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- Title
Self-Administered Acupressure for Probable Knee Osteoarthritis in Middle-Aged and Older Adults: A Randomized Clinical Trial.
- Authors
Yeung, Wing-Fai; Chen, Shu-Cheng; Cheung, Denise Shuk Ting; Wong, Carlos King-Ho; Chong, Tsz Chung; Ho, Yuen Shan; Suen, Lorna Kwai Ping; Ho, Lai Ming; Lao, Lixing
- Abstract
Key Points: Question: Is a self-administered acupressure (SAA) training program effective for relieving pain in patients with probable knee osteoarthritis (OA)? Findings: In this randomized clinical trial of 314 middle-aged and older adults, the SAA group had a significantly greater improvement in the numerical rating scale pain score than the knee health education group over 12 weeks. A cost-effectiveness acceptability curve demonstrated a greater than 90% probability of SAA being cost-effective at a willingness to pay threshold of 1 GDP per capita. Meaning: These findings suggest that the implementation of an SAA training program is an efficacious and cost-effective approach to relieve knee pain in middle-aged and older adults with probable knee OA. This randomized clinical trial evaluates the effectiveness of self-administered acupressure on reducing knee osteoarthritis (OA) pain among middle-aged and older adults. Importance: The effects of self-administered acupressure (SAA) on knee osteoarthritis (OA) pain remain unclear. Objective: To evaluate the effectiveness of SAA taught via a short training course on reducing knee OA pain in middle-aged and older adults. Design, Setting, and Participants: This randomized clinical trial was conducted among community-dwelling individuals in Hong Kong who were aged 50 years or older with probable knee OA from September 2019 to May 2022. Interventions: The intervention included 2 training sessions for SAA with a brief knee health education (KHE) session, in which participants practiced acupressure twice daily for 12 weeks. The control group (KHE only) received only education about maintaining knee health on the same schedule and duration. Main Outcomes and Measures: The primary outcome was the numerical rating scale (NRS) pain score at 12 weeks. Other outcomes included Western Ontario and McMaster University Osteoarthritis Index, Short Form 6 Dimensions (SF-6D), Timed Up and Go, and Fast Gait Speed tests. Results: A total of 314 participants (mean [SD] age, 62.7 [4.5] years; 246 [78.3%] female; mean [SD] knee pain duration, 7.3 [7.6] years) were randomized into intervention and KHE-only groups (each 157). At week 12, compared with the KHE-only group, the intervention group had a significantly greater reduction in NRS pain score (mean difference [MD], −0.54 points; 95% CI, −0.97 to −0.10 points; P =.02) and higher enhancement in SF-6D utility score (MD, 0.03 points; 95% CI, 0.003 to 0.01 points; P =.03) but did not have significant differences in other outcome measures. The cost-effectiveness acceptability curve demonstrated a greater than 90% probability that the intervention is cost-effective at a willingness to pay threshold of 1 GDP per capita. Conclusions and Relevance: In this randomized clinical trial, SAA with a brief KHE program was efficacious and cost-effective in relieving knee pain and improving mobility in middle-aged and older adults with probable knee OA. Trial Registration: ClinicalTrials.gov Identifier: NCT04191837
- Subjects
HONG Kong (China); KNEE osteoarthritis; KNEE pain; QUALITY-adjusted life years; INDEPENDENT living; COST effectiveness; T-test (Statistics); RESEARCH funding; STATISTICAL sampling; TREATMENT effectiveness; RANDOMIZED controlled trials; CHI-squared test; DESCRIPTIVE statistics; ACUPRESSURE; PAIN management; ACUPUNCTURE points; QUALITY of life; HEALTH education; CONFIDENCE intervals; DATA analysis software; COMPARATIVE studies; PHYSICAL mobility; MIDDLE age; OLD age
- Publication
JAMA Network Open, 2024, Vol 7, Issue 4, pe245830
- ISSN
2574-3805
- Publication type
Article
- DOI
10.1001/jamanetworkopen.2024.5830