Short term effectiveness of dry needling and instrument assisted soft tissue mobilization in knee osteoarthritis patients - a randomized controlled trial.

INTRODUCTION: Osteoarthritis (OA) is a chronic, progressive articular degenerative disease. It decreases quality of life, leads to pain, disability, and loss of function. The knee joint is more commonly affected, comprising 60-85% of all OA cases. Dry Needling (DN) and Instrument Assisted Soft Tissue Mobilization (IASTM) are widely used rehabilitation techniques for knee osteoarthritis (KOA). However, the comparative evidence regarding their applicability and effects in KOA remains limited. METHODS: Thirty-four participants (23 females, 11 males) with KOA were randomized into three groups: DN, IASTM, and a conventional treatment (CT). Treatment was given 3 days/week for 4 weeks, and follow-up was at the 6th week. Within- and between-group comparisons were done for pain, function, balance, muscle strength, and knee range of motion (ROM) variables. RESULTS: The mean age, height, weight, and body mass index (BMI) of the study participants were 55.71 ± 4.63 years, 1.62 ± 0.07 m, 63.75 ± 9.26 Kg and 23.10 ± 1.95 Kg/m2 respectively. Within-group comparisons showed that all interventions were effective in improving all the study variables at the 4th week. Knee pain (F = 28.44, p < 0.001), function (F = 24.45, p < 0.001), balance at the 6th week (F = 3.63, p = 0.038), and ROM (F = 22.13, p < 0.001) were significantly improved at the 4th week and 6th week, with DN showing maximum improvement followed by IASTM and CT. DISCUSSION: DN was superior and most effective for significant pain reduction, function, and ROM improvement in KOA, followed by IASTM and CT with large effect sizes, though not significantly seen for balance. IASTM was significantly better than CT for pain reduction and improvement in function. All interventions had comparable effects on knee muscle strength.