Home > DARE Reviews > Acupuncture and other physical...

PubMed Health. A service of the National Library of Medicine, National Institutes of Health.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet]. York (UK): Centre for Reviews and Dissemination (UK); 1995-.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet].

Acupuncture and other physical treatments for the relief of pain due to osteoarthritis of the knee: network meta-analysis

MS Corbett, SJ Rice, V Madurasinghe, R Slack, DA Fayter, M Harden, AJ Sutton, H MacPherson, and NF Woolacott.

Review published: 2013.

CRD summary

This review and network meta-analysis compared many different treatments within a coherent framework. It found evidence to suggest that acupuncture could be considered as one of the more effective physical treatments for alleviating osteoarthritis knee pain in the short-term. Much of the evidence was of poor quality, meaning there is uncertainty about the efficacy of many physical treatments.

Objectives

To compare the effectiveness of acupuncture with other relevant physical treatments for alleviating pain due to knee osteoarthritis.

Review methods

A wide range of databases was searched up to January 2013 to identify randomised controlled trials of patients with osteoarthritis of the knee, which reported pain. Trial quality was evaluated using two different tools. A network meta-analysis of standardised mean difference data was performed using a random-effects model. Inconsistency between direct and indirect evidence was assessed using the node-splitting method.

Results of the review

Of 156 eligible trials, 114 (covering 22 treatments and 9,709 patients) provided data suitable for analysis. Most trials studied short-term effects and many were classed as being of poor quality with high risk of bias, commonly associated with a lack of blinding (which was sometimes impossible to achieve).

End of treatment results showed that eight interventions – interferential therapy, acupuncture, transcutaneous electrical nerve stimulation (TENS), pulsed electrical stimulation, balneotherapy, aerobic exercise, sham acupuncture, and muscle-strengthening exercise – produced a statistically significant reduction in pain, compared with standard care.

In a sensitivity analysis of satisfactory and good-quality trials, most were of acupuncture (11 trials) or muscle-strengthening exercise (nine trials); both these interventions were statistically significantly better than standard care, with acupuncture being significantly better than muscle-strengthening exercise (SMD 0.49, 95% CrI 0.00 to 0.98).

Conclusions

As a summary of the available research, the network meta-analysis results indicated that acupuncture could be considered as one of the more effective physical treatments for alleviating osteoarthritis knee pain in the short-term. Much of the evidence in this area of research was of poor quality, meaning there is uncertainty about the efficacy of many physical treatments.

Funding

Funded by the NIHR, UK.

Bibliographic details

Corbett MS, Rice SJ, Madurasinghe V, Slack R, Fayter DA, Harden M, Sutton AJ, MacPherson H, Woolacott NF. Acupuncture and other physical treatments for the relief of pain due to osteoarthritis of the knee: network meta-analysis. Osteoarthritis and Cartilage 2013; 21(9): 1290-1298. [PMC free article: PMC3769860] [PubMed: 23973143]

Indexing Status

Subject indexing assigned by CRD

MeSH

Acupuncture Therapy; Humans; Osteoarthritis, Knee

AccessionNumber

12013051050

Database entry date

04/03/2014

Record Status

This is a high quality systematic review involving CRD that meets the criteria for inclusion on DARE. This structured abstract presents a brief summary of the review methods, the results and conclusions.

CRD has determined that this article meets the DARE scientific quality criteria for a systematic review.

Copyright © 2014 University of York.

PMID: 23973143

PubMed Health Blog...

read all...

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...