Effect Of Acupuncture At Myofascial Trigger Point Nodule On Patients With Knee Osteoarthritis

Objective Knee osteoarthritis is a common chronic joint disease,which is related to functional limitation and pain.In patients with knee osteoarthritis(KOA),trigger points is lower limb muscles may be a common source of pain.Objective to explore the effect of acupuncture myofascial trigger points on the recovery of pain and dysfunction in patients with knee osteoarthritis,and to provide a new idea for the treatment of knee osteoarthritis,And find the best treatment.MethodsFrom June 2020 to December 2020,60 patients who met the inclusion criteria and the diagnostic criteria of knee osteoarthritis were selected from the orthopedic clinic of Shanghai Hudong hospital and the pain clinic of East China Hospital Affiliated to Fudan University.They were randomly divided into acupuncture group(treatment group)and sham acupuncture group(control group),30 cases in each group.For 6 weeks,the patient received acupuncture and sham acupuncture treatment of quadriceps femoris related to knee pain caused by knee osteoarthritis,and received static stretching and self stretching exercise plan.During the treatment,we should pay attention to reasonable rest and avoid physical load activities.In our study,visual analogue scale(VAS)and Western Ontario and Mc Master University Osteoarthritis Index(WOMAC)were used to assess differences between groups.We used the Lequesne knee score index and the European five digit health scale(eq-5d-5l)self-report questionnaire to evaluate the improvement of knee pain and function,physical function and quality of life.We used needle electromyography to examine whether the myofascial trigger point of lower limb muscle was inactivated and whether the spontaneous potential was decreased.The data were analyzed by spss22.0 statistical software,and all data were expressed in the form of mean ± standard deviation.Results1.Pain indexVAS pain score comparison: intra group comparison: the VAS score of the acupuncture group after one week,three weeks,six weeks and one month of treatment was significantly lower than that before treatment(P < 0.05);the VAS score of the sham acupuncture group after three weeks,six weeks and one month of treatment was significantly lower than that before treatment(P < 0.05).Comparison between groups:the VAS score of the acupuncture group was significantly lower than that of the sham acupuncture group after six weeks and one month follow-up,and there was no significant change in the two groups after one week and three weeks.2.Functional recovery indexWOMAC score comparison: intra group comparison: in the acupuncture group,the WOMAC total score and each total score were significantly lower than those before treatment in the course of six weeks intervention and one month follow-up(P < 0.05);in the sham acupuncture group,except WOMAC stiffness in three weeks(P > 0.05),other changes were consistent with those in the acupuncture group,which were significantly lower than those in the three weeks,six weeks and one month follow-up Before treatment(P < 0.05).Comparison between groups: except for WOMAC stiffness,there was no significant difference between the two groups,the other scores in the acupuncture group were significantly lower than those in the sham acupuncture group after six weeks and one month of follow-up(P < 0.05).3.Severity of knee arthritisLequesne knee score index: intra group comparison: in the acupuncture group,the scores decreased significantly three and six weeks after treatment(P < 0.05).In the sham acupuncture group,it decreased significantly after six weeks(P < 0.05).Comparison between groups: the acupuncture group was significantly lower than the sham acupuncture group six weeks after treatment.4.health related quality of life:The score of EQ-5D health-related quality of life was compared: the difference between the two groups was statistically significant(P < 0.05),while that of sham acupuncture group was not significantly changed in three weeks and six weeks(P > 0.05).The comparison between the groups: the acupuncture group was significantly lower than that of the sham acupuncture group six weeks after treatment(P < 0.05).5.Inactivation index of trigger pointThe results of EMG showed that the amplitude of spontaneous potential in the acupuncture group after six weeks of treatment was significantly lower than that before treatment,the occurrence of spontaneous potential was significantly better than that before treatment,and the time limit was significantly shorter than that before treatment(P < 0.05).In the sham acupuncture group,there was no significant change in the indexes of acupuncture electromyography.Comparison between groups: after treatment,the appearance,amplitude and duration of spontaneous potential in the acupuncture group were significantly lower than those in the sham acupuncture group(P < 0.05).Conclusion1.Acupuncture at myofascial trigger point nodule has good clinical effect on knee osteoarthritis,which can relieve knee pain and stiffness symptoms,improve daily activity and quality of life,and has no obvious adverse reactions.Short term follow-up effect is good,which is worthy of further promotion in clinical practice.2.Inactivation of trigger point nodule by acupuncture can improve the dysfunction of knee osteoarthritis,and relieve quadriceps spasm by reducing the muscle tension around the joint,so as to improve dyskinesia.3.The decrease of spontaneous potential and the decrease of potential amplitude recorded by needle electromyography at the trigger point indicate that the trigger point has been effectively inactivated,so as to reduce the referred pain caused by the compression of the trigger point nodule,so as to improve the pain of knee arthritis.