Effectiveness of interferential current therapy in patients with knee osteoarthritis: a systematic review and meta-analysis of randomized controlled trials

Hung-Lun Chen, Fu-An Yang, Ting-Hsuan Lee, Tsan-Hon Liou, Reuben Escorpizo, Hung-Chou Chen, Hung-Lun Chen, Fu-An Yang, Ting-Hsuan Lee, Tsan-Hon Liou, Reuben Escorpizo, Hung-Chou Chen

Abstract

We conducted a systematic review and meta-analysis to assess the effectiveness of interferential current therapy (IFC) in patients with knee osteoarthritis. We searched PubMed, Cochrane Library, Embase, ClinicalKey, and Scopus for relevant studies from their date of launch to March 22, 2022. We included randomized controlled trials (RCTs) in which IFC was applied to knee osteoarthritis patients and the outcomes of pain scores or functional scales were assessed. Ten RCTs with 493 patients met the inclusion criteria. Nine RCTs were included in the meta-analysis. The IFC groups exhibited significant improvements relative to the control groups for short-term pain scores (SMD = - 0.64, 95% CI - 1.04 to - 0.25, P = 0.001), long-term pain scores (SMD = - 0.36, 95% CI - 0.60 to - 0.11, P = 0.005), and short-term Western Ontario and McMaster Universities Osteoarthritis Index scores (SMD = - 0.39, 95% CI - 0.77 to - 0.02, P = 0.04). All included studies did not observe any obvious adverse effects of IFC. IFC can be recommended as a treatment for knee osteoarthritis because it improves short- and long-term pain and short-term function. However, large-scale and high-quality RCTs with longer follow-up are required to establish an appropriate standardized treatment.

Conflict of interest statement

The authors declare no competing interests.

© 2022. The Author(s).

Figures

Figure 1
Figure 1
Flow chart for study selection. n number.
Figure 2
Figure 2
Forest plot of pain scores of IFC and control groups. IFC interferential current therapy, PBM photobiomodulation, 95% CI 95% confidence interval.
Figure 3
Figure 3
WOMAC scores of IFC and control groups after sensitivity analysis. WOMAC Western Ontario and McMaster Universities Osteoarthritis Index, IFC interferential current therapy, PBM photobiomodulation, 95% CI 95% confidence interval.
Figure 4
Figure 4
Forest plot of walk test results of IFC and control groups. IFC interferential current therapy, PBM photobiomodulation, 95% CI 95% confidence interval.
Figure 5
Figure 5
Forest plot of short-term stiffness results of IFC and control groups. IFC interferential current therapy, 95% CI 95% confidence interval.

References

    1. Neogi T, Zhang Y. Epidemiology of osteoarthritis. Rheum. Dis. Clin. N. Am. 2013;39:1–19. doi: 10.1016/j.rdc.2012.10.004.
    1. Dieppe PA, Lohmander LS. Pathogenesis and management of pain in osteoarthritis. Lancet (London, England) 2005;365:965–973. doi: 10.1016/s0140-6736(05)71086-2.
    1. Arendt-Nielsen L, et al. Sensitization in patients with painful knee osteoarthritis. Pain. 2010;149:573–581. doi: 10.1016/j.pain.2010.04.003.
    1. Jordan KM, et al. The use of conventional and complementary treatments for knee osteoarthritis in the community. Rheumatology (Oxford) 2004;43:381–384. doi: 10.1093/rheumatology/keh045.
    1. Zeng C, et al. Electrical stimulation for pain relief in knee osteoarthritis: Systematic review and network meta-analysis. Osteoarthr. Cartil. 2015;23:189–202. doi: 10.1016/j.joca.2014.11.014.
    1. Ferreira RM, Torres RT, Duarte JA, Gonçalves RS. Non-pharmacological and non-surgical interventions for knee osteoarthritis: A systematic review and meta-analysis. Acta Reumatol. Port. 2019;44:173–217.
    1. Fuentes JP, Armijo Olivo S, Magee DJ, Gross DP. Effectiveness of interferential current therapy in the management of musculoskeletal pain: A systematic review and meta-analysis. Phys. Ther. 2010;90:1219–1238. doi: 10.2522/ptj.20090335.
    1. Almeida CC, Silva V, Júnior GC, Liebano RE, Durigan JLQ. Transcutaneous electrical nerve stimulation and interferential current demonstrate similar effects in relieving acute and chronic pain: A systematic review with meta-analysis. Braz. J. Phys. Ther. 2018;22:347–354. doi: 10.1016/j.bjpt.2017.12.005.
    1. Liu M, Ward T, Young D, Matos H, Wei Y, Adams J, Yang K. Electronic textiles based wearable electrotherapy for pain relief. Sens. Actuators A Phys. 2020;303:111701. doi: 10.1016/j.sna.2019.111701.
    1. Rutjes AW, et al. Transcutaneous electrostimulation for osteoarthritis of the knee. Cochrane Database Syst. Rev. 2009;2009:Cd002823. doi: 10.1002/14651858.CD002823.pub2.
    1. Davis AM, MacKay C. Osteoarthritis year in review: Outcome of rehabilitation. Osteoarthr. Cartil. 2013;21:1414–1424. doi: 10.1016/j.joca.2013.08.013.
    1. Page MJ, et al. The PRISMA statement: An updated guideline for reporting systematic reviews. BMJ (Clinical research ed.) 2020;372(71):2021. doi: 10.1136/bmj.n71.
    1. de Morton NA. The PEDro scale is a valid measure of the methodological quality of clinical trials: a demographic study. Aust. J. Physiother. 2009;55:129–133. doi: 10.1016/s0004-9514(09)70043-1.
    1. Cashin AG, McAuley JH. Clinimetrics: Physiotherapy evidence database (PEDro) scale. J. Physiother. 2020;66:59. doi: 10.1016/j.jphys.2019.08.005.
    1. Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ (Clinical Research ed.) 2003;327:557–560. doi: 10.1136/bmj.327.7414.557.
    1. Quirk AS, Newman RJ, Newman KJ. An evaluation of interferential therapy, shortwave diathermy and exercise in the treatment of osteoarthritis of the knee. Physiotherapy. 1985;75:55–57.
    1. Adedoyin RA, Olaogun MOB, Fagbeja OO. Effect of interferential current stimulation in management of osteo-arthritic knee pain. Physiotherapy. 2002;88:493–499. doi: 10.1016/S0031-9406(05)60851-6.
    1. Adedoyin RA, Olaogun MOB, Oyeyemi AL. Transcutaneous electrical nerve stimulation and interferential current combined with exercise for the treatment of knee osteoarthritis: A randomised controlled trial. Hong Kong Physiother. J. 2005;23:13–19. doi: 10.1016/S1013-7025(09)70054-5.
    1. Defrin R, Ariel E, Peretz C. Segmental noxious versus innocuous electrical stimulation for chronic pain relief and the effect of fading sensation during treatment. Pain. 2005;115:152–160. doi: 10.1016/j.pain.2005.02.018.
    1. Itoh K, Hirota S, Katsumi Y, Ochi H, Kitakoji H. A pilot study on using acupuncture and transcutaneous electrical nerve stimulation (TENS) to treat knee osteoarthritis (OA) Chin. Med. 2008;3:2. doi: 10.1186/1749-8546-3-2.
    1. Dyson C. Assessing the Effect of IFT and Exercise Therapy on OA Knee. Swansea University; 2010.
    1. Atamaz FC, et al. Comparison of the efficacy of transcutaneous electrical nerve stimulation, interferential currents, and shortwave diathermy in knee osteoarthritis: A double-blind, randomized, controlled, multicenter study. Arch. Phys. Med. Rehabil. 2012;93:748–756. doi: 10.1016/j.apmr.2011.11.037.
    1. Gundog M, Atamaz F, Kanyilmaz S, Kirazli Y, Celepoglu G. Interferential current therapy in patients with knee osteoarthritis: Comparison of the effectiveness of different amplitude-modulated frequencies. Am. J. Phys. Med. Rehabil. 2012;91:107–113. doi: 10.1097/PHM.0b013e3182328687.
    1. de Paula Gomes CAF, et al. Exercise program combined with electrophysical modalities in subjects with knee osteoarthritis: A randomised, placebo-controlled clinical trial. BMC Musculoskelet. Disord. 2020;21:258. doi: 10.1186/s12891-020-03293-3.
    1. Alqualo-Costa R, Rampazo ÉP, Thome GR, Perracini MR, Liebano RE. Interferential current and photobiomodulation in knee osteoarthritis: A randomized, placebo-controlled, double-blind clinical trial. Clin. Rehabil. 2021 doi: 10.1177/02692155211012004.
    1. Bijur PE, Silver W, Gallagher EJ. Reliability of the visual analog scale for measurement of acute pain. Acad. Emerg. Med. Off. J. Soc. Acad. Emerg. Med. 2001;8:1153–1157. doi: 10.1111/j.1553-2712.2001.tb01132.x.
    1. Ehrich EW, et al. Minimal perceptible clinical improvement with the Western Ontario and McMaster Universities osteoarthritis index questionnaire and global assessments in patients with osteoarthritis. J. Rheumatol. 2000;27:2635–2641.
    1. Lluch Girbés E, Nijs J, Torres-Cueco R, López Cubas C. Pain treatment for patients with osteoarthritis and central sensitization. Phys. Ther. 2013;93:842–851. doi: 10.2522/ptj.20120253.
    1. Palmer ST, Martin DJ, Steedman WM, Ravey J. Alteration of interferential current and transcutaneous electrical nerve stimulation frequency: Effects on nerve excitation. Arch. Phys. Med. Rehabil. 1999;80:1065–1071. doi: 10.1016/s0003-9993(99)90062-x.
    1. Fuentes CJ, Armijo-Olivo S, Magee DJ, Gross D. Does amplitude-modulated frequency have a role in the hypoalgesic response of interferential current on pressure pain sensitivity in healthy subjects? A randomised crossover study. Physiotherapy. 2010;96:22–29. doi: 10.1016/j.physio.2009.06.009.
    1. Rampazo ÉP, Liebano RE. Analgesic effects of interferential current therapy: A narrative review. Medicina (Kaunas) 2022;58:141. doi: 10.3390/medicina58010141.
    1. Satter EK. Third-degree burns incurred as a result of interferential current therapy. Am. J. Dermatopathol. 2008;30:281–283. doi: 10.1097/DAD.0b013e31816a9d4f.
    1. De-la-Cruz-Torres B, et al. Heart rate variability monitoring during interferential current application in the lower back area: A cross-sectional study. Int. J. Environ. Res. Public Health. 2021;18:3394. doi: 10.3390/ijerph18073394.

Source: PubMed

Sponsors and Collaborators

Medical Conditions

Drug Interventions

3
Subscribe