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Accepted for/Published in: JMIR Research Protocols

Date Submitted: Apr 6, 2025
Open Peer Review Period: Apr 7, 2025 - Jun 2, 2025
Date Accepted: Jun 16, 2025
(closed for review but you can still tweet)

The final, peer-reviewed published version of this preprint can be found here:

Efficacy of Tuina Therapy Based on Hip-Knee-Ankle Synergy in the Lower Extremity Kinematic Chain in Patients With Knee Osteoarthritis: Protocol for a Randomized Controlled Trial

Wen Z, Lyu R, Zhang S, Yu Y, Wang J, Kong L, Fang M

Efficacy of Tuina Therapy Based on Hip-Knee-Ankle Synergy in the Lower Extremity Kinematic Chain in Patients With Knee Osteoarthritis: Protocol for a Randomized Controlled Trial

JMIR Res Protoc 2025;14:e75547

DOI: 10.2196/75547

PMID: 40623301

PMCID: 12280833

Efficacy of Tuina with Hip-Knee-Ankle Synergies on Kinematic Chain of Lower Extremity in Patients with KOA: Study Protocol for a Randomized Controlled Trial

  • Zonglin Wen; 
  • Ruoyun Lyu; 
  • Shuaipan Zhang; 
  • Yifeng Yu; 
  • Jianwei Wang; 
  • Lingjun Kong; 
  • Min Fang

ABSTRACT

Background:

Knee osteoarthritis (KOA) is a progressive degeneration of the knee joint that has the potential to impair the function of the lower extremity. Tuina, as an important component of TCM, is a common treatment for KOA. However, the prevailing practice often limits the therapeutic focus to the knee joint, overlooking potential co-existing hip and ankle injuries. Thus, the therapeutic efficacy may not be optimal in these instances.

Objective:

This study aims to evaluate the clinical efficacy of Tuina with Hip-Knee-Ankle synergies and conventional treatment in patients with KOA and to explore the potential effect on kinematic chain of lower extremity.

Methods:

This single-blind randomized controlled trial will involve a total of 96 KOA participants from one study center. Participants will be randomly divided into conventional treatment group and Tuina combined with conventional treatment group in a 1:1 ratio. Participants in the control group will receive regular health education, self-administered acupressure, and functional exercise. This routine will be completed for 4 weeks, with a total of 5 sessions planned each week. Participants in the intervention group will receive 8 sessions of Tuina with Hip-Knee-Ankle Synergies (twice a week for 4 weeks) combined with conventional treatment. The primary outcome of this study will be measurement of improvement in WOMAC from baseline to 16 weeks. Among the secondary measures, Key Symptoms and Signs/TCM Syndrome Classification Quantitative Evaluation of KOA and Tampa Scale of Kinesiophobia (TSK-17) will be evaluated from baseline to 16 weeks. The Functional Movement Screen (FMS), Timed Up and Go (TUG) and Weight Bearing Lunge Test (WBLT) will only be evaluated at baseline and 4 weeks.

Results:

The study results will be submitted to a peer-reviewed journal.

Conclusions:

None. Clinical Trial: ITMCTR2024000293


 Citation

Please cite as:

Wen Z, Lyu R, Zhang S, Yu Y, Wang J, Kong L, Fang M

Efficacy of Tuina Therapy Based on Hip-Knee-Ankle Synergy in the Lower Extremity Kinematic Chain in Patients With Knee Osteoarthritis: Protocol for a Randomized Controlled Trial

JMIR Res Protoc 2025;14:e75547

DOI: 10.2196/75547

PMID: 40623301

PMCID: 12280833

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