Self-Administered Acupressure for Probable Knee Osteoarthritis in Middle-Aged and Older Adults

Author:

Yeung Wing-Fai123,Chen Shu-Cheng1,Cheung Denise Shuk Ting4,Wong Carlos King-Ho5678,Chong Tsz Chung9,Ho Yuen Shan1,Suen Lorna Kwai Ping10,Ho Lai Ming11,Lao Lixing12

Affiliation:

1. School of Nursing, the Hong Kong Polytechnic University, Hong Kong SAR, China

2. Research Center for Chinese Medicine Innovation, The Hong Kong Polytechnic University, Hong Kong SAR, China

3. Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hong Kong SAR, China

4. School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China

5. Laboratory of Data Discovery for Health (D24H), Hong Kong SAR, China

6. Department of Family Medicine and Primary Care, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China

7. Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China

8. Department of Infectious Disease Epidemiology & Dynamics, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom

9. Sports Med Asia, Hong Kong, Hong Kong SAR, China

10. School of Nursing, Tung Wah College, Hong Kong, China

11. School of Public Health, The University of Hong Kong, Hong Kong SAR, China

12. Virginia University of Integrative Medicine, Vienna, Virginia

Abstract

ImportanceThe effects of self-administered acupressure (SAA) on knee osteoarthritis (OA) pain remain unclear.ObjectiveTo 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 ParticipantsThis 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.InterventionsThe 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 MeasuresThe 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.ResultsA 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 RelevanceIn 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 RegistrationClinicalTrials.gov Identifier: NCT04191837

Publisher

American Medical Association (AMA)

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