Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, University King Juan Carlos, Alcorcón, Spain.
American Academy of Manipulative Therapy Fellowship in Orthopaedic Manual Physical Therapy, Montgomery, AL.
Clin J Pain. 2018 Dec;34(12):1149-1158. doi: 10.1097/AJP.0000000000000634.
To compare the effects of adding electrical dry needling into a manual therapy (MT) and exercise program on pain, stiffness, function, and disability in individuals with painful knee osteoarthritis (OA).
In total, 242 participants (n=242) with painful knee OA were randomized to receive 6 weeks of electrical dry needling, MT, and exercise (n=121) or MT and exercise (n=121). The primary outcome was related-disability as assessed by the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index at 3 months.
Individuals receiving the combination of electrical dry needling, MT, and exercise experienced significantly greater improvements in related-disability (WOMAC: F=35.504; P<0.001) than those receiving MT and exercise alone at 6 weeks and 3 months. Patients receiving electrical dry needling were 1.7 times more likely to have completely stopped taking medication for their pain at 3 months than individuals receiving MT and exercise (OR, 1.6; 95% confidence interval, 1.24-2.01; P=0.001). On the basis of the cutoff score of ≥5 on the global rating of change, significantly (χ=14.887; P<0.001) more patients (n=91, 75%) within the dry needling group achieved a successful outcome compared with the MT and exercise group (n=22, 18%) at 3 months. Effect sizes were large (standardized mean differences >0.82) for all outcome measures in favor of the electrical dry needling group at 3 months.
The inclusion of electrical dry needling into a MT and exercise program was more effective for improving pain, function, and related-disability than the application of MT and exercise alone in individuals with painful knee OA.
Level 1b-therapy. Prospectively registered February 10, 2015 on www.clinicaltrials.gov (NCT02373631).
比较在手动治疗（MT）和运动方案中添加电干针疗法对膝骨关节炎（OA）疼痛、僵硬、功能和残疾患者的影响。
共有 242 名膝关节疼痛 OA 患者（n=242）被随机分为接受 6 周电干针治疗、MT 和运动（n=121）或 MT 和运动（n=121）的组。主要结局为 3 个月时用 Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index 评估的相关残疾。
接受电干针、MT 和运动联合治疗的患者在 6 周和 3 个月时在相关残疾（WOMAC：F=35.504；P<0.001）方面的改善明显优于仅接受 MT 和运动的患者。接受电干针治疗的患者在 3 个月时完全停止服用疼痛药物的可能性是接受 MT 和运动的患者的 1.7 倍（OR，1.6；95%置信区间，1.24-2.01；P=0.001）。根据变化总体评分≥5 的截止值，在 3 个月时，干针组（n=91，75%）显著（χ=14.887；P<0.001）更多患者（n=22，18%）达到成功结局，而 MT 和运动组。在 3 个月时，电干针组所有结局测量的效应大小均较大（标准化均数差异>0.82）。
在 MT 和运动方案中添加电干针疗法比单独应用 MT 和运动疗法更能有效改善膝关节 OA 疼痛、功能和相关残疾。
1b-治疗。2015 年 2 月 10 日在 www.clinicaltrials.gov（NCT02373631）前瞻性注册。
