Comparison of the effect of physiotherapy and physiotherapy with dry needling on pain, Range of motion, physical function, functional performance and the effectiveness of treatment in patients with primary knee osteoarthritis.

The effect of adding dry needle on trigger points to routine physiotherapy program on pain, range of motion, physical function, functional performance and effectiveness of treatment in patients with primary knee osteoarthritis.

Clinical trial with control group, parallel groups, blinded, randomized, on 28 patients.

People with primary osteoarthritis of the knee after evaluation are randomly divided into two groups: physiotherapy and physiotherapy with dry needling. Individual background information will be recorded. Individuals in both groups receive 12 session of treatment for 4 weeks. The place of intervention: Tehran, Gamino physiotherapy center Blinding: participants and outcome assessors

Inclusion criteria: Participants aged 40 years or older with knee pain and dysfunction, Diagnosis of primary knee osteoarthritis (Kellgren-Lawrence 1-3), At least one active or latent myofascial trigger point ipsilateral to the painful knee(s), pain of at least 2 on the NRS scale for more than 3 months. Exclusion criteria: Suffering from other conditions that could cause myofascial or neuropathic pain in the lower limb, Previous total replacement, Any other surgical procedure of the lower limbs in the previous 6 months, Myopathy or lumbo-sacral neuropathy, Physical therapy, acupuncture or other treatments for the painful knee in the last 6 months, Inflammatory joint disease such as rheumatoid arthritis, Serious trauma or systematic disease

Intervention group: Routine physiotherapy and dry needling Control group: Routine physiotherapy

Pain intensity on the NRS scale; Knee joint range of motion with goniometer; Physical function with WOMAC questionnaire; Functional performance with TUG test; The effectiveness of treatment with GROC scale

Block randomization using closed envelopes so that the number of samples, gender and unilateral or bilateral osteoarthritis are equal in two groups. The 4-volume random block allocation method will be used. All possible 4 permutations will be listed in two groups (permutations 1 to 6 are as follows) A is the intervention group and B is the control group: 1-AABB 2-ABAB 3-BAAB 4-BABA 5-BBAA 6-ABBA Then, from a random number table with a random starting point, 6 numbers between 1 and 6 will be randomly selected (either using software or randomaize.com). For example, if the 6 random numbers obtained are 3 5 4 3 4 6 , It will mean that the first four people similar to block 3, the second four people similar to block 5 and ... will be allocated.

This study will be performed in a double-blind manner and the blinding includes a physiotherapist who performs the pre- and post-treatment evaluation in addition to the person who analyzes the data.