. 2022 Jun 7;13:906597. doi: 10.3389/fphys.2022.906597

TABLE 6.

GRADE quality grading of included SRs.

Author (year)	Outcomes (n)	Limitations	Inconsistency	Imprecision	Publication bias	Quality of evidence
Wang (2015)	WOMAC physical function score (3)	−1^①	0	−1^③	0	L
	PGI-I scores (3)	−1^①	−1^②	0	0	L
	30% pain reduction rate (3)	−1^①	0	0	0	M
	50% pain reduction rate (3)	−1^①	−2^②	−1^③	0	CL
	BPI-S score (3)	−1^①	0	0	0	M
	Adverse events (3)	−1^①	0	−1^③	0	L
	Serious adverse events (3)	−1^①	0	−1^③	0	L
	Treatment emergent adverse events (3)	−1^①	0	−1^③	0	L
	Treatment discontinuation rate (3)	−1^①	−1^②	−1^③	0	CL
Chen (2019)	WOMAC stiffness score (6)	−1^①	0	−1^③	−1^④	CL
	WOMAC physical function score (6)	−1^①	−1^②	−1^③	−1^④	CL
	BPI-S score (5)	−1^①	0	0	−1^④	L
	30% pain reduction rate (4)	−1^①	0	0	−1^④	L
	50% pain reduction rate (4)	−1^①	−1^②	0	−1^④	CL
	Weekly 24-h average pain score (3)	−1^①	0	0	−1^④	L
	Treatment emergent adverse events (5)	−1^①	0	−1^③	−1^④	CL
	Serious adverse events (5)	−1^①	0	−1^③	−1^④	CL
	Treatment discontinuation rate (5)	−1^①	0	−1^③	−1^④	CL
Gao (2019)	WOMAC total score (5)	−1^①	−1^②	−1^③	−1^④	CL
	WOMAC pain score (4)	−1^①	−2^②	−1^③	−1^④	CL
	WOMAC stiffness score (4)	−1^①	−2^②	−1^③	−1^④	CL
	WOMAC physical function score (4)	−1^①	−2^②	−1^③	−1^④	CL
	PGI-I scores (5)	−1^①	−1^②	0	−1^④	CL
	BPI-S score (5)	−1^①	−1^②	0	−1^④	CL
	30% pain reduction rate (5)	−1^①	0	0	−1^④	L
	50% pain reduction rate (4)	−1^①	−2^②	0	−1^④	CL
	Treatment emergent adverse events (5)	−1^①	0	0	−1^④	L
	Serious adverse events (5)	−1^①	0	−1^③	−1^④	CL
	Treatment discontinuation rate (3)	−1^①	−1^②	−1^③	−1^④	CL
Osani (2019)	WOMAC pain score (5)	−1^①	−1^②	0	0	L
	WOMAC physical function score (5)	−1^①	−1^②	0	0	L
	Treatment emergent adverse events (5)	−1^①	−2^②	0	0	CL
	Serious adverse events (5)	−1^①	0	0	0	M
	Treatment discontinuation rate (5)	−1^①	0	0	0	M
	Gastrointestinal adverse event (5)	−1^①	−1^②	0	0	L
	Quality of life improvement (3)	−1^①	0	0	0	M
	Improvement of depressive symptoms (2)	−1^①	0	−1^③	0	L
Qu (2020)	WOMAC total score (2)	−1^①	−1^②	−1^③	−1^④	CL
	WOMAC pain score (3)	−1^①	0	0	−1^④	L
	WOMAC stiffness score (3)	−1^①	−1^②	−1^③	−1^④	CL
	WOMAC physical function score (3)	−1^①	−2^②	0	−1^④	CL
	BPI-S score (5)	−1^①	0	0	−1^④	L
	Dry mouth (2)	−1^①	−1^②	0	−1^④	CL
	Drowsiness (2)	−1^①	0	0	−1^④	L
	Nausea (2)	−1^①	−1^②	0	−1^④	CL
Chen (2021)	30% pain reduction rate (5)	−1^①	0	−1^③	−1^④	CL
	50% pain reduction rate (5)	−1^①	0	0	−1^④	L
	Pain reduction average rate (5)	−1^①	0	−1^③	−1^④	CL
	WOMAC pain score (4)	−1^①	−2^②	0	−1^④	CL
	WOMAC stiffness score (6)	−1^①	−1^②	−1^③	−1^④	CL
	WOMAC physical function score (6)	−1^①	−1^②	0	−1^④	CL
	SF-36 physical functional subscale (2)	−1^①	−2^②	−1^③	−1^④	CL
	SF-36 bodily pain subscale (2)	−1^①	−2^②	0	−1^④	CL
	SF-36 role physical subscale (3)	−1^①	−2^②	−1^③	−1^④	CL
	PGI-I scores (5)	−1^①	−1^②	0	−1^④	CL
	CGI-S scores (4)	−1^①	−2^②	−1^③	−1^④	CL
	Treatment emergent adverse events (5)	−1^①	−2^②	−1^③	−1^④	CL
	Serious adverse events (5)	−1^①	0	−1^③	−1^④	CL
	BPI-I score (3)	−1^①	−1^②	−1^③	−1^④	CL
	BPI-S score (5)	−1^①	0	0	−1^④	L

Abbreviations: CL, critically low; L, low; M: moderate; H, high; ①, The design of the experiment with a large bias in random, distributive hiding or blind; ②, The confidence interval overlaps less, the heterogeneity test P is Critically small, and the I ² is larger; ③, Confidence interval is not narrow enough; ④, Fewer studies are included and there may be greater publication bias.