The Effect of Dry Needling in Patients With Knee Osteoarthritis

Osteoarthritis, Knee Clinical Trial

Official title:

The Effect of One Dry Needling Session on Pain and Central Pain Processing in Patients With Knee Osteoarthritis: a Randomized Controlled Trial

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT04717167
• Other study ID #: B3000201630444
• Status: Completed
• Phase: N/A
• Start date: December 1, 2016
• Est. completion date: April 1, 2019

Study information

• Verified date: January 2021
• Source: Universiteit Antwerpen
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

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.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 61
• Est. completion date: April 1, 2019
• Est. primary completion date: April 1, 2019
• Accepts healthy volunteers: No
• Gender: All
• Age group: 50 Years and older

Eligibility

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

Related Conditions & MeSH terms

• Osteoarthritis
• Osteoarthritis, Knee

Intervention

Other:
• Dry Needling

• Sham Needling

Locations

Country	Name	City	State
n/a

Sponsors (1)

Lead Sponsor	Collaborator
Universiteit Antwerpen

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Pain sensation	Measured with a Visual Analogue Scale, scored from 0 to 100, where higher scores indicate higher pain sensation.	Change from baseline pain sensation at 15minutes postintervention
Primary	Pain sensation	Measured with the Knee Osteoarthritis Outcome Score- subscale pain, scored on a scale from 0 to 36, transferred from 0 to 100. Higher scores indicate a higher pain sensation.	Change from baseline pain sensation at 15minutes postintervention
Primary	Pain sensation	Measured with a Visual Analogue Scale, scored from 0 to 100, where higher scores indicate higher pain sensation.	Change from baseline pain sensation at 3days postintervention
Primary	Pain sensation	Measured with the Knee Osteoarthritis Outcome Score- subscale pain, scored on a scale from 0 to 36, transferred from 0 to 100. Higher scores indicate a higher pain sensation.	Change from baseline pain sensation at 3days postintervention
Primary	Pain sensation	Measured with a Visual Analogue Scale, scored from 0 to 100, where higher scores indicate higher pain sensation.	Change from 15minutes postintervention pain sensation at 3days postintervention
Primary	Pain sensation	Measured with the Knee Osteoarthritis Outcome Score- subscale pain, scored on a scale from 0 to 36, transferred from 0 to 100. Higher scores indicate a higher pain sensation.	Change from 15minutes postintervention pain sensation at 3days postintervention
Primary	Pain pressure thresholds	Measured with an digital algometer (kilogram force/ square cm)	Change from baseline central pain processing at 15minutes postintervention
Primary	Temporal summation	Measured with an digital algometer (kilogram force/ square cm)	Change from baseline central pain processing at 15minutes postintervention
Primary	Conditioned pain modulation	Measured with an digital algometer (test stimulus) and an inflatable cuff (conditioning stimulus). (kilogram force/ square cm)	Change from baseline central pain processing at 15minutes postintervention
Secondary	Muscle coactivation of musculus Vastus medialis and musculus Semitendinosus	Measured with wireless surface electromyography. Muscle activation patterns will be gathered through surface electrodes. Hereafter, the co-contraction index was calculated. Higher percentages indicate higher coactivation.	Change from baseline muscle coactivation at 15minutes postintervention
Secondary	Muscle coactivation of musculus Vastus medialis and musculus Biceps femoris	Measured with wireless surface electromyography. Muscle activation patterns will be gathered through surface electrodes. Hereafter, the co-contraction index was calculated. Higher percentages indicate higher coactivation.	Change from baseline muscle coactivation at 15minutes postintervention
Secondary	Muscle coactivation of musculus Vastus lateralis and musculus Semitendinosus	Measured with wireless surface electromyography. Muscle activation patterns will be gathered through surface electrodes. Hereafter, the co-contraction index was calculated. Higher percentages indicate higher coactivation.	Change from baseline muscle coactivation at 15minutes postintervention
Secondary	Muscle coactivation of musculus Vastus lateralis and musculus Biceps femoris	Measured with wireless surface electromyography. Muscle activation patterns will be gathered through surface electrodes. Hereafter, the co-contraction index was calculated. Higher percentages indicate higher coactivation.	Change from baseline muscle coactivation at 15minutes postintervention
Secondary	Muscle coactivation of musculus Tibialis anterior and musculus Gastrocnemius medialis	Measured with wireless surface electromyography. Muscle activation patterns will be gathered through surface electrodes. Hereafter, the co-contraction index was calculated. Higher percentages indicate higher coactivation.	Change from baseline muscle coactivation at 15minutes postintervention
Secondary	Muscle coactivation of musculus Tibialis anterior and musculus Gastrocnemius lateralis	Measured with wireless surface electromyography. Muscle activation patterns will be gathered through surface electrodes. Hereafter, the co-contraction index was calculated. Higher percentages indicate higher coactivation.	Change from baseline muscle coactivation at 15minutes postintervention
Secondary	Stride time (seconds)	measured with force plates and markers to measure toe off and heel strike during a 3D motion analysis.	Change from baseline muscle coactivation at 15minutes postintervention
Secondary	Stride length (meters)	measured with force plates and markers to measure toe off and heel strike during a 3D motion analysis.	Change from baseline muscle coactivation at 15minutes postintervention
Secondary	Step time (meters/second)	measured with force plates and markers to measure toe off and heel strike during a 3D motion analysis.	Change from baseline muscle coactivation at 15minutes postintervention
Secondary	Stance phase (%)	measured with force plates and markers to measure toe off and heel strike during a 3D motion analysis.	Change from baseline muscle coactivation at 15minutes postintervention
Secondary	Step length (meters)	measured with force plates and markers to measure toe off and heel strike during a 3D motion analysis.	Change from baseline muscle coactivation at 15minutes postintervention
Secondary	Step width (meters)	measured with force plates and markers to measure toe off and heel strike during a 3D motion analysis.	Change from baseline muscle coactivation at 15minutes postintervention