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Effectiveness of Adding Muscle Trigger Point Dry Needling to Physiotherapy Protocol on Pain, Active Range of Motion, and Functional Ability in Patients With Knee Osteoarthritis: A Single-Blind, Randomized, Parallel-Group, Clinical Trial Publisher Pubmed



Morshedlou M ; Daghiani M ; Negahban H ; Hosseini HA ; Bahramian M ; Ebrahimzadeh Bideskan S ; Ebrahimzadeh MH
Authors

Source: Physiotherapy Theory and Practice Published:2026


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. © 2025 Taylor & Francis Group, LLC.
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