Meta-Analysis of Randomized Controlled Trials: High-Intensity Electroacupuncture Outperforms Low-Intensity Electroacupuncture for Knee Osteoarthritis

Abstract

Background: Electroacupuncture (EA) has been proven to be efficacious and safe in patients with knee osteoarthritis (KOA), yet the superior intensity current for pain control in KOA remains unspecified. The present meta-analysis aimed to assess the efficiency of high-intensity and low-intensity EA in pain relief and functional improvement in KOA. Methods: A thorough and comprehensive literature search for randomized controlled trials (RCTs), all looking at the intensity of EA for KOA, was carried out in PubMed, EMBASE, Cochrane Library, clinicaltrials.gov, China National Knowledge Infrastructure (CNKI), China Science Journal Citation Report (VIP) and Wanfang database. All databases were searched from the available date of inception until the latest issue (Apr 2022). The study quality was evaluated via the Jadad five-point scale. Ultimately, a meta-analysis of all eligible RCTs was conducted utilizing Review Manager 5.3. Results: Three studies with 472 individuals were included in the Meta-analysis. The pain intensity reductions are significantly different between the high-intensity EA group and low-intensity EA group (MD=-0.22, 95%CI=-0.26 to -0.18, P< 0.00001). There is no significant difference between the two groups in the WOMAC index (MD=-3.62, 95%CI=-12.22 to 4.98, P= 0.41). High-intensity EA group significantly improve the emotional scale (ES) in comparison to the low-intensity EA group (MD=-0.72, 95%CI=-0.76 to -0.67, P< 0.00001). Conclusion: The findings of this work indicated that high-intensity EA provides superior pain relief and emotional scale in KOA patients. Moreover, both high-intensity and low-intensity EA exert a significant functional improvement effect in KOA.