Introduction: Knee osteoarthritis (KOA) is the biggest cause of pain and disability worldwide. As a non-pharmacological approach, ventosatherapia has been used to control pain, improve function and quality of life. However, there is a lack of high-quality scientific evidence regarding its effects on this condition. Objective: To evaluate the effects of dry cupping on pain, function and quality of life in women with KOA. Methods: This is a randomized, blinded placebo-controlled protocol. 62 women diagnosed with KOA will be recruited, based on the clinical criteria of the American College of Rheumatology, who will be randomly divided into two groups (31 per group): dry cupping and dry cupping sham.
The intervention will be carried out for 15 minutes, twice a week, for 6 consecutive weeks, totaling 12 sessions. Both groups will be evaluated in 4 moments: before the intervention (T0), after 3 weeks of interventions (T3), at the end of the protocol (T6) and 4 weeks after the end of the interventions (follow-up - T10). The analyzed outcomes will be: Primary - pain (numerical pain scale); Secondary - Physical function (WOMAC; tests of going up / down stairs, brisk walking in 40 m and sitting / rising from a chair in 30 s), quality of life (SF-36) and global perception of the effect
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
62
Dry cupping therapy application on the patient's skin
Marcelo Cardoso de Souza
Santa Cruz, Rio Grande do Norte, Brazil
Change from Numerical Rating Scale (NRS)
Subjective measure in which individuals rate their pain on an eleven-point numerical scale. Such scale will be positioned in front of the participant and will vary from 0 to 10 points, with 0 being the complete absence of pain and 10 being the worst pain imaginable by the individual
Time frame: baseline, 3 ,6 and 10 weeks after.
Change from Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)
Questionnaire translated and validated for the Portuguese language, specific for the evaluation of patients with KOA, contains 24 questions divided into three categories that assess pain, stiffness and self-reported physical function.38 The items are evaluated by a Likert scale and each question receives a score that varies from 0 to 96 points, according to the patient's response (none = 0; low = 1; moderate = 2; severe = 3; very severe = 4). The higher the score obtained, the worse the severity of pain, stiffness or physical function
Time frame: baseline, 3 ,6 and 10 weeks after.
Change from 30-second Chair Stand Test
The sit and stand test will be performed in a chair without armrests, with a height of 43 cm, with non-slip rubber under its four supports. The back of the chair will be supported by a wall to prevent oscillations during the movements of sitting and standing. The participant will sit in the middle of the chair, with an erect back, feet apart and aligned with the joints of the respective shoulders and supported on a flat and stable floor. The test will consist of getting up from the chair as many times as possible, for 30 seconds. In this way, it will be possible to assess different levels of skill, with scores ranging from 0, for those who cannot complete a single repetition, to values greater than 20 repetitions, for the most able and well-prepared individuals
Time frame: baseline, 6 and 10 weeks after.
Change from 8-step Stair Climb Test
In the test of going up and down stairs, the participant will be positioned in front of the stairs and, at the signal, must go up the indicated steps (8 steps) and go down, in the shortest time possible. The height of each step will be 20 cm and it will be a staircase with a handrail, in a lighted environment, free of traffic and external distractions. A pre-test will be carried out to identify the need for security measures. The final score will be calculated based on the time the participant performed the procedure and compared with normative values available for the test.
Time frame: baseline, 6 and 10 weeks after.
Change from 40m Fast Paced Walk Test
The 40 meter fast walk test will be performed on 4 circuits of 10 meters (marked by ribbons and bounded by cones), in which the participant will be guided to walk the 10 meters, go around the cone and travel the next 10 meters again, successively, until the total distance of 40 meters is completed. The time will be timed only between the markings (start and end). The final score will be calculated based on the time the participant will perform the procedure and compared with normative values for healthy adults.
Time frame: baseline, 6 and 10 weeks after.
Change from Short-Form 36 quality of life
The instrument consists of 36 questions and assesses eight different domains that influence quality of life, considering the individual's perception of aspects of his health in the past weeks. Each item has a group of responses distributed on a graduated Likert scale, with the following dimensions: physical function, physical aspect, pain, general health, vitality, social function, emotional aspect and mental health. Your total score ranges from 0 to 100, where the higher the value, the better the quality of life.
Time frame: baseline, 6 and 10 weeks after.
Change from Global Perceived Effect
Global perceived effect (GPE) is a 11-point Likert scale (ranging from -5 to +5) that compares the patients' current health status with that at the onset of symptoms. Positive scores are attributed to individuals who improved when compared with baseline and negative scores to those who worsened
Time frame: baseline, 3, 6 and 10 weeks after.
Change from use of analgesics and anti-inflammatories
Number of use of analgesics and anti-inflammatories at the end of the study.
Time frame: baseline, 3, 6 and 10 weeks after
Change from expectation with treatment after the intervention protocol .
A 5-point Likert scale was applied to assess patient expectation in terms of the intervention. The scale will be placed in front of the participant, who will be asked the following question: 'with dry cupping intervention do you think your situation will: (1) worsen considerably, (2) worsen a little, (3) neither improve nor worsen, (4) improve a little or (5) improve considerably
Time frame: baseline and 10 weeks after
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