Table 3

Review of reviews (evidence category 1A) regarding miscellaneous therapies: treatment modality and disease, direction of effect and the quality of the evidence according to GRADE in patients with RA, SpA and OA

Treatment modality
  Disease
Reviews (n)Direction of
effect
GRADE quality
of evidence
Acupuncture
  RA5o/+⊕⊕
  OA-general4o/+⊕⊕
  OA-hand/wrist3o/+
  OA-hip/knee2+⊕⊕
  OA-hip1o⊕⊕
  OA-knee16+⊕⊕⊕
Balneotherapy and massage
  RA3o/+⊕⊕
  SpA2o/+
  OA-general5o/+⊕ to ⊕⊕
  OA-hand/wrist3+
  OA-hip/knee2o/+
  OA-knee8+⊕⊕
Thermotherapy
  RA4o/+⊕⊕
  OA-general1o
  OA-hand/wrist3o/+⊕⊕
  OA-knee4o/+⊕⊕
Ultrasound, radiotherapy and diathermy
  RA3+⊕⊕
  OA-general2o/+⊕⊕
  OA-hip/knee2?/o⊕⊕
  OA-knee12o/+⊕⊕ to ⊕⊕⊕
Electromagnetic therapy
  RA2o/+⊕⊕
  OA-general1+⊕⊕⊕
  OA-hip/knee3+⊕⊕
  OA-knee18?/+⊕⊕ to ⊕⊕⊕
Laser therapy
  RA3+⊕⊕
  OA-general2o/+⊕⊕
  OA-hand/wrist4o⊕⊕
  OA-knee7o/+⊕⊕⊕
Magnet therapy
  OA-general1o/+⊕⊕
  OA-hand/wrist2o/+⊕⊕
  OA-knee2o⊕⊕
Manual therapy/joint mobilisation
  OA-hand/wrist4+⊕⊕⊕
  OA-hip/knee1o/+⊕⊕
  OA-hip1+⊕⊕
  OA-knee1+⊕⊕
Diverse
  OA-general (healing, qigong, chiropractic)1o/+
  OA-hand/wrist (leeches, copper bracelets)2o/?
  • Diseases without a review were excluded for the table.

  • Direction of effect: +, positive; o, no; −, negative; ?, unclear (effect equivocal) or a combination thereof meaning that different reviews reached different conclusions about the effect of the treatment or that the direction of effects differed between treatment modalities such as between transcutaneous electrical nerve stimulation and pulsed electromagnetic field therapy which are both included in ‘electromagnetic therapy’.

  • References are shown in online supplementary file 4.

  • GRADE: ⊕⊕⊕⊕, high; ⊕⊕⊕, moderate; ⊕⊕ to ⊕⊕⊕, low to moderate; ⊕⊕, low; ⊕ to ⊕⊕, very low to low; ⊕ very low. (The combined grades are due to difference in quality between studies of different modalities such as balneotherapy vs massage studies.)

  • GRADE, Grades of Recommendation, Assessment, Development and Evaluation; OA, osteoarthritis; RA, rheumatoid arthritis; SpA, spondyloarthritis.