# Acupressure for Managing Osteoarthritis: A Systematic Review and Meta-Analysis
## 3 Results
### Study Characteristics  
Of the eight RCTs, two [40; 41] originated from United States, two [44; 45] originated from China, two [38; 39] were from Iran, and one [43] from India. Four RCTs [38; 39; 40; 44] adopted a three-arm parallel design, three RCTs [41; 42; 43] adopted a two-arm parallel design and one RCT [45] adopted a four-arm parallel design. The number of participants in the trials varied from 35 to 212, with a total of 873 participants. Participants were diagnosed with knee OA according to American College Rheumatology (ACR) criteria in three RCTs [39; 40; 42] and TCM criteria of diagnosis and therapeutic effect of diseases and syndromes (TCM-DTDS) in one RCT [44], whereas the other three RCTs [38; 41; 43] did not provide relevant information. Participants in the remaining RCT [45] were diagnosed with cervical OA, also known as cervical spondylosis, based on TCM-DTDS.  
As there is only one RCT [45] investigated on the effectiveness of acupressure for cervical OA, we are unable to further analyze the data or compute relevant pooled effects. Therefore, the results of this RCT are presented in Appendix A and the results of the remaining seven RCTs will be presented in the Results section as below. Key data from the seven RCTs investigating knee OA are summarized in Table 1.  
For the intervention group, five RCTs [38; 39; 40; 41; 42] used acupuncture as the sole intervention and two RCTs [43; 44] used acupuncture as the complementary intervention. As the choice of comparator, four RCTs used no intervention [38; 39; 40; 41] while the other three RCTs each used knee health education (conventional first-line treatment) [42], pharmacological treatment (conventional second-line treatment) [43], and viscosupplementation (conventional second-line treatment) [44]. Six RCTs [39; 40; 41; 42] reported that participants continued their usual care, whereas two RCTs did not provide relevant information. For outcome measures, five RCTs used WOMAC [39; 40; 41; 42] and two RCTs used VAS [43; 44]. Other tools used to measure the outcome include NRS, 36-Item Short-Form Health Survey (SF-36), and Short-Form Six-Dimension (SF-6D). The most frequently used acupoints in the RCTs were ST34, ST36, SP9, SP10, and GB34 [39; 41; 42; 43; 44], followed by ST35 and EX-LE4, and then other points.  
Figure 1: Study selection process. COA: cervical osteoarthritis, KOA: knee osteoarthritis.  
\begin{table}
\begin{tabular}{c c c c c c c c c} \hline \hline  & **Sample Size (K, K, MB)** & **Information (Beginers,** & **Control (Beginers,** & **Control (Beginers,** & **Control (Beginers,** & **Control (Beginers,** & **Control (Change)** & **Control (Change)** \\  & **Type of ADC Channels,** & **Control (Breers,** & **Control (Breers,** & **Control (Breers,** & **Control (Change)** & **Control (Change)** & **Control (Change)** \\  & **Measure Control (Pos,** & **Control (Breers,** & **Control (Breers,** & **Control (Change)** & **Control (Change)** & **Control (Change)** & **Control (Change)** \\  & **Measure Control (Pos,** & **Control (Breers,** & **Control (Change)** & **Control (Change)** & **Control (Change)** & **Control (Change)** & **Control (Change)** \\ \hline \hline \end{tabular}
\end{table}
Table 1: Summary of included studies.