Effect of dose interval of periosteal and intraarticular electrical dry needling boosters on pain and disability in patients with knee osteoarthritis: a multi-center randomized clinical trial
Bibliographic record
Abstract
Background Periosteal and intraarticular electrical dry needling (PIEDN) has been found to reduce pain, stiffness, and disability in individuals with knee osteoarthritis (OA) in the short-term. Optimum dosing interval of PIEDN to maintain these improvements in the longer-term has yet to be determined.Objective Compare the longer-term effects (30 weeks) of three different dosing intervals of PIEDN boosters on pain, stiffness, and disability in individuals with knee OA, and to quantify the effect size of PIEDN as a stand-alone treatment.Methods Patients with knee OA (n = 586) received PIEDN (1–2 times per week) over 6 weeks. Patients were then randomized to receive a PIEDN booster session once every 4 weeks (n = 195), once every 8 weeks (n = 197), or no further treatment (n = 194) for the next 6 months. The primary outcome was the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index.Results Patients receiving PIEDN every 4 weeks experienced significantly greater improvements in disability (WOMAC: F = 33.060; p < .001) than those receiving PIEDN every 8 weeks, or those receiving no further treatment. Patients receiving PIEDN boosters every 4 weeks experienced significantly greater improvements in pain (NPRS: F = 25.678, p < .001; WOMAC-Pain: F = 22.816, p < .001), stiffness (WOMAC-Stiffness: F = 27.416, p < .001) and function (WOMAC-Physical Function: F = 32.856; p < .001). The between-group effect size was large (WOMAC: SMD = 1.32; 95% CI: 1.10, 1.54) at 30 weeks in favor of the group that received PIEDN every 4 weeks. The between-group effect size was large for the NPRS (SMD = 1.14; 95% CI: 0.93, 1.36) at 30 weeks for the PIEDN-4 group. At 30 weeks, significantly more patients in the PIEDN-4 group (n = 123, 63.1%) had completely stopped taking medication compared to the control group (X2 = 70.158; p < .001; n = 41, 21.1%).Conclusion PIEDN boosters every 4 weeks were a more effective dosage regimen for maintaining improvements in pain, stiffness, function, and disability than once every 8 weeks or no further treatment sessions.Trial Registration: www.clinicaltrials.gov XXXXXXX May 4, 2022.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".