The Effect of Dry Needling in Patients With Knee Osteoarthritis

Universiteit Antwerpen

Status: Completed

Conditions: Osteoarthritis, Knee

Treatments: Other: Sham Needling; Other: Dry Needling

Study type: Interventional

Funder types: Other

Identifiers

NCT04717167

B3000201630444

Details and patient eligibility

About

Research suggests that myofascial trigger points (MTrP) play an important role in explaining pain in patients with musculoskeletal knee disorders. Trigger points are usually defined as hypersensitive tender spots within taut bands of skeletal muscles that are painful on muscle stimulation and that usually elicit referred pain. Treatment of these trigger points could possibly alleviate symptoms in patients with knee pain. However, literature on the effect of trigger point therapy, dry needling in particular, in patients with musculoskeletal knee disorders is scarce. The purpose of this study is to examine the effect of trigger point therapy (dry needling (DN)) on pain, presence of altered central pain processing, muscle features and gait pattern in patients with knee osteoarthritis (KOA). 60 patients with symptomatic KOA will participate in this study. They will randomly be allocated in either an experimental group (EG) (dry needling technique) or a placebo group (PG) (sham needling technique). Pain (Visual analogue scale (VAS) & KOA outcome score (KOOS), muscle features during gait and gait pattern (3D gait analysis and surface electroMyoGraphy (EMG)) and presence of altered central pain processing (Central Sensitization Inventory (CSI), Quantitative Sensory testing (QST)) will be measured at baseline and 15 minutes after the intervention. Additionally, pain will be measured 3 days after the intervention. The investigators hypothesize that the effect on the outcome measures will be significantly larger in the EG compared to the PG.

Enrollment: 61 patients

Sex: All

Ages: 50+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• A minimum age of fifty years old;

• Diagnosed with KOA based on the American College of Rheumatology (ACR) clinical classification criteria(48), including:

  • A Kellgren-Lawrence grade of minimum two on radiography;
  • At least three months of chronical knee pain.

Exclusion criteria

• Patients suffering from autoimmune and/or neurological disorders
• Patients who had a major trauma/fracture of the lower limb in the past six months -
• Patients who experienced other musculoskeletal problems than OA

Trial design

Primary purpose: Supportive Care

Allocation: Randomized

Interventional model: Factorial Assignment

Masking: Double Blind

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61 participants in 2 patient groups

DN group

Experimental group

Description:

All identified MTrPs were inserted with a sterile filiform needle (0,30mm x 40mm or 0,30mm x 75mm, depending on the muscle) that moved up- and downwards until a local twitch response was elicited. When the repeated local twitch response fade away or the subject reported too much pain, the needle was removed. After the treatment, a 15 minutes break(51) was set up and the subjects were not permitted to use a hot pack or to stretch the muscle.

Treatment:

Other: Dry Needling

Sham needling (SN) group

Sham Comparator group

Description:

The SN technique was similar to DN, except for penetrating the muscle. In this technique, the needle only penetrated the skin and was therefore impossible to provoke a local twitch response.

Treatment:

Other: Sham Needling