Periosteal Electrical Dry Needling in Knee Osteoarthritis
Condition: Knee Osteoarthritis
MeSH terms: Osteoarthritis; Osteoarthritis, Knee
Study type: Interventional

Summary: 
      To determine the effect of periosteal electrical dry needling as an adjuvant to MWM in knee
      osteoarthritis for pain management, for improvement in functional activities and for ROM
      (Range Of Motion)
    

Detailed description: 
      Periosteal stimulation therapy (PST) or periosteal electroacupuncture applies direct
      electrical stimulation of the periosteum and its associated nerves using parsimoniously
      applied acupuncture needles over bony prominences. It is an aggressive local treatment for
      deep pain problems such as OA (osteoarthritis ) .

      Mobilization with movement (MWM) is a manual therapy technique that is used most frequently
      for the management of musculoskeletal conditions. In this technique, the physiological
      movement is performed in a pain-free manner with accessory glides being applied in the
      direction towards the opposite of the previously painful movement to have the greatest
      improvement MWMs has shown promising various therapeutic benefits such as reduction of pain
      and improved range of motion. Previous evidence has shown the effectiveness of MWM on pain
      reduction and functional improvement in patients with knee OA.

      The rationale for the use of PST in comparison with MWM techniques is to determine the
      effectiveness of periosteal electrical dry needling for the common use intervention for knee
      osteoarthritis.
    

Intervention name(s): MOBILIZATION with MOVEMENT; Periosteal electrical dry needling
Intervention type(s): Other; Other
Intervention description(s): They would be receiving conventional treatment as follow:
TENS (Transcutaneous electrical nerve stimulation) applied asymmetrical, biphasic waveform, pulse duration at 100 ms, intensity 10 percent below the motor threshold - 10 mins Hot Pack - 10 mins ULTRASOUND - 10 mins
Additionally, the would receive MWM techniques for Knee
Medial glide
Medial+ Internal rotation glide
Lateral Glide+ Internal Rotation glide
Anterior glide
Posterior glide; They would be receiving conventional treatment as follow:
TENS (asymmetrical, biphasic waveform, pulse duration at 100 ms, intensity 10 percent below the motor threshold) - 10 mins HOT PACK - 10 mins ULTRASOUND - 10 mins
Additionally, the would receive periosteal electrical dry needling 4 point technique for Knee
Four sterile, single-use 30-gauge dry needles would be inserted into the following locations of the symptomatic knee(s) until they touch bone:
Medial femoral condyle
Lateral femoral condyle
Flare of the tibia
Head of the fibula Needles would be stimulated with 100 Hz for 30 minutes. The intensity of the stimulus would be adjusted so that it would be clearly felt but would not cause discomfort. The stimulus intensity would be adjusted periodically so that it is perceptible for the entire 30 minutes of PST.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: Dry needling; Acupuncture; Mobilization with movement