Evidence map›Paper›PMID 40192971›Full record

ArticleAging clinical and experimental research2025

Physical modalities for the treatment of knee osteoarthritis: a network meta-analysis.

Xiangzhou Lan, Lingjia Li, Qing Jia, Fangyi He, Gaoyan Kuang, Weike Zeng, Miao Chen, Cheng Guo, Zhi Wen, Qing Chen

Abstract readNetwork Meta-Analysis
In one paragraph

Article in Aging clinical and experimental research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Low dose NSAIDs and sysadoas in the management of knee osteoarthritis.Aging clinical and experimental research · 2025
    Pooled it
  2. Pooled it
  3. Trial
  4. Trial
  5. Evolving Strategies for Knee Osteoarthritis: A Narrative Review of Integrated Rehabilitation, Pharmacologic, and Joint-Preserving Interventions.Medical science monitor : international medical journal of experimental and clinical research · 2026
    Review
  6. Review
  7. Review
  8. Review
  9. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Xiangzhou Lan *The First Affiliated Hospital of Hunan University of Traditional Chinese Medicine, Changsha, Hunan, 410007, China.
Lingjia Li *The First Affiliated Hospital of Hunan University of Traditional Chinese Medicine, Changsha, Hunan, 410007, China.
Qing JiaThe First Affiliated Hospital of Hunan University of Traditional Chinese Medicine, Changsha, Hunan, 410007, China.
Fangyi HeThe First Affiliated Hospital of Hunan University of Traditional Chinese Medicine, Changsha, Hunan, 410007, China.
Gaoyan KuangThe First Affiliated Hospital of Hunan University of Traditional Chinese Medicine, Changsha, Hunan, 410007, China.
Weike ZengChangsha Modern Nurse Magazine Co., LTD, Changsha, Hunan, 410011, China.
Miao ChenThe First Affiliated Hospital of Hunan University of Traditional Chinese Medicine, Changsha, Hunan, 410007, China.
Cheng GuoThe First Affiliated Hospital of Hunan University of Traditional Chinese Medicine, Changsha, Hunan, 410007, China.
Zhi WenThe First Affiliated Hospital of Hunan University of Traditional Chinese Medicine, Changsha, Hunan, 410007, China. 1158968790@qq.com.
Qing ChenThe First Affiliated Hospital of Hunan University of Traditional Chinese Medicine, Changsha, Hunan, 410007, China. 13787142874@163.com.

Funding

The Hunan Provincial Natural Science Foundation of China 2024JJ9424
6 · The paper itself

Abstract

objectiveThis network meta-analysis (NMA) aimed to compare the efficacy of various physical modalities in alleviating pain, stiffness, and functional impairment in patients with knee osteoarthritis (KOA).

methodsIn accordance with PRISMA-P guidelines, we systematically searched nine databases(CNKI, VIP Database, Wanfang Database, SinoMed, PubMed, Embase, CINAHL, Web of Science, and the Cochrane Library) from inception to October 2024 to identify randomized controlled trials (RCTs) evaluating physical therapies for KOA. The interventions assessed included electrical stimulation therapy (EST), low-level light therapy (LLLT), thermotherapy (TT), cryotherapy (CT), and extracorporeal shock wave therapy (ESWT), with resistance and range of motion exercises (RRE) serving as comparators. Outcome measures comprised the Visual Analog Scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and 6-minute walk test (6 MWT). Bayesian network meta-analyses and pairwise meta-analyses were performed using Stata 17.0 and R 4.4.1 software.

results32 RCTs involving 2,078 participants were included. LLLT demonstrated the highest efficacy for pain reduction (VAS: MD=-3.32, 95% CI:-3.82 to-0.75; WOMAC pain: MD=-3.74, 95% CI:-6.68 to-0.72) and joint function improvement (SUCRA = 79.8). ESWT ranked second for pain relief (VAS: MD=-1.31, 95% CI:-2.42 to-0.16) and mobility enhancement (6 MWT: SUCRA = 71.5), while TT showed superior efficacy in reducing stiffness (WOMAC stiffness: MD=-2.09, 95%CI:-3.06 to-0.94; SUCRA = 98.1). In contrast, ultrasonic therapy (UT) did not provide significant benefits.

conclusionsThe findings suggest that LLLT and ESWT may be optimal for pain relief and functional improvement in patients with KOA, whereas TT appears to be the most effective in reducing stiffness. Optimal dosing parameters of these physical modalities are crucial for maximizing clinical benefits. Clinicians should individualize treatment strategies based on patient-specific factors. Future large-scale RCTs are warranted to validate these protocols and address the heterogeneity of existing evidence. CLINICAL TRIAL NUMBER: Not applicable.

Indexed as

Osteoarthritis, KneePhysical Therapy ModalitiesHumansRandomized Controlled Trials as TopicTreatment OutcomeJoint functionKnee osteoarthritisNetwork meta-analysisPain reliefPhysical modalities therapy

Identifiers

PMID40192971
PMCPMC11976336

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.