Combined Effect of Laser Acupuncture and Electroacupuncture in Knee Osteoarthritis Patients

Combined Effect of Laser Acupuncture and Electroacupuncture in Knee Osteoarthritis Patients: a Protocol for a Randomized Controlled Trial

Background:

Knee osteoarthritis (KOA) is a common degenerative joint disorder affected 250 million people globally. It can not only result in disability, but also associated with cardiovascular disease and mortality. The most common treatment for KOA is non-steroidal anti-inflammatory drug. However, the effect of analgesic is limited and may complicate with side effect. Hence, many patients search for complementary and alternative medicine. Acupuncture is one of the most popular complementary treatment with good analgesic effect and less side effect. Electroacupuncture (EA) or laser acupuncture (LA) was reported effective in pain control in knee osteoarthritis patients. However, there is no study about combination effect of EA and LA.

Methods:

This protocol is a randomized controlled trial investigating the combination effect of EA and LA on KOA. Fifty participants diagnosed KOA with aged more than 50 years old and knee pain more than 3 months were recruited and randomly assigned to the experimental group (EA plus LA) or sham group (EA plus LA without laser output) in clinical research center. The subjects will undergo EA plus LA treatment thrice a weeks for 4 weeks. The experimental group will receive acupuncture at GB33, GB34, SP9, SP10, and ST36 with transcutaneous electrical nerve stimulator on the GB34+33 and SP9+10., and the LA deliver 6 Joule of energy at EX-LE5, ST35, and BL40. The subjects in sham group will receive the same way but the LA is without any laser output. Outcome measurement will include visual analogue scale (VAS), Western Ontario McMaster Universities Osteoarthritis Index (WOMAC), Knee injury and osteoarthritis outcome (KOOS), body composition analysis, knee range of motion test, muscle stiffness test, standing on one foot test, and the 30-second chair stand test before intervention and after 4 weeks intervention. The result will be analyze and compared between the experimental group and sham group using the paired t test and one-way analysis of variance.

Objectives:

The aim of this protocol is to investigate the combination effect of EA and LA in KOA patients.

Inclusion Criteria:

• VAS more than 3 point when daily activity
• Kellgren-Lawrence Grading Scale grade 1 to 3 on knee X-ray
• Provided informed consent

Exclusion Criteria:

• History of knee arthroplasty, traumatic injury related joint deformity,
• Body mass index more than 35
• pacemaker insertion, photosensitivity
• who had undergone intra-articular injection or acupuncture in recent one month
• other factors that may affect the evaluation of the outcome, such as psychiatric disorder or moderate mental retardation etc.