Evaluation of treatment parameters for focused-extracorporeal shock wave therapy in knee osteoarthritis patients with bone marrow lesions: a pilot study
Al-Abbad, Hani, Reznik, Jacqueline E., Biros, Erik, Paulik, Bruce, Will, Rob, Gane, Samuel, Moss, Penny, and Wright, Anthony (2024) Evaluation of treatment parameters for focused-extracorporeal shock wave therapy in knee osteoarthritis patients with bone marrow lesions: a pilot study. Journal of Rehabilitation Medicine, 56. jrm13207.
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Abstract
Objectives: To evaluate the effect of different dosage parameters of focused-extracorporeal shock wave therapy on pain and physical function in knee osteoarthritis patients with bone marrow lesions. In addition, to investigate pathophysiological changes based on imaging and biomarker measures. Methods: Using a single-case experimental design, a total of 12 participants were randomly allocated in 4 equal groups of 3 to receive different dosages of focused-extracorporeal shock wave therapy. Each group received either 4 or 6 sessions of 1500 or 3000 shocks over 4 or 6 weekly sessions. Participants underwent repeated measurements during the baseline, intervention, and post-intervention phases for Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, aggregated locomotor function score and pressure pain threshold. Imaging and inflammatory biomarker outcomes were measured at baseline and 3 months following the intervention. Results: The group receiving the highest dosage of focused-extracorporeal shock wave therapy showed clinical improvements superior to those of participants in the other 3 groups. Statistically significant changes during the follow-up phase in contrast to baseline measurements for the WOMAC score (Tau-U= –0.88, p < 0.001), aggregated locomotor function score (Tau-U= –0.77, p = 0.002), and pressure pain threshold (Tau-U= 0.54, p = 0.03) were observed. Bone marrow lesion and inflammatory cytokines demonstrated no change. Conclusion: A dose-dependent effect for focusedextracorporeal shock wave therapy on osteoarthritisrelated symptoms was suggested. However, these improvements were not associated with changes in the underlying pathophysiological mechanisms.
| Item ID: | 87513 |
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| Item Type: | Article (Research - C1) |
| ISSN: | 1651-2081 |
| Keywords: | bone marrow lesions, extracorporeal shock wave therapy, knee osteoarthritis, single-case experimental design |
| Copyright Information: | This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/) |
| Date Deposited: | 10 Dec 2025 02:32 |
| FoR Codes: | 32 BIOMEDICAL AND CLINICAL SCIENCES > 3202 Clinical sciences > 320216 Orthopaedics @ 100% |
| SEO Codes: | 20 HEALTH > 2001 Clinical health > 200105 Treatment of human diseases and conditions @ 50% 20 HEALTH > 2001 Clinical health > 200103 Human pain management @ 50% |
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