Efficacy of therapeutic ultrasound vs sham ultrasound on pain and physical function in people with knee osteoarthritis: A meta-analysis of randomized controlled trials

Table 5 Summary of findings

Outcomes	Difference1 in ultrasound group mean relative to the control group mean (95%CI)	No of Participants and knees (studies)	Strength of the body of evidence2	Inconsistency (I2)	Outcome specific risk of bias
Pain VAS; NRS Follow-up: 2-8 wk	0.39 standard deviations lower [-0.70-(-0.08)]	281 (5 studies)	Low	36%	High risk of bias of the included studies, imprecision due to small sample size and wide CI
Self-reported physical function WOMAC® LK 3.1 Physical function; Follow-up: 2-8 wk	2.49 points lower (-0.55-0.14)	130 (3 studies)	Very low	0%	High risk of bias of the included studies, imprecision due to very small sample size and wide CI
Walking performance 50 m walk speed (s); 20 m walk speed (s); 6MWT (m) Follow-up: 2-8 wks	0.11 standard deviations lower (-0.59-0.37)	212 (4 studies)	Very low	64%	High risk of bias in the included studies, imprecision due to small sample size and wide CI, inconsistent

¹Standardized mean difference reported for pain and walking performance; Mean difference reported for self-reported physical function outcomes;

²GRADE Working Group grades of evidence, High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. VAS: Horizontal 10 cm visual analogue scale for pain (maximum score = 10, lower score is better); NRS: Pain with movement numeric rating scale (maximum score = 10, lower score is better); WOMAC LK 3.1 Physical function: Likert Scale version of the Western Ontario and McMaster Osteoarthritis Index physical function subscale (maximum score = 80, lower score is better); 6MWT: 6 min walk test (distance measured in metres, higher score is better).