Motor Cortex Plasticity and the Effect of Deep Intramuscular Needling Stimulation Therapy (DIMST) in Osteoarthritis Pain
Knee Osteoarthritis, Chronic Pain
About this trial
This is an interventional treatment trial for Knee Osteoarthritis focused on measuring Osteoarthritis, Electro acupuncture, Deep intramuscular stimulation, Transcranial Magnetic Stimulation, Pain pressure threshold, Conditioned pain modulation, Clinical trial
Eligibility Criteria
Inclusion Criteria:
- Women with over 18 years old, with chronic pain because of primary osteoarthritis of the knee.
- Pain stable for at least three months. Score greater than or equal to 3 cm (0 cm = "no pain" and "worst possible pain" = 10cm) on VAS for pain perception at baseline.
- No contraindications to electro acupuncture or transcranial magnetic stimulation.
- Naive in acupuncture treatment.
Exclusion Criteria:
- Clinically significant or unstable disorder, medical or psychiatric.
- Presence of neurological or rheumatic comorbidity.
- Pregnancy.
- Having performed surgery in the knee to be treated in the last 6 months, or be planning surgery for the next semester.
- Having performed with corticosteroid infiltration in the last six weeks or are using this.
- Having performed with hyaluronic acid infiltration.
Sites / Locations
- Hospital de Clínicas de Porto Alegre.
Arms of the Study
Arm 1
Arm 2
Experimental
Sham Comparator
DIMST
Placebo-sham
The investigators used acupuncture needles with guide tubes (Suzhou Huanqiu Acupuncture Medical Appliance Co. Ltd., 218, China) that were 40 mm in length and 0.25 mm in diameter. The needling in DIMST was applied using an electro acupuncture device (Cosmotron, São Paulo, Brazil) in the dermatomes corresponding to the nerve roots involved in the knee (L1, L2, L3, L4, L5, S1, and S2). DIMST using was administered maintaining a distance from the spinous process line of 2 cm. The anatomic sites of peripheral DIMST were the muscles vastus medialis, rectus femoris, vastus lateralis, tibialis anterior; and the pes anserinus bursae. All subjects received one 30min session using a frequency of 2 Hz.
The investigators used the same electro acupuncture device (Cosmotron, Sao Paulo, Brazil), which was previously set to prevent the current to pass through the electrodes. Subjects were informed that it would be a stimulus of low intensity and high frequency that they probably would not have any sense of it. The electrodes were placed on the same points where the active stimulation was applied while the nerve stimulation unit was left in front of the subject, for 30 minutes. This positioning ensured that the intermittent diode simulating the electrical stimulus was visible and audible.