Dry Needling Versus Conventional Physical Therapy in Patients With Knee Osteoarthritis

Study Overview
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Brief Summary
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The purpose of this research is to compare the effectiveness of conventional physical therapy (manual physical therapy, exercise, range of motion, and stretching) versus conventional physical therapy combined with dry needling in patients with knee osteoarthritis (OA). Physical therapists commonly use conventional physical therapy techniques and dry needling to treat knee OA, and this study is attempting to find out if the addition of dry needling to conventional physical therapy has an equal, greater, or lesser effect than conventional physical therapy alone.

Detailed Description
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Patients with knee OA will be randomized to receive 1-2 treatments per week for 6 weeks (up to 10 sessions total) of either: (1) Dry Needling and conventional physical therapy or the (2) Conventional physical therapy (manual physical therapy, exercise, range of motion and stretching)

Official Title
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Dry Needling Versus Conventional Physical Therapy in Patients With Knee Osteoarthritis: a Multi-center Randomized Clinical Trial

Conditions
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Knee Osteoarthritis

Intervention / Treatment
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* Other: Dry Needling, Conventional PT
* Other: Conventional PT


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Report of knee pain of at least 2/10 per NPRS (0---10 scale) for >3 months Report of at least 3 of the following per Altman et al. (1986) Over 50 Years of age Less than 30 minutes of morning stiffness Crepitus on active motion Bony tenderness Bony enlargement No palpable warmth of synovium Exclusion Criteria: Report of red flags to manual physical therapy to include: hypertension, infection, diabetes, peripheral neuropathy, heart disease, stroke, chronic ischemia, edema, severe varicosities, tumor, metabolic disease, prolonged steroid use, fracture, RA, osteoporosis, severe vascular disease, malignancy, etc. History of previous surgery to the knee History of physical therapy, massage therapy, chiropractic treatment, or injections for knee pain in the last 4 weeks History of a surgical procedure on either lower extremity in last 6 months Two or more positive neurologic signs consistent with nerve root compression, including any two of the following: Weakness involving a major muscle group of the lower extremity. Diminished patella or achilles tendon reflex Diminished or absent sensation to pinprick in lower extremity dermatome Involvement in litigation or worker's compensation regarding knee pain. Any condition that might contraindicate the use of electro-needling The patient is pregnant.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Dry Needling, Conventional PT<br> | Other: Dry Needling, Conventional PT<br>* Dry needling to the knee and conventional physical therapy (stretching, ROM, strengthening), 1-2 treatments per week X6 weeks (up to 10 sessions total)<br>|
| Active Comparator: Conventional PT<br> | Other: Conventional PT<br>* Conventional physical therapy to include knee stretching, range of motion, and strengthening exercises,1-2 treatments per week X6 weeks (up to 10 sessions total)<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Knee Pain Intensity (NPRS) |  | Baseline, 2 Weeks, 6 Weeks, 3 Months | 
| Change in Knee Osteoarthritis Index (Pain) | 5 Questions each worth 0-4 points with a maximum score of 20 points possible | Baseline, 2 Weeks, 6 Weeks, 3 Months | 
| Change in Knee Osteoarthritis Index (Stiffness) | 2 Questions each worth 0-4 points with a maximum score of 8 points possible | Baseline, 2 Weeks, 6 Weeks, 3 Months | 
| Change in Knee Osteoarthritis Index (Physical Function) | 17 Questions each worth 0-4 points with a maximum score of 68 points possible | Baseline, 2 Weeks, 6 Weeks, 3 Months | 
| Change in Knee Osteoarthritis Index (Total) | 24 Questions each worth 0-4 points with a maximum score of 96 points possible | Baseline, 2 Weeks, 6 Weeks, 3 Months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Global Rating of Change Score (GROC) |  | 2 Weeks, 6 Weeks, 3 Months | 
| Change in Medicine Intake (Frequency of medication intake) | Frequency of medication intake (narcotics and over-the-counter) for knee pain | Baseline, 3 months |