Comparative Effects of Dry Needling and Kinesio Taping as Adjuncts to Strength Training on Pain, Functional Mobility, and Quality of Life in Patients with Knee Osteoarthritis: A Three-Arm Randomized Controlled Trial

Enhancing Pain Relief, Functional Mobility, and Health-Related Quality of Life in Knee Osteoarthritis

Authors

  • Hifza Imtiaz Ahmed Mukabbir University of Science and Technology, Gujrat
  • Zainab Azhar Mukabbir University of Science and Technology, Gujrat
  • Mahnoor Mahmood Akhtar University of Sargodha, Sargodha
  • Aleeza Akhtar Physio Care Center, Gujrat
  • Wafa Zainab Physio Care Center, Gujrat
  • Zainab Gulshad Physio Care Center, Gujrat

Keywords:

Athletic Tape, Dry Needling, Knee, Osteoarthritis, Quality of Life, Resistance Training

Abstract

Background: Knee osteoarthritis (OA) is the most prevalent form of OA contributing to around 60% of all the cases globally. Strength training is the recommended first-line non-drug treatment, but evidence comparing it with adjunctive therapies such as dry needling and Kinesio taping is yet to be explored.

Methods: This study was a single-masked, three-arm RCT conducted at the Physio Care Center, Gujrat, from November 2024 to December 2025. Fifty participants aged 45 to 65 with knee OA and a Visual Analog Scale pain score ≥7 were randomly assigned to one of three groups: dry needling plus strength training (n=17), Kinesio taping plus strength training (n=17), or strength training alone (n=16), all conducted three times weekly for six weeks. Pain, mobility, and quality of life were assessed at baseline and week 6 by a blinded assessor.

Results: All groups showed significant improvements (p<0.001). One-way ANOVA revealed significant differences among groups for pain (p=0.010), mobility (p=0.003), and quality of life (p<0.001). Dry needling plus strength training resulted in significantly greater improvements than strength training alone (p≤0.006), whereas Kinesio taping showed no significant advantage over strength training alone.

Conclusion: Adding dry needling to strength training yields significantly greater short-term gains in pain, mobility, and quality of life than strength training alone in knee osteoarthritis, whereas the added benefit of Kinesio taping is smaller and less certain. Larger, sham-controlled, multicenter trials with longer follow-up are warranted.

Author Biographies

Hifza Imtiaz Ahmed, Mukabbir University of Science and Technology, Gujrat

Lecturer

Zainab Azhar , Mukabbir University of Science and Technology, Gujrat

Demonstrator

Mahnoor Mahmood Akhtar, University of Sargodha, Sargodha

Physiotherapist

Aleeza Akhtar, Physio Care Center, Gujrat

Physiotherapist

Wafa Zainab, Physio Care Center, Gujrat

Physiotherapist

Zainab Gulshad , Physio Care Center, Gujrat

Physiotherapist

References

Long H, Liu Q, Yin H, Wang K, Diao N, Zhang Y, Lin J, Guo A. Prevalence trends of site-specific osteoarthritis from 1990 to 2019: findings from the global burden of disease study 2019. Arthritis & Rheumatology. 2022 Jul;74(7):1172-83. doi: https://doi.org/10.1002/art.42089

Sharma L. Osteoarthritis of the knee. New England Journal of Medicine. 2021 Jan 7;384(1):51-9. doi: https://doi.org/10.1056/NEJMcp1903768

Øiestad BE, Årøen A, Røtterud JH, Østerås N, Jarstad E, Grotle M, Risberg MA. The efficacy of strength or aerobic exercise on quality of life and knee function in patients with knee osteoarthritis. A multi-arm randomized controlled trial with 1-year follow-up. BMC Musculoskeletal Disorders. 2023 Sep 8;24(1):714. doi: https://doi.org/10.1186/s12891-023-06831-x

Katz JN, Arant KR, Loeser RF. Diagnosis and treatment of hip and knee osteoarthritis: a review. JAMA. 2021 Feb 9;325(6):568-79. doi: https://doi.org/10.1001/jama.2020.22171

Aydemir T, Çirpan R, Kartin PT. Impact of acupressure on pain, functional status, and quality of life in individuals with knee osteoarthritis. Journal of Manipulative and Physiological Therapeutics. 2025 Jan;48(1-5):204-13. doi: https://doi.org/10.1016/j.jmpt.2025.09.001

Li H, Qian S, Liu Y, Guo Y, Chen X, Hu Y, Fu Q, Li Q, Xiang Y, Liu Y, Wu X, Luo T. Opposing needling in the treatment of knee osteoarthritis: an improved study protocol for a randomized controlled trial. Frontiers in Medicine. 2025 Nov 25;12:1698983. doi: https://doi.org/10.3389/fmed.2025.1698983

Kolasinski SL, Neogi T, Hochberg MC, Oatis C, Guyatt G, Block J, Callahan L, Copenhaver C, Dodge C, Felson D, Gellar K. 2019 American College of Rheumatology/Arthritis Foundation guideline for the management of osteoarthritis of the hand, hip, and knee. Arthritis & Rheumatology. 2020 Feb;72(2):220-33. doi: https://doi.org/10.1002/art.41142

Whittaker JL, Truong LK, Dhiman K, Beck C. Osteoarthritis year in review 2020: rehabilitation and outcomes. Osteoarthritis and Cartilage. 2021 Feb;29(2):190-207. doi: https://doi.org/10.1016/j.joca.2020.10.005

Skou ST, Roos EM. Physical therapy for patients with knee and hip osteoarthritis: supervised, active treatment is current best practice. Clinical and Experimental Rheumatology. 2020 Sep;38(5):1036-9.

Mohamed SH, Albalawi HF, Nambi G, Shalabi KM, Albalawi MO. Effectiveness of manual therapy vs conventional physical therapy with neuromuscular training in the management of knee osteoarthritis: a randomized clinical control trial. International Journal of Osteopathic Medicine. 2025 Sep 11:100787. doi: https://doi.org/10.1016/j.ijosm.2025.100787

Zhang W, Moskowitz RW, Nuki G, Abramson S, Altman RD, Arden N, Bierma-Zeinstra S, Brandt KD, Croft P, Doherty M, Dougados M. OARSI recommendations for the management of hip and knee osteoarthritis, Part II: OARSI evidence-based, expert consensus guidelines. Osteoarthritis and Cartilage. 2008 Feb;16(2):137-62. doi: https://doi.org/10.1016/j.joca.2007.12.013

Holden MA, Hattle M, Runhaar J, Riley RD, Healey EL, Quicke J, van der Windt DA, Dziedzic K, van Middelkoop M, Burke D, Legha A. Moderators of the effect of therapeutic exercise for knee and hip osteoarthritis: a systematic review and individual participant data meta-analysis. The Lancet Rheumatology. 2023 Jul;5(7):e386-400. doi: https://doi.org/10.1016/S2665-9913(23)00122-4

Chiarotto A, Maxwell LJ, Ostelo RW, Boers M, Tugwell P, Terwee CB. Measurement properties of visual analogue scale, numeric rating scale, and pain severity subscale of the brief pain inventory in patients with low back pain: a systematic review. The Journal of Pain. 2019 Mar;20(3):245-63. doi: https://doi.org/10.1016/j.jpain.2018.07.009

Euasobhon P, Atisook R, Bumrungchatudom K, Zinboonyahgoon N, Saisavoey N, Jensen MP. Reliability and responsivity of pain intensity scales in individuals with chronic pain. Pain. 2022 Dec 1;163(12):e1184-91. doi: https://doi.org/10.1097/j.pain.0000000000002692

Svinøy OE, Hilde G, Bergland A, Strand BH. Timed up and go: reference values for community-dwelling older adults with and without arthritis and non-communicable diseases: the Tromsø study. Clinical Interventions in Aging. 2021 Feb 23:335-43. doi: https://doi.org/10.2147/CIA.S294512

The WHOQOL Group. The World Health Organization quality of life assessment (WHOQOL): development and general psychometric properties. Social Science & Medicine. 1998 Jun 15;46(12):1569-85. doi: https://doi.org/10.1016/s0277-9536(98)00009-4

Hinman RS, Hall M, Comensoli S, Bennell KL. Exercise and Sports Science Australia (ESSA) updated position statement on exercise and physical activity for people with hip/knee osteoarthritis. Pensar en Movimiento: Revista de Ciencias del Ejercicio y la Salud. 2024 Dec;22(2):228-65. doi: https://doi.org/10.15517/pensarmov.v22i2.62992

Liu XY, Ma Y, Huang ZY, Xiao XX, Guan L. The efficacy of acupuncture, exercise rehabilitation, and their combination in the treatment of knee osteoarthritis: a randomized controlled trial. Journal of Pain Research. 2024 Dec 31:2837-49. doi: https://doi.org/10.2147/JPR.S465058

a YT, Dong YL, Wang B, Xie WP, Huang QM, Zheng YJ. Dry needling on latent and active myofascial trigger points versus oral diclofenac in patients with knee osteoarthritis: a randomized controlled trial. BMC Musculoskeletal Disorders. 2023 Jan 18;24(1):36. doi: https://doi.org/10.1186/s12891-022-06116-9

Young I, Dunning J, Butts R, Bliton P, Zacharko N, Garcia J, Mourad F, Charlebois C, Gorby P, Fernández-de-Las-Peñas C. Spinal manipulation and electrical dry needling as an adjunct to conventional physical therapy in patients with lumbar spinal stenosis: a multi-center randomized clinical trial. The Spine Journal. 2024 Apr;24(4):590-600. doi: https://doi.org/10.1016/j.spinee.2023.12.002

Pang JC, Fu AS, Lam SK, Peng B, Fu AC. Ultrasound-guided dry needling versus traditional dry needling for patients with knee osteoarthritis: a double-blind randomized controlled trial. PLoS One. 2022 Sep 30;17(9):e0274990. doi: https://doi.org/10.1371/journal.pone.0274990

Hunter CW, Deer TR, Jones MR, Chang Chien GC, D'Souza RS, Davis T, Eldon ER, Esposito MF, Goree JH, Hewan-Lowe L, Maloney JA. Consensus guidelines on interventional therapies for knee pain (STEP guidelines) from the American Society of Pain and Neuroscience. Journal of Pain Research. 2022 Dec 31:2683-745. doi: https://doi.org/10.2147/JPR.S370469

Chys M, De Meulemeester K, De Greef I, Murillo C, Kindt W, Kouzouz Y, Lescroart B, Cagnie B. Clinical effectiveness of dry needling in patients with musculoskeletal pain: an umbrella review. Journal of Clinical Medicine. 2023 Feb 2;12(3):1205. doi: https://doi.org/10.3390/jcm12031205

De Greef I, Chys M, Gerwin RD, De Meulemeester K, Cagnie B. The neurophysiological effects of dry needling: an update of a narrative review. American Journal of Physical Medicine & Rehabilitation. 2026 Feb 1;105(2):172-80. doi: https://doi.org/10.1097/PHM.0000000000002855

Tran L, Makram AM, Makram OM, Elfaituri MK, Morsy S, Ghozy S, Zayan AH, Nam NH, Zaki MM, Allison EL, Hieu TH. Efficacy of kinesio taping compared to other treatment modalities in musculoskeletal disorders: a systematic review and meta-analysis. Research in Sports Medicine. 2023 Jul 4;31(4):416-39. doi: https://doi.org/10.1080/15438627.2021.1989432

Mohamed SH, Alatawi SF. Effectiveness of kinesio taping and conventional physical therapy in the management of knee osteoarthritis: a randomized clinical trial. Irish Journal of Medical Science. 2023 Oct;192(5):2223-33. doi: https://doi.org/10.1007/s11845-022-03247-9

Mao HY, Hu MT, Yen YY, Lan SJ, Lee SD. Kinesio taping relieves pain and improves isokinetic not isometric muscle strength in patients with knee osteoarthritis: a systematic review and meta-analysis. International Journal of Environmental Research and Public Health. 2021 Oct 4;18(19):10440. doi: https://doi.org/10.3390/ijerph181910440

Yao K, Shamim MF, Xia J, Liu TT, Guo Y, Lin X. Therapeutic potential of acupuncture in knee osteoarthritis: clinical efficacy and mechanistic insights. Journal of Inflammation Research. 2025 Dec 31:12169-90. doi: https://doi.org/10.2147/JIR.S526890

Downloads

Published

2026-07-30