Traditional Chinese acupuncture for mild to moderate knee osteoarthritis

ISRCTN ISRCTN14016893
DOI https://doi.org/10.1186/ISRCTN14016893
Secondary identifying numbers XMLX201607
Submission date
04/04/2016
Registration date
04/07/2016
Last edited
18/08/2023
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Musculoskeletal Diseases
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Background and study aims
Osteoarthritis (OA) is the most common type of arthritis and affects millions of people worldwide. It occurs when the protective cartilage on the end of bones wears away. The bones then rub against one another, causing stiffness, pain and a reduction in the range of movement. The knee is the most common joint to be affected by OA and in many sufferers, the pain prevents people from moving around leading to muscle weakness and disability. Acupuncture is a popular treatment taken from ancient Chinese medicine, in which fine needels are placed into the body at specific points. Studies have shown that it can help to stimulate nerves under the skin, causing the body to produce natural pain-relieving substances (endorphins). The aim of this study is to evaluate the effectiveness of acupuncture in reducing pain and improving function in patients with knee OA.

Who can participate?
Patients diagnosed with mild-moderate knee osteoarthritis.

What does the study involve?
Participants are randomly allocated to one of two groups. Those in the first group receive traditional Chinese acupuncture, which involves having needles placed in acupoints (locations on the body affected by acupuncture) which are stimulated manually for 10 seconds to create the intended sensation. Those in the second group receive minimal acupuncture, which involves having needles placed under the skin at non-acupoints very shallowly so that it does not cause the acupuncture sensation. Both groups receive 24, 20-minute sessions over eight weeks. Participants in both groups complete a number of questionnaires at the start of the study and then again after 8, 16 and 24 weeks to find out whether their pain levels have decreased and if their joint function has improved.

What are the possible benefits and risks of participating?
It is expected that participants will benefit from a decrease in pain and improved function. The risks of participation are minimal. Occasionally, acupuncture can make people feel nauseous or experience a temporary increase in pain either during or after treatment. Rare side effects during acupuncture treatment include fainting, infection and subcutaneous hematoma (pooling of blood under the skin). Participants are warned of these potential side-effects before consenting to have acupuncture.

Where is the study run from?
1. Beijing Hospital of Traditional Chinese Medicine affiliated to Capital Medical University (China)
2. Beijing Friendship Hospital Affiliated to Capital Medical University (China)
3. Beijing Ji Shui Tan Hospital (China)

When is the study starting and how long is it expected to run for?
December 2015 to December 2016

Who is funding the study?
Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support (China)

Who is the main contact?
Dr Cun-Zhi Liu
lcz623780@126.com

Contact information

Dr Cun-Zhi Liu
Scientific

Beijing Hospital of Traditional Chinese Medicine affiliated to Capital Medical University
23 Meishuguanhou Street
Dongcheng District
Beijing
100010
China

Study information

Study designTwo-arm randomized controlled pilot trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Hospital
Study typeTreatment
Participant information sheet No participant information sheet available
Scientific titleTraditional Chinese Acupuncture vs minimal acupuncture for mild to moderate Knee OsteoArthritis: a randomized controlled pilot trial
Study acronymCAKOA-I
Study objectivesAcupuncture at acupoints is more effective than minimal acupuncture in the treatment of mild-moderate knee osteoarthritis.
Ethics approval(s)Research Ethical Committee of Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University, 14/03/2016, ref: 2016BL-010-02
Health condition(s) or problem(s) studiedOsteoarthritis
InterventionParticipants are randomly allocated to one of two groups.

Intervention group: Participants are treated with Traditional Chinese Acupuncture for 8 weeks. Patients in Traditional Chinese Acupuncture group will be treated by use of 4-5 local acupuncture points from the following selection: ST34, ST35, ST 36, EX-LE2, EX-LE5, GB33, GB34, SP9, SP10, LV8 and Ahshi. Additionally, acupuncturists will select and needl 2-3 distant points from the following selection: GB31, GB36, GB39, GB41, ST40, ST41, LR3, BL60, SP6, KI3, LI4. Needles will be stimulated manually to achieve “De Qi” sensation for 10 seconds.

Control group: Participants are treated with minimal acupuncture for 8 weeks. Treatment in Minimal Acupuncture group will be performed at 6-8 non-acupuncture points. Needles will be placed at non-acupoints with a superficial puncture (2 mm in depth) to avoid “De Qi” and manual stimulation.

Both the Traditional Chinese Acupuncture and Minimal Acupuncture treatments consist of 24 sessions of 20 minutes duration, administered over 8 weeks (usually three sessions per week). Participants in both groups are followed up at the end of the intervention period (8 weeks), 16 weeks and 26 weeks.
Intervention typeProcedure/Surgery
Primary outcome measureResponse rate is determined using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) at baseline and 8 weeks.
Secondary outcome measures1. Pain is measured using WOMAC pain subscore at baseline, 8 weeks, 16 weeks and 26 weeks
2. Knee-joint function is measured using WOMAC functional subscore at baseline, 8 weeks, 16 weeks and 26 weeks
3. Number of emergency analgesics (Celebrex) used is recorded using Drug Use Form at 8 weeks, 16 weeks and 26 weeks
4. Quality of life is measured using the 12-Item Short Form Health Survey (SF-12) at baseline, 8 weeks, 16 weeks and 26 weeks
5. Adverse events are measured using Adverse Event Form at 8 weeks and 16 weeks
Overall study start date01/12/2015
Completion date30/12/2016

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit45 Years
Upper age limit75 Years
SexBoth
Target number of participants42
Key inclusion criteria1. Age between 45 and 75 years
2. Pain in single or double knee joints for at least 6 months
3. Kellgren–Lawrence grade II or III in the last 6 months
4. Morning stiffness at most 30 minutes
5. Signed informed consent
Key exclusion criteria1. Surgery of the afflicted extremity or waiting for surgery
2. Knee pain induced by other conditions (bone tumor, bone fracture, acute infection, gout, etc)
3. Serious organic or psychiatric diseases (epilepsy, depression, etc.)
4. Severe coagulopathy
5. Pregnant or breast-feeding
6. History of receiving acupuncture, physical therapy, rehabilitation, analgesia, anti-inflammatory medication or cartilage nutrition agent in the past week
7. Current gastrointestinal ulcer
8. Participation in another clinical study in the past three months
9. Inadequacy for this trial
Date of first enrolment30/04/2016
Date of final enrolment30/06/2016

Locations

Countries of recruitment

  • China

Study participating centres

Beijing Hospital of Traditional Chinese Medicine
23 Meishuguanhou Street
Dongcheng District
Beijing
100010
China
Beijing Friendship Hospital
36 Yong'an Road
Xicheng District
Beijing
100050
China
Beijing Ji Shui Tan Hospital
31 Xinjiekou E Road
Xicheng District
Beijing
100000
China

Sponsor information

Beijing Municipal Administration of Hospitals
Government

70 Zaolin Front Street
Xicheng District
Beijing
100035
China

ROR logo "ROR" https://ror.org/04baakq55

Funders

Funder type

Government

Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support (code: XMLX201607)

No information available

Results and Publications

Intention to publish date31/03/2017
Individual participant data (IPD) Intention to shareYes
IPD sharing plan summaryAvailable on request
Publication and dissemination planPlanned publication in a peer reviewed journal.
IPD sharing planThe datasets generated during and/or analysed during the current study are/will be available upon request from Cun-Zhi Liu at lcz623780@126.com.

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Basic results 20/12/2017 06/02/2018 No No
Protocol article 13/12/2016 18/08/2023 Yes No

Additional files

ISRCTN14016893_BasicResults_20Dec17.pdf
Uploaded 06/02/2018

Editorial Notes

18/08/2023: Publication reference added.
06/02/2018: The participant level data-sharing statement has been added. The basic results of this trial have been uploaded as an additional file.