample size used to determine precision: 75-150 = serious imprecision, <75 = very serious imprecision.</td></tr><tr><td headers="hd_h_niceng226er7.tab44_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Moderate/major adverse events at ≤3 months</td><td headers="hd_h_niceng226er7.tab44_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>55</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 12 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab44_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁⨁◯</p>
|
|
<p>MODERATE<sup>a</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab44_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Peto OR 0.14</p>
|
|
<p>(0.01 to 2.22)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab44_1_1_1_5 hd_h_niceng226er7.tab44_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">71 per 1,000</td><td headers="hd_h_niceng226er7.tab44_1_1_1_5 hd_h_niceng226er7.tab44_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>70 fewer per 1,000</b>
|
|
</p>
|
|
<p>(180 fewer to 40 more)<sup>f</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab44_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID (precision) = Peto OR 0.8-1.25.</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng226er7.tab44_1"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="niceng226er7.tab44_2"><p class="no_margin">Downgraded by 1 or 2 increments because heterogeneity, unexplained by subgroup analysis</p></div></dd></dl><dl class="bkr_refwrap"><dt>c</dt><dd><div id="niceng226er7.tab44_3"><p class="no_margin">Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias</p></div></dd></dl><dl class="bkr_refwrap"><dt>d</dt><dd><div id="niceng226er7.tab44_4"><p class="no_margin">Downgraded for heterogeneity due to conflicting number of events in different studies (zero events in one or more studies)</p></div></dd></dl><dl class="bkr_refwrap"><dt>e</dt><dd><div id="niceng226er7.tab44_5"><p class="no_margin">Downgraded by 1 to 2 increments for imprecision due to zero events and small sample size</p></div></dd></dl><dl class="bkr_refwrap"><dt>f</dt><dd><div id="niceng226er7.tab44_6"><p class="no_margin">Absolute effect calculated by risk difference due to zero events in at least one arm of the study</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab45"><div id="niceng226er7.tab45" class="table"><h3><span class="label">Table 45</span><span class="title">Clinical evidence summary: laser therapy compared to no treatment</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab45/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab45_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng226er7.tab45_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab45_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_niceng226er7.tab45_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab45_1_1_1_2" style="text-align:left;vertical-align:bottom;">№ of participants (studies) Follow up</th><th id="hd_h_niceng226er7.tab45_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab45_1_1_1_3" style="text-align:left;vertical-align:bottom;">Certainty of the evidence (GRADE)</th><th id="hd_h_niceng226er7.tab45_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab45_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95% CI)</th><th id="hd_h_niceng226er7.tab45_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Anticipated absolute effects</th><th id="hd_h_niceng226er7.tab45_1_1_1_6" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab45_1_1_1_6" style="text-align:left;vertical-align:bottom;">Comments</th></tr><tr><th headers="hd_h_niceng226er7.tab45_1_1_1_5" id="hd_h_niceng226er7.tab45_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk with no treatment</th><th headers="hd_h_niceng226er7.tab45_1_1_1_5" id="hd_h_niceng226er7.tab45_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk difference with laser therapy</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab45_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (SF-12 physical component, 0-100, high is good, final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab45_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>134</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 12 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab45_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW<sup>a</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab45_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab45_1_1_1_5 hd_h_niceng226er7.tab45_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 39.5</td><td headers="hd_h_niceng226er7.tab45_1_1_1_5 hd_h_niceng226er7.tab45_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>0.1 lower</b></p>
|
|
<p>(3.52 lower to 3.32 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab45_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab45_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (SF-12 mental component, 0-100, high is good, final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab45_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>134</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 12 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab45_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>c</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab45_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab45_1_1_1_5 hd_h_niceng226er7.tab45_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 55.8</td><td headers="hd_h_niceng226er7.tab45_1_1_1_5 hd_h_niceng226er7.tab45_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>2.8 lower</b></p>
|
|
<p>(6.03 lower to 0.43 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab45_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab45_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (SF-12 physical component, 0-100, high is good, final value) at >3 months</td><td headers="hd_h_niceng226er7.tab45_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>120</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 12 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab45_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW<sup>a</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab45_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab45_1_1_1_5 hd_h_niceng226er7.tab45_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 38.9</td><td headers="hd_h_niceng226er7.tab45_1_1_1_5 hd_h_niceng226er7.tab45_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>0.1 lower</b></p>
|
|
<p>(3.93 lower to 3.73 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab45_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab45_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (SF-12 mental component, 0-100, high is good, final value) at >3 months</td><td headers="hd_h_niceng226er7.tab45_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>120</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 12 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab45_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>c</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab45_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab45_1_1_1_5 hd_h_niceng226er7.tab45_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 54.4</td><td headers="hd_h_niceng226er7.tab45_1_1_1_5 hd_h_niceng226er7.tab45_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>2.3 lower</b></p>
|
|
<p>(5.88 lower to 1.28 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab45_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab45_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (WOMAC [different scale ranges], high is poor, final values) at ≤3 months</td><td headers="hd_h_niceng226er7.tab45_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>279</p>
|
|
<p>(4 RCTs)</p>
|
|
<p>follow up: mean 10 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab45_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup><sup>,</sup><sup>c</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab45_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab45_1_1_1_5 hd_h_niceng226er7.tab45_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab45_1_1_1_5 hd_h_niceng226er7.tab45_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>SMD <b>0.39 SD higher</b></p>
|
|
<p>(0.2 lower to 0.98 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab45_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab45_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (WOMAC, 0-20, high is poor, final value) at >3 months</td><td headers="hd_h_niceng226er7.tab45_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>120</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 12 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab45_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW<sup>a</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab45_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab45_1_1_1_5 hd_h_niceng226er7.tab45_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean pain was 7.4</td><td headers="hd_h_niceng226er7.tab45_1_1_1_5 hd_h_niceng226er7.tab45_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>0.3 lower</b></p>
|
|
<p>(1.77 lower to 1.17 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab45_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab45_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Physical function (WOMAC [different scale ranges], high is poor, final values) at ≤3 months</td><td headers="hd_h_niceng226er7.tab45_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>279</p>
|
|
<p>(4 RCTs)</p>
|
|
<p>follow up: mean 10 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab45_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup><sup>,</sup><sup>c</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab45_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab45_1_1_1_5 hd_h_niceng226er7.tab45_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab45_1_1_1_5 hd_h_niceng226er7.tab45_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>SMD <b>1 SD lower</b></p>
|
|
<p>(2.23 lower to 0.23 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab45_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab45_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Physical function (WOMAC, 0-68, high is poor, final value) at >3 months</td><td headers="hd_h_niceng226er7.tab45_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>120</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 12 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab45_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW<sup>a</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab45_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab45_1_1_1_5 hd_h_niceng226er7.tab45_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean physical function was 21.6</td><td headers="hd_h_niceng226er7.tab45_1_1_1_5 hd_h_niceng226er7.tab45_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>1 lower</b></p>
|
|
<p>(3.78 lower to 5.78 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab45_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng226er7.tab45_1"><p class="no_margin">Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="niceng226er7.tab45_2"><p class="no_margin">Downgraded by 1 or 2 increments because heterogeneity, unexplained by subgroup analysis</p></div></dd></dl><dl class="bkr_refwrap"><dt>c</dt><dd><div id="niceng226er7.tab45_3"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab46"><div id="niceng226er7.tab46" class="table"><h3><span class="label">Table 46</span><span class="title">Clinical evidence summary: transcutaneous electrical nerve stimulation compared to pulsed short-wave therapy</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab46/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab46_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng226er7.tab46_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab46_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_niceng226er7.tab46_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab46_1_1_1_2" style="text-align:left;vertical-align:bottom;">№ of participants (studies) Follow up</th><th id="hd_h_niceng226er7.tab46_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab46_1_1_1_3" style="text-align:left;vertical-align:bottom;">Certainty of the evidence (GRADE)</th><th id="hd_h_niceng226er7.tab46_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab46_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95% CI)</th><th id="hd_h_niceng226er7.tab46_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Anticipated absolute effects</th><th id="hd_h_niceng226er7.tab46_1_1_1_6" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab46_1_1_1_6" style="text-align:left;vertical-align:bottom;">Comments</th></tr><tr><th headers="hd_h_niceng226er7.tab46_1_1_1_5" id="hd_h_niceng226er7.tab46_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk with pulsed short-wave therapy</th><th headers="hd_h_niceng226er7.tab46_1_1_1_5" id="hd_h_niceng226er7.tab46_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk difference with transcutaneous electrical nerve stimulation</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab46_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (WOMAC, VAS [different scale ranges], high is poor, change score) at ≤3 months</td><td headers="hd_h_niceng226er7.tab46_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>109</p>
|
|
<p>(2 RCTs)</p>
|
|
<p>follow up: mean 10 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab46_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab46_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab46_1_1_1_5 hd_h_niceng226er7.tab46_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab46_1_1_1_5 hd_h_niceng226er7.tab46_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>SMD <b>0.24 SD higher</b></p>
|
|
<p>(0.14 lower to 0.61 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab46_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab46_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (WOMAC, 0-20, high is poor, change score) at >3 months</td><td headers="hd_h_niceng226er7.tab46_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>69</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 6 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab46_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab46_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab46_1_1_1_5 hd_h_niceng226er7.tab46_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean pain was 4.5</td><td headers="hd_h_niceng226er7.tab46_1_1_1_5 hd_h_niceng226er7.tab46_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>1.5 higher</b></p>
|
|
<p>(0.21 lower to 3.21 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab46_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab46_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Physical function (WOMAC, 0-68, high is poor, change score) at ≤3 months</td><td headers="hd_h_niceng226er7.tab46_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>69</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 6 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab46_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab46_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab46_1_1_1_5 hd_h_niceng226er7.tab46_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean physical function was 11.4</td><td headers="hd_h_niceng226er7.tab46_1_1_1_5 hd_h_niceng226er7.tab46_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>2.7 higher</b></p>
|
|
<p>(2.99 lower to 8.39 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab46_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab46_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Physical function (WOMAC, 0-68, high is poor, change score) at >3 months</td><td headers="hd_h_niceng226er7.tab46_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>69</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 6 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab46_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab46_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab46_1_1_1_5 hd_h_niceng226er7.tab46_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean physical function was 9.9</td><td headers="hd_h_niceng226er7.tab46_1_1_1_5 hd_h_niceng226er7.tab46_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>0.4 higher</b></p>
|
|
<p>(5.49 lower to 6.29 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab46_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng226er7.tab46_1"><p class="no_margin">Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="niceng226er7.tab46_2"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab47"><div id="niceng226er7.tab47" class="table"><h3><span class="label">Table 47</span><span class="title">Clinical evidence summary: transcutaneous electrical nerve stimulation compared to interferential therapy</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab47/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab47_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng226er7.tab47_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab47_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_niceng226er7.tab47_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab47_1_1_1_2" style="text-align:left;vertical-align:bottom;">№ of participants (studies) Follow up</th><th id="hd_h_niceng226er7.tab47_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab47_1_1_1_3" style="text-align:left;vertical-align:bottom;">Certainty of the evidence (GRADE)</th><th id="hd_h_niceng226er7.tab47_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab47_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95% CI)</th><th id="hd_h_niceng226er7.tab47_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Anticipated absolute effects</th><th id="hd_h_niceng226er7.tab47_1_1_1_6" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab47_1_1_1_6" style="text-align:left;vertical-align:bottom;">Comments</th></tr><tr><th headers="hd_h_niceng226er7.tab47_1_1_1_5" id="hd_h_niceng226er7.tab47_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk with interferential therapy</th><th headers="hd_h_niceng226er7.tab47_1_1_1_5" id="hd_h_niceng226er7.tab47_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk difference with transcutaneous electrical nerve stimulation</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab47_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (WOMAC, 0-20, high is poor, change score) at ≤3 months</td><td headers="hd_h_niceng226er7.tab47_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>173</p>
|
|
<p>(2 RCTs)</p>
|
|
<p>follow up: mean 10 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab47_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup><sup>,</sup><sup>c</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab47_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab47_1_1_1_5 hd_h_niceng226er7.tab47_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab47_1_1_1_5 hd_h_niceng226er7.tab47_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>1.2 higher</b></p>
|
|
<p>(0.48 lower to 2.89 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab47_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 2.2 (0.5 × median baseline SD)</td></tr><tr><td headers="hd_h_niceng226er7.tab47_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (WOMAC, 0-20, high is poor, change score) at >3 months</td><td headers="hd_h_niceng226er7.tab47_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>68</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 6 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab47_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW<sup>a</sup><sup>,</sup><sup>c</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab47_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab47_1_1_1_5 hd_h_niceng226er7.tab47_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean pain was 3.4</td><td headers="hd_h_niceng226er7.tab47_1_1_1_5 hd_h_niceng226er7.tab47_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>0.3 higher</b></p>
|
|
<p>(1.39 lower to 1.99 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab47_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab47_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Physical function (WOMAC, 0-68, high is poor, change score) at ≤3 months</td><td headers="hd_h_niceng226er7.tab47_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>173</p>
|
|
<p>(2 RCTs)</p>
|
|
<p>follow up: mean 10 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab47_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup><sup>,</sup><sup>c</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab47_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab47_1_1_1_5 hd_h_niceng226er7.tab47_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_niceng226er7.tab47_1_1_1_5 hd_h_niceng226er7.tab47_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>3.68 higher</b></p>
|
|
<p>(1.69 lower to 9.06 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab47_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 6.5 (0.5 × median baseline SD)</td></tr><tr><td headers="hd_h_niceng226er7.tab47_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Physical function (WOMAC, 0-68, high is poor, change score) at >3 months</td><td headers="hd_h_niceng226er7.tab47_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>68</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 6 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab47_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW<sup>a</sup><sup>,</sup><sup>c</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab47_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab47_1_1_1_5 hd_h_niceng226er7.tab47_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean physical function was 8.5</td><td headers="hd_h_niceng226er7.tab47_1_1_1_5 hd_h_niceng226er7.tab47_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>1 higher</b></p>
|
|
<p>(4.39 lower to 6.39 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab47_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab47_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Mild adverse events at ≤3 months</td><td headers="hd_h_niceng226er7.tab47_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>116</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 8 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab47_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>c</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab47_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RR 1.74 (0.62 to 4.88)</td><td headers="hd_h_niceng226er7.tab47_1_1_1_5 hd_h_niceng226er7.tab47_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">88 per 1,000</td><td headers="hd_h_niceng226er7.tab47_1_1_1_5 hd_h_niceng226er7.tab47_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>65 more per 1,000</b>
|
|
</p>
|
|
<p>(33 fewer to 340 more)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab47_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID (precision) = RR 0.8-1.25.</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng226er7.tab47_1"><p class="no_margin">Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="niceng226er7.tab47_2"><p class="no_margin">Downgraded by 1 or 2 increments because heterogeneity, unexplained by subgroup analysis</p></div></dd></dl><dl class="bkr_refwrap"><dt>c</dt><dd><div id="niceng226er7.tab47_3"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab48"><div id="niceng226er7.tab48" class="table"><h3><span class="label">Table 48</span><span class="title">Clinical evidence summary: transcutaneous electrical nerve stimulation compared to sham electrotherapy</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab48/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab48_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng226er7.tab48_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab48_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_niceng226er7.tab48_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab48_1_1_1_2" style="text-align:left;vertical-align:bottom;">№ of participants (studies) Follow up</th><th id="hd_h_niceng226er7.tab48_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab48_1_1_1_3" style="text-align:left;vertical-align:bottom;">Certainty of the evidence (GRADE)</th><th id="hd_h_niceng226er7.tab48_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab48_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95% CI)</th><th id="hd_h_niceng226er7.tab48_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Anticipated absolute effects</th><th id="hd_h_niceng226er7.tab48_1_1_1_6" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab48_1_1_1_6" style="text-align:left;vertical-align:bottom;">Comments</th></tr><tr><th headers="hd_h_niceng226er7.tab48_1_1_1_5" id="hd_h_niceng226er7.tab48_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk with sham electrotherapy</th><th headers="hd_h_niceng226er7.tab48_1_1_1_5" id="hd_h_niceng226er7.tab48_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk difference with transcutaneous electrical nerve stimulation</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab48_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (SF-36 physical function, 0-1, high is good, final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab48_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>40</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 3 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab48_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW<sup>a</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab48_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab48_1_1_1_5 hd_h_niceng226er7.tab48_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 0.45</td><td headers="hd_h_niceng226er7.tab48_1_1_1_5 hd_h_niceng226er7.tab48_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>0.16 higher</b></p>
|
|
<p>(0.07 higher to 0.25 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab48_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab48_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (SF-36 vitality, 0-1, high is good, final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab48_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>40</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 3 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab48_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab48_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab48_1_1_1_5 hd_h_niceng226er7.tab48_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 0.72</td><td headers="hd_h_niceng226er7.tab48_1_1_1_5 hd_h_niceng226er7.tab48_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>0.02 lower</b></p>
|
|
<p>(0.12 lower to 0.08 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab48_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab48_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (SF-36 general health, 0-1, high is good, final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab48_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>40</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 3 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab48_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab48_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab48_1_1_1_5 hd_h_niceng226er7.tab48_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 0.67</td><td headers="hd_h_niceng226er7.tab48_1_1_1_5 hd_h_niceng226er7.tab48_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>0.06 higher</b></p>
|
|
<p>(0.02 lower to 0.14 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab48_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab48_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (SF-36 mental health, 0-1, high is good, final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab48_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>40</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 3 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab48_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab48_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab48_1_1_1_5 hd_h_niceng226er7.tab48_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 0.02</td><td headers="hd_h_niceng226er7.tab48_1_1_1_5 hd_h_niceng226er7.tab48_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>0.02 higher</b></p>
|
|
<p>(0.08 lower to 0.12 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab48_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab48_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (SF-36 social function, 0-1, high is good, final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab48_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>40</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 3 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab48_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab48_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab48_1_1_1_5 hd_h_niceng226er7.tab48_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 0.72</td><td headers="hd_h_niceng226er7.tab48_1_1_1_5 hd_h_niceng226er7.tab48_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>MD 0.11 higher</b>
|
|
</p>
|
|
<p>(0.02 higher to 0.2 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab48_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab48_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (WOMAC, 0-20, high is poor, change score) at ≤3 months</td><td headers="hd_h_niceng226er7.tab48_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>74</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 12 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab48_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab48_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab48_1_1_1_5 hd_h_niceng226er7.tab48_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean pain was 3.6</td><td headers="hd_h_niceng226er7.tab48_1_1_1_5 hd_h_niceng226er7.tab48_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>0.8 lower</b></p>
|
|
<p>(2.26 lower to 0.66 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab48_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab48_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (WOMAC, VAS [different scale ranges], high is poor, final values) at ≤3 months</td><td headers="hd_h_niceng226er7.tab48_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>361</p>
|
|
<p>(5 RCTs)</p>
|
|
<p>follow up: mean 6 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab48_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup><sup>,</sup><sup>c</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab48_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab48_1_1_1_5 hd_h_niceng226er7.tab48_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab48_1_1_1_5 hd_h_niceng226er7.tab48_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>SMD <b>0.32 SD lower</b></p>
|
|
<p>(0.76 lower to 0.13 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab48_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab48_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (WOMAC, 0-20, high is poor, change score and final value) at >3 months</td><td headers="hd_h_niceng226er7.tab48_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>221</p>
|
|
<p>(2 RCTs)</p>
|
|
<p>follow up: mean 25 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab48_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab48_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab48_1_1_1_5 hd_h_niceng226er7.tab48_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean pain was 5</td><td headers="hd_h_niceng226er7.tab48_1_1_1_5 hd_h_niceng226er7.tab48_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>0.49 higher</b></p>
|
|
<p>(0.81 lower to 1.8 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab48_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 2.4 (0.5 × median baseline SD)</td></tr><tr><td headers="hd_h_niceng226er7.tab48_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Physical function (WOMAC, 0-68, high is poor, change score) at ≤3 months</td><td headers="hd_h_niceng226er7.tab48_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>74</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 12 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab48_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab48_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab48_1_1_1_5 hd_h_niceng226er7.tab48_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean physical function was 9.4</td><td headers="hd_h_niceng226er7.tab48_1_1_1_5 hd_h_niceng226er7.tab48_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>0.7 lower</b></p>
|
|
<p>(5.78 lower to 4.38 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab48_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab48_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Physical function (WOMAC [different scale ranges], high is poor, final values) at ≤3 months</td><td headers="hd_h_niceng226er7.tab48_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>313</p>
|
|
<p>(4 RCTs)</p>
|
|
<p>follow up: mean 7 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab48_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup><sup>,</sup><sup>c</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab48_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab48_1_1_1_5 hd_h_niceng226er7.tab48_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab48_1_1_1_5 hd_h_niceng226er7.tab48_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>SMD <b>0.17 SD lower</b></p>
|
|
<p>(0.52 lower to 0.18 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab48_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab48_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Physical function (WOMAC, 0-68, high is poor, change score and final value) at >3 months</td><td headers="hd_h_niceng226er7.tab48_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>221</p>
|
|
<p>(2 RCTs)</p>
|
|
<p>follow up: mean 25 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab48_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁⨁◯</p>
|
|
<p>MODERATE<sup>a</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab48_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab48_1_1_1_5 hd_h_niceng226er7.tab48_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean physical function was 17.2</td><td headers="hd_h_niceng226er7.tab48_1_1_1_5 hd_h_niceng226er7.tab48_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>0.45 higher</b></p>
|
|
<p>(2.97 lower to 3.88 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab48_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 6.5 (0.5 × median baseline SD)</td></tr><tr><td headers="hd_h_niceng226er7.tab48_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Mild adverse events at ≤3 months</td><td headers="hd_h_niceng226er7.tab48_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>24</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 4 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab48_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>d</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab48_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>RD 0.00</p>
|
|
<p>(−0.15 to 0.15)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab48_1_1_1_5 hd_h_niceng226er7.tab48_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">0 per 1,000</td><td headers="hd_h_niceng226er7.tab48_1_1_1_5 hd_h_niceng226er7.tab48_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>0 fewer per 1,000</b>
|
|
</p>
|
|
<p>(150 fewer to 150 more)<sup>e</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab48_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sample size used to determine precision: 75-150 = serious imprecision, <75 = very serious imprecision.</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng226er7.tab48_1"><p class="no_margin">Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="niceng226er7.tab48_2"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl><dl class="bkr_refwrap"><dt>c</dt><dd><div id="niceng226er7.tab48_3"><p class="no_margin">Downgraded by 1 or 2 increments because heterogeneity, unexplained by subgroup analysis</p></div></dd></dl><dl class="bkr_refwrap"><dt>d</dt><dd><div id="niceng226er7.tab48_4"><p class="no_margin">Downgraded by 1 to 2 increments for imprecision due to zero events and small sample size</p></div></dd></dl><dl class="bkr_refwrap"><dt>e</dt><dd><div id="niceng226er7.tab48_5"><p class="no_margin">Absolute effect calculated by risk difference due to zero events in at least one arm of one study</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab49"><div id="niceng226er7.tab49" class="table"><h3><span class="label">Table 49</span><span class="title">Clinical evidence summary: transcutaneous electrical nerve stimulation compared to no treatment</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab49/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab49_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng226er7.tab49_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab49_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_niceng226er7.tab49_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab49_1_1_1_2" style="text-align:left;vertical-align:bottom;">№ of participants (studies) Follow up</th><th id="hd_h_niceng226er7.tab49_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab49_1_1_1_3" style="text-align:left;vertical-align:bottom;">Certainty of the evidence (GRADE)</th><th id="hd_h_niceng226er7.tab49_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab49_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95% CI)</th><th id="hd_h_niceng226er7.tab49_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Anticipated absolute effects</th><th id="hd_h_niceng226er7.tab49_1_1_1_6" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab49_1_1_1_6" style="text-align:left;vertical-align:bottom;">Comments</th></tr><tr><th headers="hd_h_niceng226er7.tab49_1_1_1_5" id="hd_h_niceng226er7.tab49_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk with no treatment</th><th headers="hd_h_niceng226er7.tab49_1_1_1_5" id="hd_h_niceng226er7.tab49_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk difference with transcutaneous electrical nerve stimulation</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab49_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (VAS, 0-10, high is poor, change score) at ≤3 months</td><td headers="hd_h_niceng226er7.tab49_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>40</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 8 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab49_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab49_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab49_1_1_1_5 hd_h_niceng226er7.tab49_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean pain was −2.27</td><td headers="hd_h_niceng226er7.tab49_1_1_1_5 hd_h_niceng226er7.tab49_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>0.05 lower</b></p>
|
|
<p>(0.52 lower to 0.42 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab49_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab49_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (WOMAC [different scale ranges], high is poor, final values) at ≤3 months</td><td headers="hd_h_niceng226er7.tab49_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>111</p>
|
|
<p>(3 RCTs)</p>
|
|
<p>follow up: mean 7 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab49_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup><sup>,</sup><sup>c</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab49_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab49_1_1_1_5 hd_h_niceng226er7.tab49_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab49_1_1_1_5 hd_h_niceng226er7.tab49_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>SMD <b>0 SD higher</b></p>
|
|
<p>(0.45 lower to 0.46 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab49_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab49_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Physical function (WOMAC [different scale ranges], high is poor, final values) at ≤3 months</td><td headers="hd_h_niceng226er7.tab49_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>111</p>
|
|
<p>(3 RCTs)</p>
|
|
<p>follow up: mean 7 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab49_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup><sup>,</sup><sup>c</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab49_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab49_1_1_1_5 hd_h_niceng226er7.tab49_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab49_1_1_1_5 hd_h_niceng226er7.tab49_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>SMD <b>0.08 SD higher</b></p>
|
|
<p>(0.53 lower to 0.68 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab49_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab49_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Mild adverse events at ≤3 months</td><td headers="hd_h_niceng226er7.tab49_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>24</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 4 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab49_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>d</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab49_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>RD 0.00</p>
|
|
<p>(−0.15 to 0.15)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab49_1_1_1_5 hd_h_niceng226er7.tab49_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">0 per 1,000</td><td headers="hd_h_niceng226er7.tab49_1_1_1_5 hd_h_niceng226er7.tab49_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>0 fewer per 1,000</b>
|
|
</p>
|
|
<p>(150 fewer to 150 more)<sup>e</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab49_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sample size used to determine precision: 75-150 = serious imprecision, <75 = very serious imprecision.</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng226er7.tab49_1"><p class="no_margin">Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="niceng226er7.tab49_2"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl><dl class="bkr_refwrap"><dt>c</dt><dd><div id="niceng226er7.tab49_3"><p class="no_margin">Downgraded by 1 or 2 increments because heterogeneity, unexplained by subgroup analysis</p></div></dd></dl><dl class="bkr_refwrap"><dt>d</dt><dd><div id="niceng226er7.tab49_4"><p class="no_margin">Downgraded by 1 to 2 increments for imprecision due to zero events and small sample size</p></div></dd></dl><dl class="bkr_refwrap"><dt>e</dt><dd><div id="niceng226er7.tab49_5"><p class="no_margin">Absolute effect calculated by risk difference due to zero events in at least one arm of one study</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab50"><div id="niceng226er7.tab50" class="table"><h3><span class="label">Table 50</span><span class="title">Clinical evidence summary: ultrasound compared to pulsed short-wave therapy</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab50/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab50_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng226er7.tab50_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab50_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_niceng226er7.tab50_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab50_1_1_1_2" style="text-align:left;vertical-align:bottom;">№ of participants (studies) Follow up</th><th id="hd_h_niceng226er7.tab50_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab50_1_1_1_3" style="text-align:left;vertical-align:bottom;">Certainty of the evidence (GRADE)</th><th id="hd_h_niceng226er7.tab50_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab50_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95% CI)</th><th id="hd_h_niceng226er7.tab50_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Anticipated absolute effects</th><th id="hd_h_niceng226er7.tab50_1_1_1_6" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab50_1_1_1_6" style="text-align:left;vertical-align:bottom;">Comments</th></tr><tr><th headers="hd_h_niceng226er7.tab50_1_1_1_5" id="hd_h_niceng226er7.tab50_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk with pulsed short-wave therapy</th><th headers="hd_h_niceng226er7.tab50_1_1_1_5" id="hd_h_niceng226er7.tab50_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk difference with ultrasound</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab50_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (VAS, 0-10, high is poor, change score) at ≤3 months</td><td headers="hd_h_niceng226er7.tab50_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>40</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 8 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab50_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab50_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab50_1_1_1_5 hd_h_niceng226er7.tab50_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean pain was −2.33</td><td headers="hd_h_niceng226er7.tab50_1_1_1_5 hd_h_niceng226er7.tab50_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>0.01 lower</b></p>
|
|
<p>(0.54 lower to 0.52 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab50_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng226er7.tab50_1"><p class="no_margin">Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="niceng226er7.tab50_2"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab51"><div id="niceng226er7.tab51" class="table"><h3><span class="label">Table 51</span><span class="title">Clinical evidence summary: ultrasound compared to neuromuscular electrical stimulation</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab51/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab51_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng226er7.tab51_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab51_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_niceng226er7.tab51_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab51_1_1_1_2" style="text-align:left;vertical-align:bottom;">№ of participants (studies) Follow up</th><th id="hd_h_niceng226er7.tab51_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab51_1_1_1_3" style="text-align:left;vertical-align:bottom;">Certainty of the evidence (GRADE)</th><th id="hd_h_niceng226er7.tab51_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab51_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95% CI)</th><th id="hd_h_niceng226er7.tab51_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Anticipated absolute effects</th><th id="hd_h_niceng226er7.tab51_1_1_1_6" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab51_1_1_1_6" style="text-align:left;vertical-align:bottom;">Comments</th></tr><tr><th headers="hd_h_niceng226er7.tab51_1_1_1_5" id="hd_h_niceng226er7.tab51_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk with neuromuscular electrical stimulation</th><th headers="hd_h_niceng226er7.tab51_1_1_1_5" id="hd_h_niceng226er7.tab51_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk difference with ultrasound</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab51_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (WOMAC, 0-20, high is poor, final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab51_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>60</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 3 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab51_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab51_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab51_1_1_1_5 hd_h_niceng226er7.tab51_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean pain was 5.1</td><td headers="hd_h_niceng226er7.tab51_1_1_1_5 hd_h_niceng226er7.tab51_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>0.94 lower</b></p>
|
|
<p>(1.78 lower to 0.1 lower)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab51_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab51_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Physical function (WOMAC, 0-68, high is poor, final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab51_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>60</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 3 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab51_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab51_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab51_1_1_1_5 hd_h_niceng226er7.tab51_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean physical function was 13.26</td><td headers="hd_h_niceng226er7.tab51_1_1_1_5 hd_h_niceng226er7.tab51_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>1.16 lower</b></p>
|
|
<p>(2.24 lower to 0.08 lower)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab51_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng226er7.tab51_1"><p class="no_margin">Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="niceng226er7.tab51_2"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab52"><div id="niceng226er7.tab52" class="table"><h3><span class="label">Table 52</span><span class="title">Clinical evidence summary: ultrasound compared to transcutaneous electrical nerve stimulation</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab52/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab52_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng226er7.tab52_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab52_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_niceng226er7.tab52_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab52_1_1_1_2" style="text-align:left;vertical-align:bottom;">№ of participants (studies) Follow up</th><th id="hd_h_niceng226er7.tab52_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab52_1_1_1_3" style="text-align:left;vertical-align:bottom;">Certainty of the evidence (GRADE)</th><th id="hd_h_niceng226er7.tab52_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab52_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95% CI)</th><th id="hd_h_niceng226er7.tab52_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Anticipated absolute effects</th><th id="hd_h_niceng226er7.tab52_1_1_1_6" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab52_1_1_1_6" style="text-align:left;vertical-align:bottom;">Comments</th></tr><tr><th headers="hd_h_niceng226er7.tab52_1_1_1_5" id="hd_h_niceng226er7.tab52_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk with transcutaneous electrical nerve stimulation</th><th headers="hd_h_niceng226er7.tab52_1_1_1_5" id="hd_h_niceng226er7.tab52_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk difference with ultrasound</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab52_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (VAS, 0-10, high is poor, change score) at ≤3 months</td><td headers="hd_h_niceng226er7.tab52_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>40</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 8 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab52_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab52_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab52_1_1_1_5 hd_h_niceng226er7.tab52_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean pain was −2.32</td><td headers="hd_h_niceng226er7.tab52_1_1_1_5 hd_h_niceng226er7.tab52_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>0.02 lower</b></p>
|
|
<p>(0.51 lower to 0.47 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab52_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab52_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (WOMAC, 0-20, high is poor, final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab52_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>24</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 8 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab52_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab52_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab52_1_1_1_5 hd_h_niceng226er7.tab52_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean pain was 3.2</td><td headers="hd_h_niceng226er7.tab52_1_1_1_5 hd_h_niceng226er7.tab52_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>3 higher</b></p>
|
|
<p>(0.11 higher to 5.89 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab52_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab52_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Physical function (WOMAC, 0-68, high is poor, final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab52_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>24</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 8 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab52_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab52_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab52_1_1_1_5 hd_h_niceng226er7.tab52_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean physical function was 10.1</td><td headers="hd_h_niceng226er7.tab52_1_1_1_5 hd_h_niceng226er7.tab52_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>10.5 higher</b></p>
|
|
<p>(3.23 higher to 17.77 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab52_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng226er7.tab52_1"><p class="no_margin">Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="niceng226er7.tab52_2"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab53"><div id="niceng226er7.tab53" class="table"><h3><span class="label">Table 53</span><span class="title">Clinical evidence summary: ultrasound compared to sham electrotherapy</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab53/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab53_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng226er7.tab53_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab53_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_niceng226er7.tab53_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab53_1_1_1_2" style="text-align:left;vertical-align:bottom;">№ of participants (studies) Follow up</th><th id="hd_h_niceng226er7.tab53_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab53_1_1_1_3" style="text-align:left;vertical-align:bottom;">Certainty of the evidence (GRADE)</th><th id="hd_h_niceng226er7.tab53_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab53_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95% CI)</th><th id="hd_h_niceng226er7.tab53_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Anticipated absolute effects</th><th id="hd_h_niceng226er7.tab53_1_1_1_6" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab53_1_1_1_6" style="text-align:left;vertical-align:bottom;">Comments</th></tr><tr><th headers="hd_h_niceng226er7.tab53_1_1_1_5" id="hd_h_niceng226er7.tab53_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk with sham electrotherapy</th><th headers="hd_h_niceng226er7.tab53_1_1_1_5" id="hd_h_niceng226er7.tab53_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk difference with ultrasound</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab53_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (SF-36 physical function, 0-100, high is good, change score) at ≤3 months</td><td headers="hd_h_niceng226er7.tab53_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>97</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 13 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁⨁⨁</p>
|
|
<p>HIGH</p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab53_1_1_1_5 hd_h_niceng226er7.tab53_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 15.4</td><td headers="hd_h_niceng226er7.tab53_1_1_1_5 hd_h_niceng226er7.tab53_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>11.5 higher</b></p>
|
|
<p>(6.4 higher to 16.6 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 3 (established value)</td></tr><tr><td headers="hd_h_niceng226er7.tab53_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (SF-36 bodily pain, 0-100, high is good, change score and final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab53_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>153</p>
|
|
<p>(2 RCTs)</p>
|
|
<p>follow up: mean 13 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW<sup>a</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab53_1_1_1_5 hd_h_niceng226er7.tab53_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 33.96</td><td headers="hd_h_niceng226er7.tab53_1_1_1_5 hd_h_niceng226er7.tab53_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>8.67 higher</b></p>
|
|
<p>(8.02 lower to 25.36 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 3 (established value)</td></tr><tr><td headers="hd_h_niceng226er7.tab53_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (SF-36 role physical, 0-100, high is good, change score) at ≤3 months</td><td headers="hd_h_niceng226er7.tab53_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>97</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 13 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW<sup>a</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab53_1_1_1_5 hd_h_niceng226er7.tab53_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 12.33</td><td headers="hd_h_niceng226er7.tab53_1_1_1_5 hd_h_niceng226er7.tab53_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>0.67 higher</b></p>
|
|
<p>(6.09 lower to 7.43 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 3 (established value)</td></tr><tr><td headers="hd_h_niceng226er7.tab53_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (SF-36 vitality, 0-100, high is good, change score) at ≤3 months</td><td headers="hd_h_niceng226er7.tab53_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>97</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 13 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁⨁◯</p>
|
|
<p>MODERATE<sup>a</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab53_1_1_1_5 hd_h_niceng226er7.tab53_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 15.9</td><td headers="hd_h_niceng226er7.tab53_1_1_1_5 hd_h_niceng226er7.tab53_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>5.72 higher</b></p>
|
|
<p>(1.36 higher to 10.08 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 2 (established value)</td></tr><tr><td headers="hd_h_niceng226er7.tab53_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (SF-36 general health, 0-100, high is good, change score and final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab53_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>153</p>
|
|
<p>(2 RCTs)</p>
|
|
<p>follow up: mean 13 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW<sup>a</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab53_1_1_1_5 hd_h_niceng226er7.tab53_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 23.2</td><td headers="hd_h_niceng226er7.tab53_1_1_1_5 hd_h_niceng226er7.tab53_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>7.30 higher</b></p>
|
|
<p>(7.57 lower to 22.17 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 2 (established value)</td></tr><tr><td headers="hd_h_niceng226er7.tab53_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (SF-36 mental health, 0-100, high is good, change score) at ≤3 months</td><td headers="hd_h_niceng226er7.tab53_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>97</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 13 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁⨁⨁</p>
|
|
<p>HIGH</p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab53_1_1_1_5 hd_h_niceng226er7.tab53_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 40.8</td><td headers="hd_h_niceng226er7.tab53_1_1_1_5 hd_h_niceng226er7.tab53_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>0.6 higher</b></p>
|
|
<p>(1.78 lower to 2.98 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 3 (established value)</td></tr><tr><td headers="hd_h_niceng226er7.tab53_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (SF-36 role emotional, 0-100, high is good, change score) at ≤3 months</td><td headers="hd_h_niceng226er7.tab53_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>97</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 13 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW<sup>a</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab53_1_1_1_5 hd_h_niceng226er7.tab53_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 14.88</td><td headers="hd_h_niceng226er7.tab53_1_1_1_5 hd_h_niceng226er7.tab53_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>0.35 lower</b></p>
|
|
<p>(8.2 lower to 7.5 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 4 (established value)</td></tr><tr><td headers="hd_h_niceng226er7.tab53_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (SF-36 social function, 0-100, high is good, change score) at ≤3 months</td><td headers="hd_h_niceng226er7.tab53_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>97</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 13 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁⨁◯</p>
|
|
<p>MODERATE<sup>a</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab53_1_1_1_5 hd_h_niceng226er7.tab53_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 19.5</td><td headers="hd_h_niceng226er7.tab53_1_1_1_5 hd_h_niceng226er7.tab53_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>6.75 higher</b></p>
|
|
<p>(0.27 higher to 13.23 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 3 (established value)</td></tr><tr><td headers="hd_h_niceng226er7.tab53_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (SF-36 physical component, 0-100, high is good, change score and final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab53_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>92</p>
|
|
<p>(2 RCTs)</p>
|
|
<p>follow up: mean 9 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁⨁◯</p>
|
|
<p>LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab53_1_1_1_5 hd_h_niceng226er7.tab53_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 22.7</td><td headers="hd_h_niceng226er7.tab53_1_1_1_5 hd_h_niceng226er7.tab53_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>1.75 higher</b></p>
|
|
<p>(1.57 lower to 5.06 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 2 (established value)</td></tr><tr><td headers="hd_h_niceng226er7.tab53_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (SF-36 mental component, 0-100, high is good, change score and final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab53_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>92</p>
|
|
<p>(2 RCTs)</p>
|
|
<p>follow up: mean 9 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab53_1_1_1_5 hd_h_niceng226er7.tab53_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 20.5</td><td headers="hd_h_niceng226er7.tab53_1_1_1_5 hd_h_niceng226er7.tab53_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>0.34 higher</b></p>
|
|
<p>(3.17 lower to 3.86 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 3 (established value)</td></tr><tr><td headers="hd_h_niceng226er7.tab53_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (WOMAC, VAS [different scale ranges], high is poor, change scores) at ≤3 months</td><td headers="hd_h_niceng226er7.tab53_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>341</p>
|
|
<p>(5 RCTs)</p>
|
|
<p>follow up: mean 6 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup><sup>,</sup><sup>c</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab53_1_1_1_5 hd_h_niceng226er7.tab53_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab53_1_1_1_5 hd_h_niceng226er7.tab53_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>SMD <b>0.53 SD lower</b></p>
|
|
<p>(0.91 lower to 0.15 lower)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab53_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (WOMAC, VAS [different scale ranges], high is poor, final values) at ≤3 months</td><td headers="hd_h_niceng226er7.tab53_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>458</p>
|
|
<p>(8 RCTs)</p>
|
|
<p>follow up: mean 6 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup><sup>,</sup><sup>c</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab53_1_1_1_5 hd_h_niceng226er7.tab53_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab53_1_1_1_5 hd_h_niceng226er7.tab53_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>SMD <b>0.53 SD lower</b></p>
|
|
<p>(0.91 lower to 0.15 lower)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab53_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (VAS, 0-100, high is poor, change score) at >3 months</td><td headers="hd_h_niceng226er7.tab53_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>60</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 6 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab53_1_1_1_5 hd_h_niceng226er7.tab53_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean pain was −34.1</td><td headers="hd_h_niceng226er7.tab53_1_1_1_5 hd_h_niceng226er7.tab53_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>1.4 lower</b></p>
|
|
<p>(8.54 lower to 5.74 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab53_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Physical function (WOMAC [different scale ranges], high is poor, change scores) at ≤3 months</td><td headers="hd_h_niceng226er7.tab53_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>244</p>
|
|
<p>(4 RCTs)</p>
|
|
<p>follow up: mean 5 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab53_1_1_1_5 hd_h_niceng226er7.tab53_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab53_1_1_1_5 hd_h_niceng226er7.tab53_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>SMD <b>0.41 SD lower</b></p>
|
|
<p>(0.67 lower to 0.15 lower)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab53_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Physical function (WOMAC, 0-68, high is poor, final values) at ≤3 months</td><td headers="hd_h_niceng226er7.tab53_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>167</p>
|
|
<p>(3 RCTs)</p>
|
|
<p>follow up: mean 5 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW<sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab53_1_1_1_5 hd_h_niceng226er7.tab53_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean physical function was 23.0</td><td headers="hd_h_niceng226er7.tab53_1_1_1_5 hd_h_niceng226er7.tab53_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD 1.92 <b>lower</b></p>
|
|
<p>(5.67 lower to 1.83 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 5.7 (0.5 × median baseline SD)</td></tr><tr><td headers="hd_h_niceng226er7.tab53_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Physical function (WOMAC, 0-68, high is poor, change score) at >3 months</td><td headers="hd_h_niceng226er7.tab53_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>60</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 6 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab53_1_1_1_5 hd_h_niceng226er7.tab53_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean physical function was −17</td><td headers="hd_h_niceng226er7.tab53_1_1_1_5 hd_h_niceng226er7.tab53_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>2.2 lower</b></p>
|
|
<p>(6.58 lower to 2.18 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab53_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Psychological distress (HADS anxiety, 0-21, high is poor, change score) at ≤3 months</td><td headers="hd_h_niceng226er7.tab53_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>40</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 3 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab53_1_1_1_5 hd_h_niceng226er7.tab53_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean psychological distress was −1.65</td><td headers="hd_h_niceng226er7.tab53_1_1_1_5 hd_h_niceng226er7.tab53_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>0.45 lower</b></p>
|
|
<p>(1.93 lower to 1.03 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab53_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Psychological distress (HADS depression, 0-21, high is poor, change score) at ≤3 months</td><td headers="hd_h_niceng226er7.tab53_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>40</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 3 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab53_1_1_1_5 hd_h_niceng226er7.tab53_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean psychological distress was −1.35</td><td headers="hd_h_niceng226er7.tab53_1_1_1_5 hd_h_niceng226er7.tab53_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>0.3 lower</b></p>
|
|
<p>(1.84 lower to 1.24 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab53_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Mild adverse events at ≤3 months</td><td headers="hd_h_niceng226er7.tab53_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>330</p>
|
|
<p>(5 RCTs)</p>
|
|
<p>follow up: mean 5 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>b</sup><sup>,</sup><sup>d</sup><sup>,</sup><sup>e</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>RD −0.01</p>
|
|
<p>(−0.05 to 0.03)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_5 hd_h_niceng226er7.tab53_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">32 per 1,000</td><td headers="hd_h_niceng226er7.tab53_1_1_1_5 hd_h_niceng226er7.tab53_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>10 fewer per 1,000</b>
|
|
</p>
|
|
<p>(50 fewer to 30 more)<sup>f</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Precision calculated through Optimal Information Size (OIS) due to zero events in some studies (0.8-0.9 = serious, <0.8 = very serious).</td></tr><tr><td headers="hd_h_niceng226er7.tab53_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Moderate/major adverse events at ≤3 months</td><td headers="hd_h_niceng226er7.tab53_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>56</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 14 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW<sup>e</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>RD 0.00</p>
|
|
<p>(−0.08 to 0.08)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_5 hd_h_niceng226er7.tab53_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">0 per 1,000</td><td headers="hd_h_niceng226er7.tab53_1_1_1_5 hd_h_niceng226er7.tab53_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>0 fewer per 1,000</b>
|
|
</p>
|
|
<p>(80 fewer to 80 more)<sup>f</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab53_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sample size used to determine precision: 75-150 = serious imprecision, <75 = very serious imprecision.</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng226er7.tab53_1"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="niceng226er7.tab53_2"><p class="no_margin">Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias</p></div></dd></dl><dl class="bkr_refwrap"><dt>c</dt><dd><div id="niceng226er7.tab53_3"><p class="no_margin">Downgraded by 1 or 2 increments because heterogeneity, unexplained by subgroup analysis</p></div></dd></dl><dl class="bkr_refwrap"><dt>d</dt><dd><div id="niceng226er7.tab53_4"><p class="no_margin">Downgraded for heterogeneity due to conflicting number of events in different studies (zero events in one or more studies)</p></div></dd></dl><dl class="bkr_refwrap"><dt>e</dt><dd><div id="niceng226er7.tab53_5"><p class="no_margin">Downgraded by 1 to 2 increments for imprecision due to zero events and small sample size</p></div></dd></dl><dl class="bkr_refwrap"><dt>f</dt><dd><div id="niceng226er7.tab53_6"><p class="no_margin">Absolute effect calculated by risk difference due to zero events in at least one arm of one study</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab54"><div id="niceng226er7.tab54" class="table"><h3><span class="label">Table 54</span><span class="title">Clinical evidence summary: ultrasound compared to no treatment</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab54/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab54_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng226er7.tab54_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab54_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_niceng226er7.tab54_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab54_1_1_1_2" style="text-align:left;vertical-align:bottom;">№ of participants (studies) Follow up</th><th id="hd_h_niceng226er7.tab54_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab54_1_1_1_3" style="text-align:left;vertical-align:bottom;">Certainty of the evidence (GRADE)</th><th id="hd_h_niceng226er7.tab54_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab54_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95% CI)</th><th id="hd_h_niceng226er7.tab54_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Anticipated absolute effects</th><th id="hd_h_niceng226er7.tab54_1_1_1_6" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab54_1_1_1_6" style="text-align:left;vertical-align:bottom;">Comments</th></tr><tr><th headers="hd_h_niceng226er7.tab54_1_1_1_5" id="hd_h_niceng226er7.tab54_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk with no treatment</th><th headers="hd_h_niceng226er7.tab54_1_1_1_5" id="hd_h_niceng226er7.tab54_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk difference with ultrasound</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab54_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (SF-36 physical component, 0-100, high is poor, final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab54_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>30</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 12 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab54_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab54_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab54_1_1_1_5 hd_h_niceng226er7.tab54_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 40.9</td><td headers="hd_h_niceng226er7.tab54_1_1_1_5 hd_h_niceng226er7.tab54_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>0</b></p>
|
|
<p>(4.22 lower to 4.22 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab54_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 2 (established value)</td></tr><tr><td headers="hd_h_niceng226er7.tab54_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (SF-36 mental component, 0-100, high is poor, final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab54_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>30</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 12 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab54_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab54_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab54_1_1_1_5 hd_h_niceng226er7.tab54_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 39.3</td><td headers="hd_h_niceng226er7.tab54_1_1_1_5 hd_h_niceng226er7.tab54_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>2.1 higher</b></p>
|
|
<p>(1.13 lower to 5.33 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab54_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 3 (established value)</td></tr><tr><td headers="hd_h_niceng226er7.tab54_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (VAS, 0-10, high is poor, change scores) at ≤3 months</td><td headers="hd_h_niceng226er7.tab54_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>300</p>
|
|
<p>(4 RCTs)</p>
|
|
<p>follow up: mean 8 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab54_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup><sup>,</sup><sup>c</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab54_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab54_1_1_1_5 hd_h_niceng226er7.tab54_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab54_1_1_1_5 hd_h_niceng226er7.tab54_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>SMD <b>0.38 SD lower</b></p>
|
|
<p>(1.16 lower to 0.4 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab54_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab54_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (WOMAC, VAS [different scale ranges], high is poor, final values) at ≤3 months</td><td headers="hd_h_niceng226er7.tab54_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>58</p>
|
|
<p>(2 RCTs)</p>
|
|
<p>follow up: mean 10 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab54_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup><sup>,</sup><sup>c</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab54_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab54_1_1_1_5 hd_h_niceng226er7.tab54_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab54_1_1_1_5 hd_h_niceng226er7.tab54_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>SMD <b>0.18 SD lower</b></p>
|
|
<p>(2.99 lower to 2.64 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab54_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab54_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (VAS, 0-10, high is poor, final values) at >3 months</td><td headers="hd_h_niceng226er7.tab54_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>160</p>
|
|
<p>(2 RCTs)</p>
|
|
<p>follow up: 12 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab54_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup><sup>,</sup><sup>c</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab54_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab54_1_1_1_5 hd_h_niceng226er7.tab54_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean pain was 3.1</td><td headers="hd_h_niceng226er7.tab54_1_1_1_5 hd_h_niceng226er7.tab54_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>0.21 lower</b></p>
|
|
<p>(2.36 lower to 1.95 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab54_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.78 (0.5 × median baseline SD)</td></tr><tr><td headers="hd_h_niceng226er7.tab54_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Physical function (WOMAC, 0-68, high is poor, final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab54_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>128</p>
|
|
<p>(2 RCTs)</p>
|
|
<p>follow up: mean 8 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab54_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup><sup>,</sup><sup>c</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab54_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab54_1_1_1_5 hd_h_niceng226er7.tab54_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean physical function was 3.5</td><td headers="hd_h_niceng226er7.tab54_1_1_1_5 hd_h_niceng226er7.tab54_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>3.42 lower</b></p>
|
|
<p>(6.93 lower to 0.1 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab54_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 5.7 (0.5 × median baseline SD)</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng226er7.tab54_1"><p class="no_margin">Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="niceng226er7.tab54_2"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl><dl class="bkr_refwrap"><dt>c</dt><dd><div id="niceng226er7.tab54_3"><p class="no_margin">Downgraded by 1 or 2 increments because heterogeneity, unexplained by subgroup analysis</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab55"><div id="niceng226er7.tab55" class="table"><h3><span class="label">Table 55</span><span class="title">Clinical evidence summary: combination therapy compared to interferential therapy</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab55/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab55_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng226er7.tab55_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab55_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_niceng226er7.tab55_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab55_1_1_1_2" style="text-align:left;vertical-align:bottom;">№ of participants (studies) Follow-up</th><th id="hd_h_niceng226er7.tab55_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab55_1_1_1_3" style="text-align:left;vertical-align:bottom;">Certainty of the evidence (GRADE)</th><th id="hd_h_niceng226er7.tab55_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab55_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95% CI)</th><th id="hd_h_niceng226er7.tab55_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Anticipated absolute effects</th><th id="hd_h_niceng226er7.tab55_1_1_1_6" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab55_1_1_1_6" style="text-align:left;vertical-align:bottom;">Comments</th></tr><tr><th headers="hd_h_niceng226er7.tab55_1_1_1_5" id="hd_h_niceng226er7.tab55_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk with interferential therapy</th><th headers="hd_h_niceng226er7.tab55_1_1_1_5" id="hd_h_niceng226er7.tab55_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk difference with combination therapy</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab55_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (VAS, 0-10, high is poor, final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab55_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>84</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 3 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab55_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁⨁◯</p>
|
|
<p>MODERATE<sup>a</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab55_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab55_1_1_1_5 hd_h_niceng226er7.tab55_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean pain was 3.55</td><td headers="hd_h_niceng226er7.tab55_1_1_1_5 hd_h_niceng226er7.tab55_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>1.1 lower</b></p>
|
|
<p>(2.33 lower to 0.13 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab55_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab55_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (VAS, 0-10, high is poor, final value) at >3 months</td><td headers="hd_h_niceng226er7.tab55_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>84</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 6 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab55_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁⨁◯</p>
|
|
<p>MODERATE<sup>a</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab55_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab55_1_1_1_5 hd_h_niceng226er7.tab55_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean pain was 3.65</td><td headers="hd_h_niceng226er7.tab55_1_1_1_5 hd_h_niceng226er7.tab55_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>1.15 lower</b></p>
|
|
<p>(2.25 lower to 0.05 lower)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab55_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng226er7.tab55_1"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab56"><div id="niceng226er7.tab56" class="table"><h3><span class="label">Table 56</span><span class="title">Clinical evidence summary: combination therapy compared to neuromuscular electrical stimulation</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab56/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab56_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng226er7.tab56_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab56_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_niceng226er7.tab56_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab56_1_1_1_2" style="text-align:left;vertical-align:bottom;">№ of participants (studies) Follow up</th><th id="hd_h_niceng226er7.tab56_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab56_1_1_1_3" style="text-align:left;vertical-align:bottom;">Certainty of the evidence (GRADE)</th><th id="hd_h_niceng226er7.tab56_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab56_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95% CI)</th><th id="hd_h_niceng226er7.tab56_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Anticipated absolute effects</th><th id="hd_h_niceng226er7.tab56_1_1_1_6" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab56_1_1_1_6" style="text-align:left;vertical-align:bottom;">Comments</th></tr><tr><th headers="hd_h_niceng226er7.tab56_1_1_1_5" id="hd_h_niceng226er7.tab56_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk with neuromuscular electrical stimulation</th><th headers="hd_h_niceng226er7.tab56_1_1_1_5" id="hd_h_niceng226er7.tab56_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk difference with combination therapy</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab56_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (VAS, 0-10, high is poor, final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab56_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>29</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 12 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab56_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab56_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab56_1_1_1_5 hd_h_niceng226er7.tab56_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean pain was 0.9</td><td headers="hd_h_niceng226er7.tab56_1_1_1_5 hd_h_niceng226er7.tab56_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>0.3 higher</b></p>
|
|
<p>(0.24 lower to 0.84 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab56_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng226er7.tab56_1"><p class="no_margin">Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="niceng226er7.tab56_2"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab57"><div id="niceng226er7.tab57" class="table"><h3><span class="label">Table 57</span><span class="title">Clinical evidence summary: combination therapy compared to laser therapy</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab57/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab57_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng226er7.tab57_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab57_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_niceng226er7.tab57_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab57_1_1_1_2" style="text-align:left;vertical-align:bottom;">№ of participants (studies) Follow up</th><th id="hd_h_niceng226er7.tab57_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab57_1_1_1_3" style="text-align:left;vertical-align:bottom;">Certainty of the evidence (GRADE)</th><th id="hd_h_niceng226er7.tab57_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab57_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95% CI)</th><th id="hd_h_niceng226er7.tab57_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Anticipated absolute effects</th><th id="hd_h_niceng226er7.tab57_1_1_1_6" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab57_1_1_1_6" style="text-align:left;vertical-align:bottom;">Comments</th></tr><tr><th headers="hd_h_niceng226er7.tab57_1_1_1_5" id="hd_h_niceng226er7.tab57_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk with laser therapy</th><th headers="hd_h_niceng226er7.tab57_1_1_1_5" id="hd_h_niceng226er7.tab57_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk difference with combination therapy</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab57_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (VAS, NRS, 0-10, high is poor, final values) at ≤3 months</td><td headers="hd_h_niceng226er7.tab57_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>113</p>
|
|
<p>(2 RCTs)</p>
|
|
<p>follow up: mean 12 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab57_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW<sup>a</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab57_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab57_1_1_1_5 hd_h_niceng226er7.tab57_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean pain was 2.4</td><td headers="hd_h_niceng226er7.tab57_1_1_1_5 hd_h_niceng226er7.tab57_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>0.46 lower</b></p>
|
|
<p>(1.02 lower to 0.09 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab57_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 1.2 (0.5 × median baseline SD)</td></tr><tr><td headers="hd_h_niceng226er7.tab57_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (NRS, 0-10, high is poor, final value) at >3 months</td><td headers="hd_h_niceng226er7.tab57_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>84</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 6 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab57_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁⨁◯</p>
|
|
<p>MODERATE<sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab57_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab57_1_1_1_5 hd_h_niceng226er7.tab57_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean pain was 2.95</td><td headers="hd_h_niceng226er7.tab57_1_1_1_5 hd_h_niceng226er7.tab57_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>0.45 lower</b></p>
|
|
<p>(1.47 lower to 0.57 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab57_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng226er7.tab57_1"><p class="no_margin">Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="niceng226er7.tab57_2"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab58"><div id="niceng226er7.tab58" class="table"><h3><span class="label">Table 58</span><span class="title">Clinical evidence summary: combination therapy compared to transcutaneous electrical nerve stimulation</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab58/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab58_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng226er7.tab58_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab58_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_niceng226er7.tab58_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab58_1_1_1_2" style="text-align:left;vertical-align:bottom;">№ of participants (studies) Follow-up</th><th id="hd_h_niceng226er7.tab58_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab58_1_1_1_3" style="text-align:left;vertical-align:bottom;">Certainty of the evidence (GRADE)</th><th id="hd_h_niceng226er7.tab58_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab58_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95% CI)</th><th id="hd_h_niceng226er7.tab58_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Anticipated absolute effects</th><th id="hd_h_niceng226er7.tab58_1_1_1_6" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab58_1_1_1_6" style="text-align:left;vertical-align:bottom;">Comments</th></tr><tr><th headers="hd_h_niceng226er7.tab58_1_1_1_5" id="hd_h_niceng226er7.tab58_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk with transcutaneous electrical nerve stimulation</th><th headers="hd_h_niceng226er7.tab58_1_1_1_5" id="hd_h_niceng226er7.tab58_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk difference with combination therapy</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab58_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (SF-36, 0-100, high is good, final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab58_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>38</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow-up: 3 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab58_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab58_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab58_1_1_1_5 hd_h_niceng226er7.tab58_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 67.34</td><td headers="hd_h_niceng226er7.tab58_1_1_1_5 hd_h_niceng226er7.tab58_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>0.46 higher</b></p>
|
|
<p>(9.12 lower to 10.04 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab58_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab58_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (WOMAC, 0-20, high is poor, final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab58_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>38</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow-up: 3 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab58_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁⨁◯</p>
|
|
<p>MODERATE<sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab58_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab58_1_1_1_5 hd_h_niceng226er7.tab58_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean pain was 4.26</td><td headers="hd_h_niceng226er7.tab58_1_1_1_5 hd_h_niceng226er7.tab58_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>1.06 higher</b></p>
|
|
<p>(1.12 lower to 3.24 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab58_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab58_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Physical function (WOMAC, 0-68, high is poor, final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab58_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>38</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow-up: 3 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab58_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁⨁◯</p>
|
|
<p>MODERATE<sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab58_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab58_1_1_1_5 hd_h_niceng226er7.tab58_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean physical function was 10.79</td><td headers="hd_h_niceng226er7.tab58_1_1_1_5 hd_h_niceng226er7.tab58_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>5.05 higher</b></p>
|
|
<p>(1.22 lower to 11.32 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab58_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab58_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Mild adverse events at ≤3 months</td><td headers="hd_h_niceng226er7.tab58_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>40</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow-up: 3 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab58_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW<sup>c</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab58_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>RD 0.00</p>
|
|
<p>(−0.09 to 0.09)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab58_1_1_1_5 hd_h_niceng226er7.tab58_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">0 per 1,000</td><td headers="hd_h_niceng226er7.tab58_1_1_1_5 hd_h_niceng226er7.tab58_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>0 fewer per 1,000</b>
|
|
</p>
|
|
<p>(90 fewer to 90 more)<sup>d</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab58_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sample size used to determine precision: 75-150 = serious imprecision, <75 = very serious imprecision.</td></tr><tr><td headers="hd_h_niceng226er7.tab58_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Moderate/major adverse events at ≤3 months</td><td headers="hd_h_niceng226er7.tab58_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>40</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow-up: 3 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab58_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW<sup>c</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab58_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>RD 0.00</p>
|
|
<p>(−0.09 to 0.09)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab58_1_1_1_5 hd_h_niceng226er7.tab58_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">0 per 1,000</td><td headers="hd_h_niceng226er7.tab58_1_1_1_5 hd_h_niceng226er7.tab58_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>0 fewer per 1,000</b>
|
|
</p>
|
|
<p>(90 fewer to 90 more)<sup>d</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab58_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sample size used to determine precision: 75-150 = serious imprecision, <75 = very serious imprecision.</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng226er7.tab58_1"><p class="no_margin">Downgraded by 1 increment due to outcome indirectness (reported the global score of SF-36 rather than subscales)</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="niceng226er7.tab58_2"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl><dl class="bkr_refwrap"><dt>c</dt><dd><div id="niceng226er7.tab58_3"><p class="no_margin">Downgraded by 1 to 2 increments for imprecision due to zero events and small sample size</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab59"><div id="niceng226er7.tab59" class="table"><h3><span class="label">Table 59</span><span class="title">Clinical evidence summary: combination therapy compared to ultrasound</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab59/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab59_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng226er7.tab59_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab59_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_niceng226er7.tab59_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab59_1_1_1_2" style="text-align:left;vertical-align:bottom;">№ of participants (studies) Follow up</th><th id="hd_h_niceng226er7.tab59_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab59_1_1_1_3" style="text-align:left;vertical-align:bottom;">Certainty of the evidence (GRADE)</th><th id="hd_h_niceng226er7.tab59_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab59_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95% CI)</th><th id="hd_h_niceng226er7.tab59_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Anticipated absolute effects</th><th id="hd_h_niceng226er7.tab59_1_1_1_6" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab59_1_1_1_6" style="text-align:left;vertical-align:bottom;">Comments</th></tr><tr><th headers="hd_h_niceng226er7.tab59_1_1_1_5" id="hd_h_niceng226er7.tab59_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk with ultrasound</th><th headers="hd_h_niceng226er7.tab59_1_1_1_5" id="hd_h_niceng226er7.tab59_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk difference with combination therapy</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab59_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (SF-36 pain, 0-100, high is good, final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab59_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>53</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 14 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab59_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW<sup>a</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab59_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab59_1_1_1_5 hd_h_niceng226er7.tab59_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 46.3</td><td headers="hd_h_niceng226er7.tab59_1_1_1_5 hd_h_niceng226er7.tab59_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>1.75 higher</b></p>
|
|
<p>(12.59 lower to 16.09 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab59_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 3 (established value)</td></tr><tr><td headers="hd_h_niceng226er7.tab59_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (SF-36 general health, 0-100, high is good, final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab59_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>53</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 14 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab59_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW<sup>a</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab59_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab59_1_1_1_5 hd_h_niceng226er7.tab59_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 42.75</td><td headers="hd_h_niceng226er7.tab59_1_1_1_5 hd_h_niceng226er7.tab59_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>8.88 higher</b></p>
|
|
<p>(2.22 lower to 19.98 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab59_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 2 (established value)</td></tr><tr><td headers="hd_h_niceng226er7.tab59_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (VAS, 0-100, high is poor, change score and final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab59_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>201</p>
|
|
<p>(2 RCTs)</p>
|
|
<p>follow up: mean 8 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab59_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab59_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab59_1_1_1_5 hd_h_niceng226er7.tab59_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean pain was 34</td><td headers="hd_h_niceng226er7.tab59_1_1_1_5 hd_h_niceng226er7.tab59_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>0.65 higher</b></p>
|
|
<p>(10.88 lower to 12.19 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab59_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab59_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Mild adverse events at ≤3 months</td><td headers="hd_h_niceng226er7.tab59_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>185</p>
|
|
<p>(2 RCTs)</p>
|
|
<p>follow up: mean 8 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab59_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>b</sup><sup>,</sup><sup>c</sup><sup>,</sup><sup>d</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab59_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>RD 0.01</p>
|
|
<p>(−0.05 to 0.08)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab59_1_1_1_5 hd_h_niceng226er7.tab59_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">28 per 1,000</td><td headers="hd_h_niceng226er7.tab59_1_1_1_5 hd_h_niceng226er7.tab59_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>10 more per 1,000</b>
|
|
</p>
|
|
<p>(50 fewer to 80 more)<sup>e</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab59_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Precision calculated through Optimal Information Size (OIS) due to zero events in some studies (0.8-0.9 = serious, <0.8 = very serious).</td></tr><tr><td headers="hd_h_niceng226er7.tab59_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Moderate/major adverse events ≤3 months</td><td headers="hd_h_niceng226er7.tab59_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>53</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow up: 14 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab59_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW<sup>d</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab59_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>RD 0.00</p>
|
|
<p>(−0.09 to 0.09)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab59_1_1_1_5 hd_h_niceng226er7.tab59_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">0 per 1,000</td><td headers="hd_h_niceng226er7.tab59_1_1_1_5 hd_h_niceng226er7.tab59_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>0 fewer per 1,000</b>
|
|
</p>
|
|
<p>(90 fewer to 90 more)<sup>e</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab59_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sample size used to determine precision: 75-150 = serious imprecision, <75 = very serious imprecision.</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng226er7.tab59_1"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="niceng226er7.tab59_2"><p class="no_margin">Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias</p></div></dd></dl><dl class="bkr_refwrap"><dt>c</dt><dd><div id="niceng226er7.tab59_3"><p class="no_margin">Downgraded for heterogeneity due to conflicting number of events in different studies (zero events in one or more studies)</p></div></dd></dl><dl class="bkr_refwrap"><dt>d</dt><dd><div id="niceng226er7.tab59_4"><p class="no_margin">Downgraded by 1 to 2 increments for imprecision due to zero events and small sample size</p></div></dd></dl><dl class="bkr_refwrap"><dt>e</dt><dd><div id="niceng226er7.tab59_5"><p class="no_margin">Absolute effect calculated by risk difference due to zero events in at least one arm of one study</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab60"><div id="niceng226er7.tab60" class="table"><h3><span class="label">Table 60</span><span class="title">Clinical evidence summary: combination therapy compared to sham electrotherapy</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab60/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab60_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng226er7.tab60_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab60_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_niceng226er7.tab60_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab60_1_1_1_2" style="text-align:left;vertical-align:bottom;">№ of participants (studies) Follow-up</th><th id="hd_h_niceng226er7.tab60_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab60_1_1_1_3" style="text-align:left;vertical-align:bottom;">Certainty of the evidence (GRADE)</th><th id="hd_h_niceng226er7.tab60_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab60_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95% CI)</th><th id="hd_h_niceng226er7.tab60_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Anticipated absolute effects</th><th id="hd_h_niceng226er7.tab60_1_1_1_6" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab60_1_1_1_6" style="text-align:left;vertical-align:bottom;">Comments</th></tr><tr><th headers="hd_h_niceng226er7.tab60_1_1_1_5" id="hd_h_niceng226er7.tab60_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk with sham electrotherapy</th><th headers="hd_h_niceng226er7.tab60_1_1_1_5" id="hd_h_niceng226er7.tab60_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk difference with combination therapy</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab60_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (SF-36 pain, 0-100, high is good, final values) at ≤3 months</td><td headers="hd_h_niceng226er7.tab60_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>33</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow-up: 14 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab60_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW<sup>a</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab60_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab60_1_1_1_5 hd_h_niceng226er7.tab60_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 47.15</td><td headers="hd_h_niceng226er7.tab60_1_1_1_5 hd_h_niceng226er7.tab60_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>0.85 higher</b></p>
|
|
<p>(14.04 lower to 15.74 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab60_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 3 (established MID)</td></tr><tr><td headers="hd_h_niceng226er7.tab60_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (SF-36 general health, 0-100, high is good, final values) at ≤3 months</td><td headers="hd_h_niceng226er7.tab60_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>33</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow-up: 14 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab60_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW<sup>a</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab60_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab60_1_1_1_5 hd_h_niceng226er7.tab60_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 43.89</td><td headers="hd_h_niceng226er7.tab60_1_1_1_5 hd_h_niceng226er7.tab60_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>7.74 higher</b></p>
|
|
<p>(4.55 lower to 20.03 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab60_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 2 (established MID)</td></tr><tr><td headers="hd_h_niceng226er7.tab60_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (VAS, 0-100, high is poor, final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab60_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>117</p>
|
|
<p>(2 RCTs)</p>
|
|
<p>follow-up: mean 13 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab60_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁⨁◯</p>
|
|
<p>MODERATE<sup>a</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab60_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab60_1_1_1_5 hd_h_niceng226er7.tab60_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean pain was 46.1</td><td headers="hd_h_niceng226er7.tab60_1_1_1_5 hd_h_niceng226er7.tab60_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>16.04 lower</b></p>
|
|
<p>(24.97 lower to 7.11 lower)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab60_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 15 (0.5 × median baseline SD)</td></tr><tr><td headers="hd_h_niceng226er7.tab60_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (VAS, 0-10, high is poor, final value) at >3 months</td><td headers="hd_h_niceng226er7.tab60_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>84</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow-up: 6 months</p>
|
|
</td><td headers="hd_h_niceng226er7.tab60_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁⨁⨁</p>
|
|
<p>HIGH</p>
|
|
</td><td headers="hd_h_niceng226er7.tab60_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab60_1_1_1_5 hd_h_niceng226er7.tab60_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean pain was 4.9</td><td headers="hd_h_niceng226er7.tab60_1_1_1_5 hd_h_niceng226er7.tab60_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>3 lower</b></p>
|
|
<p>(4.03 lower to 1.97 lower)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab60_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab60_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Mild adverse events at ≤3 months</td><td headers="hd_h_niceng226er7.tab60_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>33</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow-up: 14 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab60_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW<sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab60_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>RD 0.00</p>
|
|
<p>(−0.11 to 0.11)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab60_1_1_1_5 hd_h_niceng226er7.tab60_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">0 per 1,000</td><td headers="hd_h_niceng226er7.tab60_1_1_1_5 hd_h_niceng226er7.tab60_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>0 fewer per 1,000</b>
|
|
</p>
|
|
<p>(110 fewer to 110 more)<sup>c</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab60_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sample size used to determine precision: 75-150 = serious imprecision, <75 = very serious imprecision.</td></tr><tr><td headers="hd_h_niceng226er7.tab60_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Moderate/major adverse events at ≤3 months</td><td headers="hd_h_niceng226er7.tab60_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>33</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow-up: 14 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab60_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW<sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab60_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>RD 0.00</p>
|
|
<p>(−0.11 to 0.11)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab60_1_1_1_5 hd_h_niceng226er7.tab60_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">0 per 1,000</td><td headers="hd_h_niceng226er7.tab60_1_1_1_5 hd_h_niceng226er7.tab60_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>0 fewer per 1,000</b>
|
|
</p>
|
|
<p>(110 fewer to 110 more)<sup>c</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab60_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sample size used to determine precision: 75-150 = serious imprecision, <75 = very serious imprecision.</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng226er7.tab60_1"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="niceng226er7.tab60_2"><p class="no_margin">Downgraded by 1 to 2 increments for imprecision due to zero events and small sample size</p></div></dd></dl><dl class="bkr_refwrap"><dt>c</dt><dd><div id="niceng226er7.tab60_3"><p class="no_margin">Absolute effect calculated by risk difference due to zero events in at least one arm of one study</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab61"><div id="niceng226er7.tab61" class="table"><h3><span class="label">Table 61</span><span class="title">Clinical evidence summary: combination therapy compared to no treatment</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab61/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab61_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng226er7.tab61_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab61_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_niceng226er7.tab61_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab61_1_1_1_2" style="text-align:left;vertical-align:bottom;">№ of participants (studies) Follow-up</th><th id="hd_h_niceng226er7.tab61_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab61_1_1_1_3" style="text-align:left;vertical-align:bottom;">Certainty of the evidence (GRADE)</th><th id="hd_h_niceng226er7.tab61_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab61_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95% CI)</th><th id="hd_h_niceng226er7.tab61_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Anticipated absolute effects</th><th id="hd_h_niceng226er7.tab61_1_1_1_6" rowspan="2" colspan="1" headers="hd_h_niceng226er7.tab61_1_1_1_6" style="text-align:left;vertical-align:bottom;">Comments</th></tr><tr><th headers="hd_h_niceng226er7.tab61_1_1_1_5" id="hd_h_niceng226er7.tab61_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk with no treatment</th><th headers="hd_h_niceng226er7.tab61_1_1_1_5" id="hd_h_niceng226er7.tab61_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk difference with combination therapy</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab61_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (SF-36 physical function, 0-100, high is good, final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab61_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>40</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow-up: 3 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab61_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW<sup>a</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab61_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab61_1_1_1_5 hd_h_niceng226er7.tab61_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 59</td><td headers="hd_h_niceng226er7.tab61_1_1_1_5 hd_h_niceng226er7.tab61_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>24 higher</b></p>
|
|
<p>(15.51 higher to 32.49 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab61_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 3 (established value)</td></tr><tr><td headers="hd_h_niceng226er7.tab61_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (SF-36 pain, 0-100, high is good, final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab61_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>40</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow-up: 3 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab61_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab61_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab61_1_1_1_5 hd_h_niceng226er7.tab61_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 45.4</td><td headers="hd_h_niceng226er7.tab61_1_1_1_5 hd_h_niceng226er7.tab61_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>10.2 higher</b></p>
|
|
<p>(1.58 higher to 18.82 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab61_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 3 (established value)</td></tr><tr><td headers="hd_h_niceng226er7.tab61_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (SF-36 role physical, 0-100, high is good, final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab61_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>40</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow-up: 3 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab61_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW<sup>a</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab61_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab61_1_1_1_5 hd_h_niceng226er7.tab61_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 28.75</td><td headers="hd_h_niceng226er7.tab61_1_1_1_5 hd_h_niceng226er7.tab61_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>37.55 higher</b></p>
|
|
<p>(24.51 higher to 50.59 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab61_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 3 (established value)</td></tr><tr><td headers="hd_h_niceng226er7.tab61_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (SF-36 vitality, 0-100, high is good, final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab61_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>40</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow-up: 3 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab61_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW<sup>a</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab61_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab61_1_1_1_5 hd_h_niceng226er7.tab61_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 40</td><td headers="hd_h_niceng226er7.tab61_1_1_1_5 hd_h_niceng226er7.tab61_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>22 higher</b></p>
|
|
<p>(13 higher to 31 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab61_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 2 (established value)</td></tr><tr><td headers="hd_h_niceng226er7.tab61_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (SF-36 general health, 0-100, high is good, final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab61_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>40</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow-up: 3 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab61_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁◯◯◯</p>
|
|
<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab61_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab61_1_1_1_5 hd_h_niceng226er7.tab61_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 40.9</td><td headers="hd_h_niceng226er7.tab61_1_1_1_5 hd_h_niceng226er7.tab61_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>2.9 higher</b></p>
|
|
<p>(5.46 lower to 11.26 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab61_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 2 (established value)</td></tr><tr><td headers="hd_h_niceng226er7.tab61_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (SF-36 role emotion, 0-100, high is good, final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab61_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>40</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow-up: 3 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab61_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW<sup>a</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab61_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab61_1_1_1_5 hd_h_niceng226er7.tab61_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 47.9</td><td headers="hd_h_niceng226er7.tab61_1_1_1_5 hd_h_niceng226er7.tab61_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>31.8 higher</b></p>
|
|
<p>(17.64 higher to 45.96 higher)</p>
|
|
</td><td headers="hd_h_niceng226er7.tab61_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 4 (established value)</td></tr><tr><td headers="hd_h_niceng226er7.tab61_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (SF-36 mental health, 0-100, high is good, final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab61_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>40</p>
|
|
<p>(1 RCT)</p>
|
|
<p>follow-up: 3 weeks</p>
|
|
</td><td headers="hd_h_niceng226er7.tab61_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>⨁⨁◯◯</p>
|
|
<p>LOW<sup>a</sup></p>
|
|
</td><td headers="hd_h_niceng226er7.tab61_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab61_1_1_1_5 hd_h_niceng226er7.tab61_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 56</td><td headers="hd_h_niceng226er7.tab61_1_1_1_5 hd_h_niceng226er7.tab61_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>MD <b>13 higher</b></p>
|
|
<p>(4.56 higher to 21.44 higher)</p>
|
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</td><td headers="hd_h_niceng226er7.tab61_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 3 (established value)</td></tr><tr><td headers="hd_h_niceng226er7.tab61_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Quality of life (SF-36 social function, 0-100, high is good, final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab61_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>40</p>
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<p>(1 RCT)</p>
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<p>follow-up: 3 weeks</p>
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</td><td headers="hd_h_niceng226er7.tab61_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⨁⨁◯◯</p>
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<p>LOW<sup>a</sup></p>
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</td><td headers="hd_h_niceng226er7.tab61_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab61_1_1_1_5 hd_h_niceng226er7.tab61_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean quality of life was 50</td><td headers="hd_h_niceng226er7.tab61_1_1_1_5 hd_h_niceng226er7.tab61_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>MD <b>26.2 higher</b></p>
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<p>(14.16 higher to 38.24 higher)</p>
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</td><td headers="hd_h_niceng226er7.tab61_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 3 (established value)</td></tr><tr><td headers="hd_h_niceng226er7.tab61_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pain (WOMAC, NRS [different scale ranges], high is poor, final values) at ≤3 months</td><td headers="hd_h_niceng226er7.tab61_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>84</p>
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<p>(2 RCTs)</p>
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<p>follow-up: mean 5 weeks</p>
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</td><td headers="hd_h_niceng226er7.tab61_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⨁◯◯◯</p>
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<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup><sup>,</sup><sup>c</sup></p>
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</td><td headers="hd_h_niceng226er7.tab61_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab61_1_1_1_5 hd_h_niceng226er7.tab61_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab61_1_1_1_5 hd_h_niceng226er7.tab61_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>SMD <b>0.59 SD lower</b></p>
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<p>(2.69 lower to 1.52 higher)</p>
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</td><td headers="hd_h_niceng226er7.tab61_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab61_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Physical function (WOMAC, 0-68, high is poor, final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab61_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>44</p>
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<p>(1 RCT)</p>
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<p>follow-up: 7 weeks</p>
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</td><td headers="hd_h_niceng226er7.tab61_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⨁⨁◯◯</p>
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<p>LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
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</td><td headers="hd_h_niceng226er7.tab61_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab61_1_1_1_5 hd_h_niceng226er7.tab61_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean physical function was 20</td><td headers="hd_h_niceng226er7.tab61_1_1_1_5 hd_h_niceng226er7.tab61_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>MD <b>4.18 higher</b></p>
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<p>(2.27 lower to 10.63 higher)</p>
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</td><td headers="hd_h_niceng226er7.tab61_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr><tr><td headers="hd_h_niceng226er7.tab61_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Psychological distress (BDI, 0-51, high is poor, final value) at ≤3 months</td><td headers="hd_h_niceng226er7.tab61_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>40</p>
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<p>(1 RCT)</p>
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<p>follow-up: 3 weeks</p>
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</td><td headers="hd_h_niceng226er7.tab61_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>⨁◯◯◯</p>
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<p>VERY LOW<sup>a</sup><sup>,</sup><sup>b</sup></p>
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</td><td headers="hd_h_niceng226er7.tab61_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">-</td><td headers="hd_h_niceng226er7.tab61_1_1_1_5 hd_h_niceng226er7.tab61_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The mean psychological distress was 8.4</td><td headers="hd_h_niceng226er7.tab61_1_1_1_5 hd_h_niceng226er7.tab61_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>MD <b>1.6 lower</b></p>
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<p>(3.2 lower to 0 )</p>
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</td><td headers="hd_h_niceng226er7.tab61_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MID = 0.5 SD (SMD)</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng226er7.tab61_1"><p class="no_margin">Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="niceng226er7.tab61_2"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl><dl class="bkr_refwrap"><dt>c</dt><dd><div id="niceng226er7.tab61_3"><p class="no_margin">Downgraded by 1 or 2 increments because heterogeneity, unexplained by subgroup analysis</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab62"><div id="niceng226er7.tab62" class="table"><h3><span class="label">Table 62</span><span class="title">Health economic evidence profile: Electrotherapy versus usual care</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab62/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab62_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng226er7.tab62_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Study</th><th id="hd_h_niceng226er7.tab62_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Applicability</th><th id="hd_h_niceng226er7.tab62_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Limitations</th><th id="hd_h_niceng226er7.tab62_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Other comments</th><th id="hd_h_niceng226er7.tab62_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Incremental cost<sup>(d)</sup></th><th id="hd_h_niceng226er7.tab62_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Incremental effects</th><th id="hd_h_niceng226er7.tab62_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Cost effectiveness</th><th id="hd_h_niceng226er7.tab62_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Uncertainty</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab62_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>MacPherson 2017<a class="bibr" href="#niceng226er7.s1.1.ref145" rid="niceng226er7.s1.1.ref145"><sup>145</sup></a></p>
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<p>(UK)</p>
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</td><td headers="hd_h_niceng226er7.tab62_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Partially applicable</td><td headers="hd_h_niceng226er7.tab62_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Potentially serious limitations<sup>(a)</sup></td><td headers="hd_h_niceng226er7.tab62_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><ul><li class="half_rhythm"><div>Probabilistic model based on three separate network meta-analyses of RCTs<sup>(b)</sup></div></li><li class="half_rhythm"><div>Cost-utility analysis (QALYs)</div></li><li class="half_rhythm"><div>Population: Patients reporting pain resulting from OA of the knee.</div></li><li class="half_rhythm"><div>Comparators:<sup>(c)</sup>
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<ol><li class="half_rhythm"><div>Usual care</div></li><li class="half_rhythm"><div>TENS</div></li><li class="half_rhythm"><div>PES</div></li><li class="half_rhythm"><div>NMES</div></li><li class="half_rhythm"><div>Laser light therapy</div></li><li class="half_rhythm"><div>Interferential therapy</div></li><li class="half_rhythm"><div>PEMF</div></li></ol></div></li></ul>
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Time horizon was 8 weeks</td><td headers="hd_h_niceng226er7.tab62_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><u>All trials</u>
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<ul class="simple-list"><li class="half_rhythm"><div>2-1: £31</div></li><li class="half_rhythm"><div>3-1: £396</div></li><li class="half_rhythm"><div>4-1: £481</div></li><li class="half_rhythm"><div>5-1: £503</div></li><li class="half_rhythm"><div>6-1: £770</div></li><li class="half_rhythm"><div>7-1: £1,453</div></li></ul>
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<u>Trials with adequate allocation concealment and endpoint at 3-13 weeks</u>
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<ul class="simple-list"><li class="half_rhythm"><div>2-1: £30</div></li><li class="half_rhythm"><div>3-1: £410</div></li><li class="half_rhythm"><div>4-1: NR</div></li><li class="half_rhythm"><div>5-1: £288</div></li><li class="half_rhythm"><div>6-1: £1,179</div></li><li class="half_rhythm"><div>7-1: £577</div></li></ul></td><td headers="hd_h_niceng226er7.tab62_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>
|
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<b>Inc. QALYs</b>
|
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</p>
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<p><u>All trials</u>
|
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<ul class="simple-list"><li class="half_rhythm"><div>2-1: 0.011</div></li><li class="half_rhythm"><div>3-1: 0.011</div></li><li class="half_rhythm"><div>4-1: 0.005</div></li><li class="half_rhythm"><div>5-1: 0.007</div></li><li class="half_rhythm"><div>6-1: 0.033</div></li><li class="half_rhythm"><div>7-1: 0.007</div></li></ul>
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<u>Trials with adequate allocation concealment and endpoint at 3-13 weeks</u>
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<ul class="simple-list"><li class="half_rhythm"><div>2-1: 0.006</div></li><li class="half_rhythm"><div>3-1: 0.010</div></li><li class="half_rhythm"><div>4-1: NR</div></li><li class="half_rhythm"><div>5-1: 0.003</div></li><li class="half_rhythm"><div>6-1: 0.017</div></li><li class="half_rhythm"><div>7-1: 0.007</div></li></ul></p>
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</td><td headers="hd_h_niceng226er7.tab62_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>
|
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<b>Cost per QALY gained</b>
|
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<sup>
|
|
(e)
|
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</sup>
|
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</p>
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<p><u>All trials</u>
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<ul class="simple-list"><li class="half_rhythm"><div>2-1: £2,690</div></li><li class="half_rhythm"><div>3-1: £36,000</div></li><li class="half_rhythm"><div>4-1: £96,200</div></li><li class="half_rhythm"><div>5-1: £71,857</div></li><li class="half_rhythm"><div>6-1: £23,333</div></li><li class="half_rhythm"><div>7-1: £207,571</div></li></ul>
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<u>Trials with adequate allocation concealment and endpoint at 3-13 weeks</u>
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<ul class="simple-list"><li class="half_rhythm"><div>2-1: £6,142</div></li><li class="half_rhythm"><div>3-1: £41,000</div></li><li class="half_rhythm"><div>4-1: NR</div></li><li class="half_rhythm"><div>5-1: £96,000</div></li><li class="half_rhythm"><div>6-1: £69,353</div></li><li class="half_rhythm"><div>7-1: £82,429</div></li></ul></p>
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</td><td headers="hd_h_niceng226er7.tab62_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>This study analysed a variety of different intervention classes and so all reports of uncertainty were based on an analysis of all interventions and not any intervention(s) in isolation.</p>
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<p>For a summary of the analysis of uncertainty involving all interventions, see <a href="#niceng226er7.apph">Appendix H</a>.</p>
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</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">Abbreviations: ICER = incremental cost-effectiveness ratio; Inc.= incremental; NMES= neuromuscular electrical stimulation; NR = not reported; OA = Osteoarthritis; PEMF= pulsed electromagnetic field; PES= pulsed electrical stimulation; QALYs = quality-adjusted life years; RCT= randomised controlled trial; TENS= transcutaneous electrical nerve stimulation</p></div></dd></dl><dl class="bkr_refwrap"><dt>(a)</dt><dd><div id="niceng226er7.tab62_1"><p class="no_margin">Unit costs taken from 2011/12 may not reflect current UK NHS practice. The time horizon was only 8 weeks. Adverse events and their downstream consequences were not considered.</p></div></dd></dl><dl class="bkr_refwrap"><dt>(b)</dt><dd><div id="niceng226er7.tab62_2"><p class="no_margin">Only model results from 2 of the 3 network meta analyses presented in this evidence profile. See <a href="#niceng226er7.apph">Appendix H</a> for all model results.</p></div></dd></dl><dl class="bkr_refwrap"><dt>(c)</dt><dd><div id="niceng226er7.tab62_3"><p class="no_margin">The original report listed 13 interventions in total. Only those interventions that fit the protocol for electrotherapy were included here. Please note intervention numbers in this profile do not match to intervention numbers in evidence table (<a href="#niceng226er7.apph">Appendix H</a>).</p></div></dd></dl><dl class="bkr_refwrap"><dt>(d)</dt><dd><div id="niceng226er7.tab62_4"><p class="no_margin">2011/12 UK pounds. Cost components incorporated: Physiotherapist’s time to conduct sessions. Changes in non-treatment-related visits to GPs and specialists arising from changes to EQ-5D score</p></div></dd></dl><dl class="bkr_refwrap"><dt>(e)</dt><dd><div id="niceng226er7.tab62_5"><p class="no_margin">In a full incremental analysis of all interventions, TENS was the most cost-effective option in the network meta-analysis all trials with a cost per QALY of £2,690. In the other two network meta-analyses (1. only those trials with adequate allocation concealment and 2. only those trials with adequate allocation concealment and an endpoint between 3-13 weeks), acupuncture was the most cost-effective option with costs per QALYs of £13,502 and £14,275, respectively.</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng226er7tab63"><div id="niceng226er7.tab63" class="table"><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK589223/table/niceng226er7.tab63/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng226er7.tab63_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng226er7.tab63_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Resource</th><th id="hd_h_niceng226er7.tab63_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Average unit cost</th><th id="hd_h_niceng226er7.tab63_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Source</th></tr></thead><tbody><tr><td headers="hd_h_niceng226er7.tab63_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Community physiotherapist (band 5/6/7)</td><td headers="hd_h_niceng226er7.tab63_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£38/£50/£60<sup>(a)</sup></td><td headers="hd_h_niceng226er7.tab63_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">PSSRU 2020<a class="bibr" href="#niceng226er7.s1.1.ref61" rid="niceng226er7.s1.1.ref61"><sup>61</sup></a></td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>(a)</dt><dd><div id="niceng226er7.tab63_1"><p class="no_margin">Per hour, including qualification costs</p></div></dd></dl></dl></div></div></div></article></div><div id="jr-scripts"><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/libs.min.js"> </script><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/jr.min.js"> </script></div></div>
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