The effects of various physical modalities on pain in patients with knee osteoarthritis: A network meta-analysis

This study aims to evaluate the effectiveness of various physical therapy methods in reducing pain for patients with knee osteoarthritis (KOA) through a network meta-analysis.

We conducted a comprehensive search across multiple databases, including PubMed, Embase, Cochrane Library, VIP, WanFang Data, and CNKI, to identify randomized controlled trials (RCTs) on physical therapies for KOA. The search spanned from the inception of each database to October 2024. The methodological quality of the studies was assessed using the Cochrane Handbook. Pain was measured using tools such as the visual analog scale, numeric pain rating scale, and the Western Ontario and McMaster University Osteoarthritis Index. All pain scores were standardized to a 10-point scale. Data collection and analysis were performed independently by two researchers using Stata 15.0 software.

The analysis included 64 studies with 3855 patients and 12 physical therapy modalities. Based on the surface under the cumulative ranking curve (SUCRA), the most effective treatments were HILT, ESWT, Hydrotherapy, Land-EX, LLLT, Braces, tDCS, US, IFCs, SWD, Insoles, and TENS.

HILT appears to be the most effective treatment for pain relief in KOA patients. Further large-scale RCTs are needed to confirm these findings.