Discussion
pain, knee joint injuries, TCM, KOA
OSTEOARTHRITIS, SYNDROME, DYSFUNCTION
KOA, referred to as “Knee Arthralgia” in traditional Chinese medicine (TCM), falls under the category of “Bi syndrome” in TCM [Building on this foundation, we conducted a randomized, double-blind controlled trial involving LM. After a four-week treatment period, we observed significant improvements in pain symptoms in individuals with KOA, as indicated by the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) score (Furthermore, our research team conducted separate randomized, double-blind, and controlled clinical trials for moxibustion and LM. Both interventions led to a substantial improvement in the fastest walking time (46 m or 50 yards) for patients with KOA before and after treatment. Consequently, we posit that LM enhances the walking ability of patients with KOA by alleviating pain and enhancing cartilage health. Our primary research objective is to investigate whether LM can influence the shortest walking time. The current method for detecting the fastest walking time involves having patients walk 50 yards as fast as possible. However, this can lead to knee joint injuries, pain, and falls in patients, causing them to be reluctant to participate in the test and dropping out. In the early stages of our study, we decided to make the test safer and more reflective of the walking abilities of patients with KOA. As a result, we conducted the fastest walking time test over a shorter distance of 15 m in this study. This approach also revealed a correlation between the fastest walking time over a short distance and the pain and other symptoms experienced by patients with KOA, as indicated by previous studies [The primary factors contributing to reduced walking ability in these patients are pain, stiffness, and dysfunction in the knee joint. Therefore, the key to their treatment lies in reducing inflammatory pain, alleviating stiffness, and enhancing knee function. Our study demonstrated that in the LM group, the fastest 15-m walking time was significantly shorter at Week 4 and Week 12 compared to before treatment. In contrast, there were no significant differences in the fastest walking time before and after treatment or between Week 4 and Week 12 in the sham LM group. When comparing the two groups, it is evident that the LM group showed greater improvement in the fastest walking time compared to the sham LM group. This indicates that LM treatment effectively enhances the fastest walking time over 15 m in patients.On the other hand, sham LM did not result in any improvement in the fastest walking time. There were no significant differences observed before and after the end of treatment or at Week 4 and Week 12 in this group. These findings suggest that LM treatment has a lasting effect on KOA treatment, with improved walking ability persisting for at least 8 weeks after treatment completion. Future research could explore the specific duration of this efficacy through longer follow-up periods.Overall, the study results highlight the significance of the 15-m walking distance as a means to assess the walking abilities of patients with KOA. The fastest 15-m walking test not only enhances the efficiency of healthcare providers but also encourages greater patient compliance, reduces risks, and supports its broader adoption and clinical application. This research, however, is subject to several limitations. Beginning with the fact that the research was conducted in six separate sites with differing numbers of recruited participants in each, selection bias and conditional bias could be introduced. Furthermore, in TCM, acupoint selection is based on the concepts of syndrome classification, whereas in this therapy, we only used two fixed acupoints. Furthermore, although patients were instructed to keep a drug use diary, we cannot guarantee that this instruction was followed to the letter. Although we believe randomization can solve this problem by guaranteeing that both groups have an equal number of participants, our requirements might not be followed exactly. As a result, we plan to adopt tougher techniques for regulating fundamental drug usage of patients in future studies and to more closely link our methodologies with clinical practice.