Is a Combination of Exercise and Dry Needling Effective for Knee OA?

OBJECTIVE: To assess the effectiveness of adding dry needling (DN) to an exercise program on pain intensity and disability in patients with knee osteoarthritis. DESIGN: Double-blind randomized clinical trial with one-year follow-up. SETTING: Older adults in a multicenter study. SUBJECTS: Sixty-two patients with knee osteoarthritis were randomly allocated into one of two groups: exercise plus DN (exercise + DN; N = 31) or exercise plus sham DN (exercise + sham DN; N = 31). METHODS: Participants received six sessions of either DN or sham DN over the leg muscles related to knee pain from osteoarthritis plus a supervised exercise program. We evaluated between-group differences in terms of the numerical pain rating scale (NPRS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score. We used the EuroQol Group 5-Dimension Self-Report Questionnaire, Barthel Index, Timed Up & Go Test, and Global Rating of Change Scale to examine between-group differences for health-related quality of life, functional status evaluation, balance assessment, and clinical progress, respectively. RESULTS: The groups were not different in terms of pain intensity (0.32 points, 95% confidence interval [CI] = -1.12 to 1.18, P = 0.92) or WOMAC score (0.29 points, 95% CI = -6.16 to 6.74, P = 0.92) at one year. Both groups presented within-group differences at all follow-up periods (F = 28.349, P < 0.0001, ηp2 = 0.32) on secondary outcomes. Nevertheless, 90.3% of the DN group had reduced medication consumption vs only 26.3% in the sham DN group. CONCLUSIONS: The inclusion of DN to an exercise program does not reduce pain or disability in patients with knee osteoarthritis.

Effects of dry needling in an exercise program for older adults with knee osteoarthritis: A pilot clinical trial.

BACKGROUND: Few studies have investigated the dry needling (DN) approach on knee osteoarthritis (KO) patients. The study's aim was to evaluate the short-term efficacy of adding DN to a therapeutic exercise protocol in the treatment of KO in older adults. METHODS: A double-blind, pilot clinical trial with parallel groups [NCT02698072] was carried out for 12 weeks of treatment and follow-up. Twenty patients aged 65 years and older with myofascial trigger points (MTrPs) in the muscles of the thigh were recruited from older-adult care centers and randomly assigned to a DN + Exercise group or a Sham-DN + Exercise group. The Numeric Rating Scale (NRS; primary outcome) and Western Ontario and McMaster Universities Osteoarthritis Index questionnaire (WOMAC) were assessed before and after the intervention. RESULTS: The NRS (analysis of variance, ANOVA) showed statistically significant differences in the time factor (F = 53.038; P < .0001; ηp = 0.747). However, it did not show a significant change in the group-time interaction (F = 0.082; P = .777; ηp = 0.005). The WOMAC scores (ANOVA) showed statistically significant differences in the time factor for total score WOMAC questionnaire (F = 84.826; P < .0001; ηp = 0.825), WOMAC pain (F = 90.478; P < .0001; ηp = 0.834), WOMAC stiffness (F = 14.556; P < .001; ηp = 0.447), and WOMAC function (F = 70.872; P < .0001; ηp = 0.797). However, it did not show a statistically significant change in the group-time interaction. CONCLUSION: Despite the pain intensity and disability clinically relevant improvement for both DN and Sham-DN combined with exercise, 6 sessions of DN added to a therapeutic exercise program for older adults with KO did not seem to improve pain intensity and functionality.