Table 6.59Symptoms: function and stiffness

Function outcomeReferenceInterventionAssessment timeOutcome/effect size
Knee osteoarthritis
Acupuncture vs sham/no treatment
WOMAC function – outlier study removed to remove heterogeneity1MA (White et al. 2007) 4 RCTs, N=1245Acupuncture vs sham acupunctureShort term (up to 25 weeks)WMD 2.41,% CI 0.60 to 4.21, p=0.009
Favours acupuncture
WOMAC function1MA (White et al. 2007) 3 RCTs, N=1178Acupuncture vs sham acupunctureLong term (up to 52 weeks)WMD 2.01,% CI 0.36 to 3.66, p<0.05
Favours acupuncture
WOMAC function1MA (White et al. 2007) 2 RCTs, N=403Acupuncture vs true sham acupunctureShort term (up to 25 weeks)Significant heterogeneity
WOMAC function1MA (White et al. 2007) 3 RCTs, N=907Acupuncture vs no additional treatmentShort term (up to 25 weeks)Significant heterogeneity
WOMAC function1MA (White et al. 2007)Acupuncture vs other sham treatment (sham TENS)Short term (up to 25 weeks)Insufficient data
WOMAC function1MA (White et al 2007)Acupuncture vs other sham treatment (sham AL-TENS or education)Short term (up to 25 weeks)Insufficient data
Unilateral acupuncture vs bilateral acupuncture
Hospital for special surgery knee score, HSS (composite outcomes, max. score 100); 50 m walk time (seconds); 20 stair climb time (seconds)1 RCT (Tillu et al. 2001 2207)Unilateral acupuncture vs bilateral acupuncture2 weeks and at 4.5 months post- intervention.NS
Electroacupuncture vs Ice massage
50-foot walk time (seconds); quadriceps muscle strength; active knee flexion (degrees)1 RCT (Yurtkuran and Kocagil 1999)Electroacupuncture vs Ice massage2 weeks (end of treatment)NS
Electroacupuncture vs AL-TENS
50-foot walk time (seconds); quadriceps muscle strength; active knee flexion (degrees)1 RCT (Yurtkuran and Kocagil 1999)Electroacupuncture vs AL-TENS2 weeks (end of treatment)NS
Hip
Acupuncture vs sham acupuncture
Lequesne function1 RCT (Fink et al. 2001) (N=67)Acupuncture vs placebo (sham acupuncture)1 week, 6 weeks and 6 months post-intervention.NS
Thumb
Acupuncture vs mock TNS
Function score at end of treatment (change from baseline and change from end of treatment scores); pinch grip and joint tenderness1 RCT (Dickens and Lewis 1989) (N=13)Acupuncture vs placebo (mock TNS)End of treatment and 2 weeks post- interventionNS
Knee or hip
Acupuncture vs no acupuncture
WOMAC total (change from baseline)1 RCT (Witt et al. 2006) (N=712)Acupuncture vs no acupuncture3 months, end of treatmentMean change 37.3% (acupuncture) and 2.8% (no acupuncture), p<0.001
Favours acupuncture
WOMAC function (change from baseline)1 RCT (Witt et al. 2006) (N=712)Acupuncture vs no acupuncture3 months, end of treatmentMean change 35.8% (acupuncture) and 2.5% (no acupuncture), p<0.001
Favours acupuncture
Mixed (knee, hip, finger, lumbar, thoracic or cervical)
Acupuncture vs sham acupuncture
Activity (patient’s evaluation, scale 1–4, change from baseline)1 RCT (Gaw et al. 1975) (N=40)Acupuncture vs placebo (sham acupuncture)End of treatment (8 weeks) and at 2 weeks and 6 weeks post- interventionNS

From: 6, Non-pharmacological management of osteoarthritis

Cover of Osteoarthritis
Osteoarthritis: National Clinical Guideline for Care and Management in Adults.
NICE Clinical Guidelines, No. 59.
National Collaborating Centre for Chronic Conditions (UK).
Copyright © 2008, Royal College of Physicians of London.

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