Synergistic effects of low-intensity pulsed ultrasound and extracorporeal shock wave therapy in knee osteoarthritis: clinical outcomes and biochemical mechanisms
Bibliographic record
Abstract
BACKGROUND: Knee Osteoarthritis (KOA) is a degenerative joint condition that leads to pain and limited mobility. Non-invasive treatments like Low-Intensity Pulsed Ultrasound (LIPUS) and Extracorporeal Shockwave Therapy (ESWT) help manage symptoms and support recovery. While both methods are effective, no studies have directly compared ESWT alone to its combination with LIPUS (LESWT) for KOA. This study aims to assess their efficacy and provide evidence for treatment choices. METHODS: for 20-min daily sessions. The study included 110 patients with KOA who underwent LESWT, forming the LESWT group, and another 110 KOA patients who were treated with R-ESWT, constituting the R-ESWT group. Evaluations were conducted to compare clinical outcomes, levels of inflammatory markers in joint synovial fluid, and the occurrence of adverse events before and after the treatment. RESULTS: The LESWT group showed a higher clinical effective rate (81.57%) compared to the R-ESWT group (64.82%, p < 0.01), with greater improvements in the Lysholm Knee Scoring Scale (LKSS), Visual Analog Scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and range of motion (ROM) scores (p < 0.05). Levels of inflammatory markers (nitric oxide [NO], interleukin-1β [IL-1β], tumor necrosis factor-α [TNF-α], matrix metalloproteinase-3 [MMP-3]) declined, whereas superoxide dismutase [SOD] and transforming growth factor-β1 [TGF-β1] levels rose, with the LESWT group exhibiting more pronounced changes (p < 0.01). The occurrence of adverse events showed no significant difference between the groups (p > 0.05). CONCLUSION: LESWT demonstrates significant efficacy in alleviating pain and reducing inflammatory markers in patients with KOA, making it a promising therapeutic option deserving of further clinical consideration. TRIAL REGISTRATION: The study protocol was registered on ClinicalTrials.gov registration with the register number CTR2457249805 (registration date: 2022/08/03).
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".