Combined effect of therapeutic ultrasound and exercise on pain and swelling in people with knee osteoarthritis: a systematic review

Combined effect of therapeutic ultrasound and exercise on pain and swelling in people with knee osteoarthritis: a systematic review | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Systematic Review Combined effect of therapeutic ultrasound and exercise on pain and swelling in people with knee osteoarthritis: a systematic review Suleiman Mohammed, Bashir kaka, Lawal Umar, Babangida Shehu Bappah, and 6 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8832889/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 12 You are reading this latest preprint version Abstract Background Knee osteoarthritis (KOA) is a chronic musculoskeletal disorder associated with pain, swelling, functional limitation, and reduced quality of life. Therapeutic ultrasound and exercise are frequently prescribed conservative interventions; however, evidence regarding their combined effectiveness remains unclear. Objective To systematically evaluate the combined effects of therapeutic ultrasound and any form of exercise on pain and swelling in individuals with knee osteoarthritis. Methods A systematic search of Web of Science, CINAHL, PubMed, AMED, and MEDLINE was conducted for studies published between 2004 and 2024. Randomized controlled trials involving adults aged ≥40 years with knee osteoarthritis were included. Methodological quality was assessed using the Joanna Briggs Institute (JBI) critical appraisal tools. The review was conducted in accordance with PRISMA 2020 guidelines and registered with PROSPERO (CRD42024579383). Results Six studies met the inclusion criteria. Overall, 75% of included studies were rated as moderate to high methodological quality. Evidence consistently supported improvements in pain and functional performance following combined therapeutic ultrasound and exercise interventions. Evidence for reduction in joint swelling was limited, with only one study reporting a significant effect. Conclusion Combined therapeutic ultrasound and exercise interventions appear effective for reducing pain and improving function in individuals with knee osteoarthritis. Evidence supporting effects on swelling is limited. High-quality randomized trials with longer follow-up are required to confirm long-term benefits. Therapeutic ultrasound Exercise Pain Swelling Knee osteoarthritis Systematic review Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 13 Apr, 2026 Reviews received at journal 20 Mar, 2026 Reviewers agreed at journal 20 Mar, 2026 Reviews received at journal 15 Mar, 2026 Reviewers agreed at journal 12 Mar, 2026 Reviews received at journal 11 Mar, 2026 Reviewers agreed at journal 11 Mar, 2026 Reviews received at journal 11 Mar, 2026 Reviewers agreed at journal 11 Mar, 2026 Reviewers invited by journal 11 Mar, 2026 Submission checks completed at journal 09 Mar, 2026 First submitted to journal 09 Mar, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8832889","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Systematic Review","associatedPublications":[],"authors":[{"id":612388554,"identity":"bb3976d4-a98c-4c65-94a7-e1e8075677e6","order_by":0,"name":"Suleiman 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Therapeutic ultrasound and exercise are frequently prescribed conservative interventions; however, evidence regarding their combined effectiveness remains unclear.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eObjective\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTo systematically evaluate the combined effects of therapeutic ultrasound and any form of exercise on pain and swelling in individuals with knee osteoarthritis.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA systematic search of Web of Science, CINAHL, PubMed, AMED, and MEDLINE was conducted for studies published between 2004 and 2024. Randomized controlled trials involving adults aged ≥40 years with knee osteoarthritis were included. Methodological quality was assessed using the Joanna Briggs Institute (JBI) critical appraisal tools. 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