Effects of Acupuncture-Combined Tuina on Patients With Knee Osteoarthritis: Protocol for a Randomized Controlled Trial.

Researchers are launching a study to determine whether combining acupuncture with Tuina (traditional Chinese therapeutic massage) works better than acupuncture alone for knee osteoarthritis. Knee osteoarthritis is a common degenerative joint condition that causes pain, stiffness, and difficulty moving, affecting millions of people and creating significant healthcare costs each year. While both acupuncture and Tuina are frequently used in traditional Chinese medicine to treat this condition, scientists want to understand if using them together provides additional benefits. The study will enroll 60 patients with knee osteoarthritis who will be randomly divided into two groups. One group will receive acupuncture combined with Tuina, while the other will receive acupuncture alone. Both groups will continue their standard medical care. The treatments will last for six weeks, followed by a 12-week follow-up period. Researchers will measure pain levels, walking ability, joint function, and muscle tension, and will also use advanced brain imaging to understand how these treatments work in the body. This is a protocol paper, meaning the study is being planned but hasn't started yet—results won't be available until 2027. If the combination treatment proves more effective, it could provide patients with knee osteoarthritis a more comprehensive treatment option that addresses pain and improves function. If you're considering acupuncture or Tuina for knee osteoarthritis, seek treatment from a licensed acupuncturist or qualified traditional Chinese medicine practitioner.

This protocol describes a single-center, parallel-group randomized controlled trial evaluating whether acupuncture-combined Tuina demonstrates superior efficacy to acupuncture monotherapy for knee osteoarthritis (KOA). The study will randomize 60 KOA patients into two groups (n=30 per group) receiving either acupuncture-combined Tuina or acupuncture alone over six weeks, with both groups continuing standard care. Primary outcome measures include VAS scores from the short-form McGill Pain Questionnaire, pain threshold, muscle tension, 10-meter walking test, and WOMAC scores. Secondary outcomes incorporate multimodal MRI to elucidate neuroimaging mechanisms. Assessments occur at baseline, post-treatment, and 12-week follow-up, conducted by blinded assessors with independent statistical analysis. The trial, funded August 2024, will run from December 2025 to May 2027. This study addresses a clinically relevant question regarding the additive therapeutic value of Tuina to acupuncture for KOA management, with neuroimaging providing mechanistic insights into treatment effects.