Physiother Theory Pract. 2025 Nov 25:1-15. doi: 10.1080/09593985.2025.2589275. Online ahead of print.

ABSTRACT

BACKGROUND: Knee Osteoarthritis (KOA) is one of the most common types of arthritis, and Physiotherapy (PT) is a standard noninvasive treatment for KOA.

OBJECTIVE: To compare the effectiveness of adding Muscle Trigger Point Dry Needling (MTrP-DN) to Physiotherapy (PT) protocol including exercise and physical modalities protocol for improving pain, range of motion (ROM), and functional ability in KOA patients.

METHODS: Forty patients with KOA were randomly assigned to either a PT (N = 20) or PT plus MTrP-DN group (N = 20). Both groups received 12 sessions of exercise with physical modalities, with the MTrP-DN group additionally receiving DN. Pain (Numerical Pain Rating Scale – NPRS), active knee flexion and extension ROM (goniometer), functional ability (Western Ontario and McMaster Universities Osteoarthritis Index – WOMAC, Timed Up and Go test – TUG), and treatment effectiveness (Global Rating of Change – GROC) were assessed at baseline, week 4, and at 3-month follow-up.

RESULTS: The PT plus MTrP-DN group showed statistically significant improvements compared to the PT group for NPRS (-1.96, d: 1.59, p < .001), active flexion ROM (-13.53, d: -1.44, p < .001), WOMAC (-11.86, d: -0.99, p = .007), TUG (2.01, d: 1.01, p = .009), and GROC (p = .04). Between-group effects were large for pain and flexion and medium for TUG and WOMAC (Hedges’ g up to ≈1.6). No significant between-group difference was found in active knee extension ROM (p > .05).

CONCLUSION: The addition of MTrP-DN to PT protocol resulted in superior improvements in pain, ROM, and functional ability in KOA patients compared to physiotherapy.

TRIAL REGISTRATION: This trial was registered with IR.MUMS.FHMPM.REC.1401.002.

PMID:41289332 | DOI:10.1080/09593985.2025.2589275