This study evaluates the combination of a therapeutic exercise program and dry needling in the treatment of knee osteoarthritis in older adults. Half of participants will receive therapeutic exercise program and dry needling in combination, while the other half will receive the same therapeutic exercise program and sham dry needling.
Therapeutic exercise and dry needling each relieve pain and improve function, but they are different treatment tools. Therapeutic exercise takes a multitude of forms and results in numerous systemic and local effects, some of which have been investigate among people with knee osteoarthritis. Therapeutic exercise covers a range of targeted physical activities that directly aim to improve muscle strength, neuromotor control, joint range of motion and aerobic fitness. One of the main aims of this therapeutic approach is to improve muscle strength, given that weakness is common in knee osteoarthritis. Enhanced strength of the lower limb may lessen internal knee forces, reduce pain and improve physical function. Primary knee osteoarthritis provokes pain and disfunction is thought mediated by joint damage and changes in joint homeostasis. Recently, investigations focused in impaired neuromuscular system as a contribution to the above mentioned symptoms in the knee osteoarthritis syndrome explore the use of dry needling. Dry needling is a therapeutic approach for decreasing pain and improve function with high recommended evidence (grade A) effectiveness for upper-quarter myofascial pain, but poorly understood in knee osteoarthritis patients.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
100
20-25 minutes aerobic exercise, 20-25 minutes strength exercise and 10-15 minutes stretch exercise.
Dry needling needle AGUPUNT®
Sham dry needling DONGBANG-ACUPRIME®
Universidad Rey Juan Carlos
Alcorcón, Madrid, Spain
Western Ontario and McMaster Osteoarthritis Index (WOMAC) change assessment.
The disease-specific questionnaire WOMAC is the most widely used instrument created and validated to evaluate both the symptomatology and function on osteoarthritis of the hip or knee.
Time frame: Base line, through study completion (3 months); and 3, 6 and 12 months follow-up
Numeric Pain Rating Scale (NPRS)
Pain intensity will be assessed using a NPRS of 11 points (from 0, no pain, to 10, maximum pain). The patient determined their subjective pain intensity of the painful knee by pointing with 1 of their fingers to mark the level of pain on the scale. .
Time frame: Base line, through study completion (3 months); ; and 3, 6 and 12 months follow-up
Barthel Index
The Barthel Index is considered to be the best of the activities of daily living measurement scales. The modified scoring of the Barthel Index by Shah achieved greater sensitivity and improved reliability than the original version, without causing additional difficulty or affecting the implementation time.
Time frame: Base line, through study completion (3 months); and 3, 6 and 12 months follow-up
The Timed Up & Go Test
The patient is asked to perform the rise from a standard arm chair, walk to a line on the floor 3 meters away, turn, return, return and sit down again. The score given is the time taken in seconds to complete the test.
Time frame: Base line, through study completion (3 months); and 3, 6 and 12 months follow-up
Mini-Mental State Examination (MMSE)
It's a 30-point questionnaire that is used extensively in clinical and research settings to measure cognitive impairment and to screen for dementia.
Time frame: Base line and 12 months follow-up
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EuroQol-5
It provides a simple descriptive profile and a single index value for health status through rating of 5 items.
Time frame: Base line, through study completion (3 months); and 3, 6 and 12 months follow-up