Osteoarthritis, Knee Clinical Trial
Official title:
Warm Needle Acupuncture vs. Needle Acupuncture for Osteoarthritis of the Knee: A Pilot Study
This is a two-armed randomised controlled pilot study that investigates the component
efficacy of moxibustion for osteoarthritis of the knee. Participants will be randomised to
receive either warm needle acupuncture or needle acupuncture. Participants and
acupuncturists will be blinded to group allocation. The primary and secondary outcome
measures are WOMAC and SF36 respectively. Qualitative interviews will be used to gather
information on the patients' experiences and perceptions of the trial and the treatment
provided.
It is hypothesised that warm needle acupuncture will lead to a greater reduction in clinical
signs and symptoms than needle acupuncture.
Acupuncture Treatment
All participants will receive acupuncture. Only points local to the knee will be used. There
will be 4-6 points used per knee, therefore 8 -12 needles per treatment. A record will be
kept of the points used at each treatment. Both knees will be treated even if only one knee
is painful. This will ensure that participants receive similar treatments.
Patients will be treated seated, as this allows better access to the relevant acupuncture
points. It also helps ensure the moxibustion is carried out safely.
Participants will receive 8 treatments in the first 4 weeks (twice a week), then 4
treatments in 4 weeks (once a week).
Blinding procedures
The only difference in the procedures will be that lit cones are placed on the needles of
the treatment group whilst unlit moxa cones will be placed on the needles of the control
group. Smokeless moxa will be used. All patients will see the needles being inserted and the
moxa cones placed on the needles by the acupuncturist. Skin guards will be placed at the
base of the needle to reduce the immediate sense of heat on the surface of the skin. Similar
skin guards are routinely used in acupuncture treatment to prevent any discomfort.
The acupuncturist will carry out a consultation at each session as per normal practice.
After the needles have been inserted and the moxa cones have been placed on needles the
acupuncturist leaves and an assistant acupuncturist enters the room. The assistant
acupuncturist will place a screen in front of the patient to prevent them from seeing their
knees. The assistant acupuncturist will then remove one cone at a time and light it. In the
treatment group the lit cone is placed on the needle. In the control group the lit cone is
place in a small dish close to the knee, a replacement unlit cone is placed on the needle.
This process is repeated until all the cones are lit. The unlit cone is replaced on the
needle of the control group to try and ensure they experience the same sensations as the
treatment group. The use of a second acupuncturist to light the moxa ensures that the
acupuncturist who carries out the consultation and inserts the needles is blinded to group
allocation.
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