School of Health Sciences, Caritas Institute of Higher Education, Hong Kong, China.
Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China.
PLoS One. 2022 Sep 30;17(9):e0274990. doi: 10.1371/journal.pone.0274990. eCollection 2022.
To compare the effect of ultrasound (US)-guided dry needling (DN) with traditional DN in the treatment of pain and dysfunction for patients with knee osteoarthritis (KOA).
A double-blind, randomized controlled trial.
Patients (25 male and 65 female), age 50-80 years diagnosed with KOA were recruited and randomly assigned to one of three groups in a 1:1:1 ratio for intervention: real US-guided DN with exercise therapy (G1), placebo US-guided DN with exercise therapy (G2), and exercise therapy solely (G3). G1 and G2 were blinded to the application of real or placebo US guidance by turning the monitor of US imaging out-of-view from participants' vantage points. The effectiveness of blinding was evaluated by asking the participants whether they had received real-US guided DN. The responses were assessed by Chi-square test. Visual Analogue Scale (VAS), Knee injury, and Osteoarthritis Outcome Score (KOOS) subscales (KOOS-pain, KOOS-symptoms, KOOS-quality-of-life (QoL)) were collected at baseline, 4 weeks, and 8 weeks by a blinded assessor. Data were analyzed by mixed model analysis of variance (ANOVA) with Bonferroni correction.
Eighty-four participants (61.26±5.57 years) completed the study. G1 achieved significant improvement in VAS at 8 weeks compared to G2 and G3 (G1 vs. G2: MD = -15.61, 95% CI [-25.49, -5.51], p = 0.001; G1 vs. G3: MD = -19.90, 95% CI [-29.71, -10.08], p< 0.001). G1 achieved significant improvement in KOOS-pain at 8 weeks compared to G2 and G3 (G1 vs. G2: MD = 9.76, 95% CI [2.38, 17.14], p = 0.006; G1 vs. G3: MD = 9.48, 95% CI [2.31, 16.66], p = 0.010). KOOS-symptoms and KOOS-QoL were not statistically significant between groups. G2 had no significant difference of the perceptions as G1 with p = 0.128. G2 were successfully blinded to placebo US-guided DN.
US-guided DN with exercise therapy may be more effective than traditional DN with exercise therapy or exercise therapy alone in reduce pain of KOA.
比较超声（US）引导下干针（DN）与传统 DN 治疗膝骨关节炎（KOA）患者疼痛和功能障碍的效果。
双盲、随机对照试验。
招募年龄在 50-80 岁之间、被诊断为 KOA 的 25 名男性和 65 名女性患者，并按照 1:1:1 的比例随机分配至 3 个干预组之一：接受真 US 引导下 DN 联合运动疗法（G1）、假 US 引导下 DN 联合运动疗法（G2）或单纯运动疗法（G3）。G1 和 G2 通过将 US 成像监视器从参与者的有利位置转离视线，对参与者进行真或假 US 引导应用进行盲法。通过询问参与者他们是否接受了真 US 引导下 DN，评估盲法的有效性。采用卡方检验进行评估。通过盲法评估者在基线、4 周和 8 周时收集视觉模拟量表（VAS）、膝关节损伤和骨关节炎结果评分（KOOS）亚量表（KOOS-疼痛、KOOS-症状、KOOS-生活质量（QoL））。数据采用混合模型方差分析（ANOVA）进行分析，并进行 Bonferroni 校正。
84 名参与者（61.26±5.57 岁）完成了研究。与 G2 和 G3 相比，G1 在 8 周时 VAS 显著改善（G1 与 G2：MD=-15.61，95%CI[-25.49，-5.51]，p=0.001；G1 与 G3：MD=-19.90，95%CI[-29.71，-10.08]，p<0.001）。与 G2 和 G3 相比，G1 在 8 周时 KOOS-疼痛显著改善（G1 与 G2：MD=9.76，95%CI[2.38，17.14]，p=0.006；G1 与 G3：MD=9.48，95%CI[2.31，16.66]，p=0.010）。组间 KOOS-症状和 KOOS-QoL 无统计学差异。G2 与 G1 的感知无显著差异（p=0.128）。G2 成功对假 US 引导下 DN 进行了盲法。
与传统 DN 联合运动疗法或单纯运动疗法相比，US 引导下 DN 联合运动疗法可能更能有效减轻 KOA 的疼痛。
