Ya-Fei Zhang, Yang Liu, Shao-Wen Chou, Hao Weng
Department of Rehabilitation Medicine, Aerospace Center Hospital, China.
DOI: 10.2340/16501977-2782

Objective: To assess the dose-related effects of radial extracorporeal shock wave therapy on pain alleviation in knee osteoarthritis.
Methods: With the use of a 2?×?2 factorial randomized controlled design, 89 patients diagnosed with knee osteoarthritis were assigned to 1 of 4 treatment groups, which varied in terms of shock intensity (0. 12 mJ/mm2, lower density, or 0. 24 mJ/mm2, higher density) and shock number (2,000 impulses or 4,000 impulses), or to a placebo control. Each group received 4 sessions of radial extracorporeal shock wave therapy, one week apart. The primary outcome was pain intensity measured on a visual analogue scale, and the secondary outcome was the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score. Assessments were performed at baseline, after each session, and at 4-week follow-up.
Results: Two-way repeated-measures analysis of variance revealed a significant effect on the Pain score for intensity (p? Conclusion: Moderate-intensity radial extracorporeal shock wave therapy was effective, and a higher density might be more efficacious in alleviating pain in knee osteoarthritis.

Extracorporeal shock wave therapy may be a viable treatment for knee osteoarthritis with local pain and dysfunction; however, there are no standards on how to choose the treatment parameters to obtain the best outcome. This study compared 5 different levels of amount of treatment in 89 patients with knee osteoarthritis, and found that a medium intensity of therapy was effective. In addition, a higher intensity of extracorporeal shock wave therapy, rather than higher shock numbers, might result in a higher level of alleviation of symptoms in these patients.