Please select the eligibility criteria that correspond to the clinical trial below.
Title: Efficacy of Acupuncture Therapy Versus Sham Acupuncture on Knee Osteoarthritis: a Randomized Controlled Trial
Brief Summary: Knee osteoarthritis (KOA), also called degenerative knee disease, is one of the most common bone and joint diseases in clinic. It was estimated to affect more than 9 million individuals in the United States in 2005 and is a leading cause of disability and medical costs. Most elderly people over the age of 65 have radiographic and/or clinical evidence of osteoarthritis. KOA is a lifelong disease which can lead to obvious pain, joint stiffness, limitation of activity and even joint failure or disability. Acupuncture is a popular treatment taken from ancient Chinese medicine, in which fine needles are placed into the body at specific points. Studies have shown that acupuncture can stimulate nerves under the skin, causing the body to produce natural pain-relieving substances (endorphins). However the evidences of acupuncture for KOA are contradictory. According to the review, intensive acupuncture with three sessions a week is more effective for KOA than sparse acupuncture with one session a week. Moreover, the papers published in the past years suggest that manual acupuncture and electro-acupuncture are most commonly used acupuncture therapy for the treatment of knee osteoarthritis. The aim of this study is to evaluate the efficacy of intensive electro-acupuncture or manual acupuncture versus sham acupuncture in reducing pain and improving function in patients with KOA.


Options:
A: Inclusion Criteria:

1. \>/= age 60
2. meets accepted clinical criteria for knee OA based on the American College of Rheumatology 1986 clinical criteria guidelines.
3. Western Ontario and McMaster University Arthritis Index (WOMAC) pain subscale score in the range of 7-15 (to minimize including subjects with knee OA so severe they may be better served by arthroplasty)
4. PHQ-9 scores 1-9, with at least one of the cardinal symptoms of depression (low mood or anhedonia) endorsed.
5. Modified Mini Mental State (3MS) Examination \>/= 80.
6. Has or is willing to establish care with a personal physician prior to any experimental procedures.

Exclusion Criteria:

1. Major Depressive Episode or anxiety disorder within the past 1 year
2. Currently taking an antidepressant
3. History of bipolar or schizophrenia
4. Drug or alcohol use disorder within the past 12 months
5. Receiving knee-related workers compensation or involved in knee pain-related litigation.
6. Currently taking an anti-anxiety medicine \> 4 times/week for the past 4 weeks.
B: Inclusion Criteria:

1. Age 45-75 years old, male or female
2. Single / bilateral knee pain, duration of more than 6 months
3. KL (Kellgren-Lawrence) grade Ⅱ or Ⅲ
4. NRS ≥ 4

Exclusion Criteria:

1. Surgery history of knee or waiting for surgery (knee replacement or knee arthroscopy)
2. Knee pain caused by other diseases (such as joint bodies, severe effusion of joint cavity, infection, malignant tumors, autoimmune diseases, trauma, fracture, gout, lumbosacral vertebrae disease, etc.)
3. History of arthroscopy within 1 year or intra-articular injection within 4 months
4. History of receiving acupuncture or massage treatment within 3 months
5. Severe acute/chronic organic or mental diseases
6. Coagulation disorders (such as hemophilia, etc.)
7. Cardiac pacemaker, metal allergy or needle phobia
8. Pregnant women, pregnant and lactating women
9. Participation in another clinical study in the past 3 months
C: Inclusion Criteria:

* Had unilateral or bilateral knee OA
* Knee OA K\&L grade ≥ 2
* VAS = 3 cm over the previous 24 hours
* Able to walk ≥ 6-meter distances with or without an aid

Exclusion Criteria:

* Had knee or lower limb surgery
* Oral corticosteroid use (current\\ 4 weeks)
* Altered sensation around knee and shoulder
* Exhibited cognitive difficulties
* Intra-articular corticosteroid or hyaluronic acid injection within 6 months
* Had leg sciatica
* Contraindication to manual therapy
D: Inclusion Criteria:

* • Female subjects aged 60 years and over, non-obese (BMI between 18.5 and 24.9 kg / m2), with diagnosis of knee OA according to the criteria of the American College of Rheumatology (Altman et al. , 1986), which are: knee pain most of the day during the last weeks and age greater than 60 years (mandatory criteria), and at least two of the following criteria: stiffness after rest less than 30 minutes, crackle in the affected knee , joint increase of firm consistency, absence of temperature increase and painful hypersensitivity to palpation;

  * Individuals with radiographic signs of degeneration of the knee joint;
  * Individuals with any degree of degeneration according to the Kellgren-Lawrence scale;
  * Individuals with a pain scale above 3 according to NPRS;
  * Stiffness in the knee for at least 6 months prior to screening;
  * Stiffness during the beginning of activities;
  * Intermittent swelling;
  * Never have used KT;
  * Individuals with no history of associated joint disease or systemic rheumatic disease and / or history of surgery in the affected lower limb;
  * Individuals who are not under physiotherapeutic treatment during the intervention;
  * Individuals without neurological, vestibular, visual or auditory deficits that make evaluations impossible.

Exclusion Criteria:

* • Individuals who report pain during the procedure;

  * Individuals who do not complete the treatment time or who do not perform the evaluation procedures correctly, making it impossible to collect any of the data investigated;
  * Individuals with allergy to bandage or cutaneous injury in the region where KT will be applied;
  * Individuals who present hypertensive peak during the evaluations.

Answer: B