The Effect of One Dry Needling Session on Pain and Central Pain Processing in Patients With Knee Osteoarthritis: a Randomized Controlled Trial
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Osteoarthritis, Knee
- Sponsor
- Universiteit Antwerpen
- Enrollment
- 61
- Primary Endpoint
- Pain pressure thresholds
- Status
- Completed
- Last Updated
- 5 years ago
Overview
Brief Summary
Research suggests that myofascial trigger points (MTrP) play an important role in explaining pain in patients with musculoskeletal knee disorders. Trigger points are usually defined as hypersensitive tender spots within taut bands of skeletal muscles that are painful on muscle stimulation and that usually elicit referred pain. Treatment of these trigger points could possibly alleviate symptoms in patients with knee pain. However, literature on the effect of trigger point therapy, dry needling in particular, in patients with musculoskeletal knee disorders is scarce. The purpose of this study is to examine the effect of trigger point therapy (dry needling (DN)) on pain, presence of altered central pain processing, muscle features and gait pattern in patients with knee osteoarthritis (KOA). 60 patients with symptomatic KOA will participate in this study. They will randomly be allocated in either an experimental group (EG) (dry needling technique) or a placebo group (PG) (sham needling technique). Pain (Visual analogue scale (VAS) & KOA outcome score (KOOS), muscle features during gait and gait pattern (3D gait analysis and surface electroMyoGraphy (EMG)) and presence of altered central pain processing (Central Sensitization Inventory (CSI), Quantitative Sensory testing (QST)) will be measured at baseline and 15 minutes after the intervention. Additionally, pain will be measured 3 days after the intervention. The investigators hypothesize that the effect on the outcome measures will be significantly larger in the EG compared to the PG.
Investigators
Sophie Vervullens
Doctoral Candidate
Universiteit Antwerpen
Eligibility Criteria
Inclusion Criteria
- •A minimum age of fifty years old;
- •Diagnosed with KOA based on the American College of Rheumatology (ACR) clinical classification criteria(48), including:
- •A Kellgren-Lawrence grade of minimum two on radiography;
- •At least three months of chronical knee pain.
Exclusion Criteria
- •Patients suffering from autoimmune and/or neurological disorders
- •Patients who had a major trauma/fracture of the lower limb in the past six months -
- •Patients who experienced other musculoskeletal problems than OA
Outcomes
Primary Outcomes
Pain pressure thresholds
Time Frame: Change from baseline central pain processing at 15minutes postintervention
Measured with an digital algometer (kilogram force/ square cm)
Conditioned pain modulation
Time Frame: Change from baseline central pain processing at 15minutes postintervention
Measured with an digital algometer (test stimulus) and an inflatable cuff (conditioning stimulus). (kilogram force/ square cm)
Pain sensation
Time Frame: Change from 15minutes postintervention pain sensation at 3days postintervention
Measured with the Knee Osteoarthritis Outcome Score- subscale pain, scored on a scale from 0 to 36, transferred from 0 to 100. Higher scores indicate a higher pain sensation.
Temporal summation
Time Frame: Change from baseline central pain processing at 15minutes postintervention
Measured with an digital algometer (kilogram force/ square cm)
Secondary Outcomes
- Muscle coactivation of musculus Vastus medialis and musculus Biceps femoris(Change from baseline muscle coactivation at 15minutes postintervention)
- Muscle coactivation of musculus Tibialis anterior and musculus Gastrocnemius medialis(Change from baseline muscle coactivation at 15minutes postintervention)
- Step time (meters/second)(Change from baseline muscle coactivation at 15minutes postintervention)
- Muscle coactivation of musculus Vastus medialis and musculus Semitendinosus(Change from baseline muscle coactivation at 15minutes postintervention)
- Step width (meters)(Change from baseline muscle coactivation at 15minutes postintervention)
- Muscle coactivation of musculus Vastus lateralis and musculus Semitendinosus(Change from baseline muscle coactivation at 15minutes postintervention)
- Muscle coactivation of musculus Vastus lateralis and musculus Biceps femoris(Change from baseline muscle coactivation at 15minutes postintervention)
- Muscle coactivation of musculus Tibialis anterior and musculus Gastrocnemius lateralis(Change from baseline muscle coactivation at 15minutes postintervention)
- Stride time (seconds)(Change from baseline muscle coactivation at 15minutes postintervention)
- Stride length (meters)(Change from baseline muscle coactivation at 15minutes postintervention)
- Step length (meters)(Change from baseline muscle coactivation at 15minutes postintervention)
- Stance phase (%)(Change from baseline muscle coactivation at 15minutes postintervention)