Determining the effect of self-administered acupressure and isometric exercises on pain and quality of life in elderly people with knee osteoarthritis
Design
This clinical trial includes three groups (self-administered acupressure, isometric exercises, and control groups). For random allocation of 126 eligible elderly people to the three groups, a simple random method (random numbers table) will be used.
Settings and conduct
Intervention is performed on elderly over 60 years old with knee osteoarthritis referred to comprehensive health service centers. Self-administered acupressure interventions and isometric exercises are taught separately to their respective groups by the researcher in one in-person training session. Then, participants perform the interventions for eight weeks, three days a week, for a total of 24 sessions at home and remotely.
Participants/Inclusion and exclusion criteria
Inclusion criteria:
* Age >60 years, conscious.
* Knee osteoarthritis (6 months to 5 years) with moderate to severe pain (VAS 40-70).
* No underlying diseases, recent surgery, or skin infection.
* Possession of a smartphone.
Exclusion:
* Worsening pain.
* Absence for ≥3 sessions.
* Withdrawal from the study.
Intervention groups
This study has three groups (two intervention groups and one control group). The self-administered acupressure and isometric exercises group includes clients with knee osteoarthritis who have pain along with at least three of the American Rheumatology Association's clinical criteria, and whose visual pain scale is between 4 and 7; they will receive the interventions. The control group is also based on the same criteria and performs their usual daily activities.
Main outcome variables
pain and Quality of life
General information
Reason for update
Acronym
IRCT registration information
IRCT registration number:IRCT20150519022320N38
Registration date:2026-07-21, 1405/04/30
Registration timing:prospective
Last update:2026-07-21, 1405/04/30
Update count:0
Registration date
2026-07-21, 1405/04/30
Registrant information
Name
Tayebeh Mirzaei
Name of organization / entity
Rafsanjan University of Medical Sciences
Country
Iran (Islamic Republic of)
Phone
+98 34 3425 5900
Email address
t.mirzaei@rums.ac.ir
Recruitment status
recruiting
Funding source
Expected recruitment start date
2026-08-24, 1405/06/02
Expected recruitment end date
2026-11-11, 1405/08/20
Actual recruitment start date
empty
Actual recruitment end date
empty
Trial completion date
empty
Scientific title
Comparing the Effect of Self-Administered Acupressure and Isometric Exercises on Pain and Quality of Life in Elderly with Knee Osteoarthritis
Public title
Effect of Self-Administered Acupressure and Isometric Exercises on Pain and Quality of Life in Elderly with Knee Osteoarthritis
Purpose
Supportive
Inclusion/Exclusion criteria
Inclusion criteria:
Individuals over 60 years old
Individuals who are mentally alert and able to answer questionnaire questions
Diagnosed with knee osteoarthritis (presence of pain along with at least 3 out of 6 clinical criteria from the American College of Rheumatology and a history of the disease for at least 6 months and a maximum of 5 years).
Having pain for more than three months (chronic pain).
A baseline score of 40-70 (out of 100) for knee pain on the VAS scale
Absence of local skin infections or open skin in acupressure-related areas.
No history of other autoimmune diseases, including lupus erythematosus, rheumatoid arthritis, and chronic neuropathic diseases such as diabetes.
No intra-articular injection within the past three months.
No history of knee surgery or severe knee trauma.
Own a smartphone.
Exclusion criteria:
Worsening of disease symptoms
Non-adherence to interventions for 3 or more sessions
Unwillingness to continue cooperation in this study
Age
From 60 days old
Gender
Both
Phase
N/A
Groups that have been masked
No information
Sample size
Target sample size:
126
Randomization (investigator's opinion)
Randomized
Randomization description
After determining the framework of the samples, the data will be divided into 3 blocks A, B, C based on age and gender using block randomization. The first data in one of the 3 groups will be selected by simple random sampling using "Random allocation software", and in the next 2 groups, the data will be allocated similarly based on the software. After equal allocation of data to the 3 groups, the treatment methods were written on 3 separate sheets and one method was assigned to each group by drawing lots, and the self-administered acupressure intervention groups, isometric exercises, and the control group will be determined.
Blinding (investigator's opinion)
Not blinded
Blinding description
Placebo
Not used
Assignment
Parallel
Other design features
Secondary Ids
empty
Ethics committees
1
Ethics committee
Name of ethics committee
Research Ethics Committee of Rafsanjan University of Medical Sciences
Street address
Rafsanjan, Nurse Street, Rafsanjan School of Nursing and Midwifery
City
rafsanjan
Province
Kerman
Postal code
7718796755
Approval date
2026-07-12, 1405/04/21
Ethics committee reference number
IR.RUMS.REC.1405.050
Health conditions studied
1
Description of health condition studied
Knee osteoarthritis pain
ICD-10 code
ICD-10 code description
Primary outcomes
1
Description
pain in elderly
Timepoint
All participants complete the visual pain scale before, during, and after the intervention.
Method of measurement
visual pain scale(VAS)
2
Description
Quality of Life
Timepoint
All participants complete the 36-item Quality of Life Questionnaire (SF-36) before, during, and after the intervention.
Method of measurement
Quality of Life Questionnaire (SF-36)
Secondary outcomes
empty
Intervention groups
1
Description
Intervention group: The self-administered acupressure training group offers a 2-hour session for groups of 12 people. To prevent disorganization in training and participant delays, groups are trained separately on different days. This includes educational videos for home sessions, identifying target points, and pressure technique. It is performed by the conscious and aware elderly person themselves or by one of their family members. The method is as follows: participants first sit on a chair or the edge of a bed and identify 3 target points around their knee. Patients should hold the affected knee with their hand for 3 minutes and massage the area without gloves and without using oil or ointment until they feel the area has warmed up. Then, they should apply pressure to each identified point with their thumb for 3 minutes. This action continues for 3 minutes (for each point) and then is repeated at the next point for 3 minutes. This process should be done twice a day for 8 consecutive weeks (3 days a week). Acupressure is applied for three minutes at each point using the thumbs. Pressure is applied vertically and gradually increased from gentle to firm, slowly, gently, and continuously, without sudden or excessive force. Acupressure is applied to both painful knees of individuals with knee OA. The pressure should be firm and deep to massage each point, massaging each point until a numb sensation is felt. The participant should sit comfortably and breathe deeply. These maneuvers should not be performed immediately before or after strenuous exercise or meals. If the patient is unable to perform this method, they can ask for help from another person at home who has been trained by the researcher. Key points in the Dubbi acupressure group are (ST35) Dubbi below the outer patella, (ST36) Zusanli below the knee on the tibia, and (Yanglingquan) GB34: lower than the outer part of the knee, one cun below the head of the fibula. Bilaterally (if both knees are involved).
Category
Treatment - Other
2
Description
Intervention group: In the isometric exercise group, training is provided in a 60-minute in-person session by the researcher, along with instructional videos for home sessions. In the isometric exercise group, training is provided in groups of 12 people to prevent disorganization in training and participant delays; groups are trained separately on different days. Exercises are repeated 3 days a week (twice a day) for 8 weeks, for a total of 24 sessions. Movements suitable for the elderly, considering their limitations, are performed for 40 minutes, including 10 minutes of warm-up, 20 minutes of isometric exercises, and 10 minutes of cool-down. Seated and supine movements will be performed with 10 repetitions per item, holding for 10 seconds. Quadriceps isometric contractions (Quad Sets): Lie down or sit up. Contract the quadriceps muscle without moving the knee joint. Maintain the contraction for 10 seconds. Repeat 10 times for the injured knee. Lie down, bend one knee, and place a pillow under the heel of the other foot. Contract the quadriceps muscle without moving the knee joint, and simultaneously press the knee against the surface below. Maintain the contraction for 10 seconds. Repeat 10 times for the injured knee. Isometric exercises for hamstring muscles: Lie on your back with one leg bent and the sole of your foot on the ground. Grab the other leg from below the thigh with both hands and gently try to straighten your knee. Hold this position for 10 seconds and repeat 10 times for the injured knee. This causes contraction of the hamstring muscles. Semi-squat exercise: Stand between a door frame and place a pillow between your two knees. While pressing your knees together, bend them and go down (foot angle between 30 and 45 degrees). Stay in this position for 10 seconds, repeating 10 rounds. Pillow squeeze exercise: Sit on a flat surface with both legs straight. Place one pillow underneath and one pillow between your two knees. With both knees, simultaneously press the pillow between them and keep your legs as straight as possible so that your knees press against the pillow underneath. Hold this movement for 10 seconds and perform 10 times.
Category
Treatment - Other
3
Description
Control group: This group, with conditions similar to the intervention groups, receives no intervention and is told to continue their usual daily activities.
Category
Treatment - Other
Recruitment centers
1
Recruitment center
Name of recruitment center
Comprehensive Health Service Centers in Rafsanjan
Full name of responsible person
Dr. Tayebeh Mirzaei Khalilabadi
Street address
Rafsanjan, Jomhouri Street, Nurse Boulevard, School of Nursing
City
rafsanjan
Province
Kerman
Postal code
7718796755
Phone
+98 34 3425 5900
Email
t.mirzaei@rums.ac.ir
Sponsors / Funding sources
1
Sponsor
Name of organization / entity
Rafsanjan University of Medical Sciences
Full name of responsible person
Dr.Reza Vazirinejad
Street address
Emam Ali Blvd
City
rafsanjan
Province
Kerman
Postal code
7718174715
Phone
+98 34 3131 5075
Email
rvazirinejad@yahoo.com
Grant name
Grant code / Reference number
Is the source of funding the same sponsor organization/entity?
Yes
Title of funding source
Rafsanjan University of Medical Sciences
Proportion provided by this source
100
Public or private sector
Public
Domestic or foreign origin
Domestic
Category of foreign source of funding
empty
Country of origin
Type of organization providing the funding
Academic
Person responsible for general inquiries
Contact
Name of organization / entity
Rafsanjan University of Medical Sciences
Full name of responsible person
Dr Tayebeh Mirzaei khalilabadi
Position
associate profssor
Latest degree
Ph.D.
Other areas of specialty/work
Nursery
Street address
Rafsanjan, Jomhouri Street,Nurse Boulevard, School of Nursing
City
rafsanjan
Province
Kerman
Postal code
7718796755
Phone
+98 34 3425 5900
Email
t.mirzaei@rums.ac.ir
Person responsible for scientific inquiries
Contact
Name of organization / entity
Rafsanjan University of Medical Sciences
Full name of responsible person
Dr.Tayebeh Mirzaei khailabadi
Position
associate professor
Latest degree
Ph.D.
Other areas of specialty/work
Nursery
Street address
Rafsanjan, Jomhouri Street, Nurse Boulevard, School of Nursing
City
rafsanjan
Province
Kerman
Postal code
7718796755
Phone
+98 34 3425 5900
Email
t.mirzaei@rums.ac.ir
Person responsible for updating data
Contact
Name of organization / entity
Rafsanjan University of Medical Sciences
Full name of responsible person
Dr Tayebeh Mirzaei khalilabadi
Position
associate professor
Latest degree
Ph.D.
Other areas of specialty/work
Nursery
Street address
Rafsanjan, Jomhouri Street, Nurse Boulevard, School of Nursing
City
rafsanjan
Province
Kerman
Postal code
7718796755
Phone
+98 34 3425 5900
Email
t.mirzaei@rums.ac.ir
Sharing plan
Deidentified Individual Participant Data Set (IPD)
Undecided - It is not yet known if there will be a plan to make this available
Study Protocol
Undecided - It is not yet known if there will be a plan to make this available
Statistical Analysis Plan
Undecided - It is not yet known if there will be a plan to make this available
Informed Consent Form
Undecided - It is not yet known if there will be a plan to make this available
Clinical Study Report
Undecided - It is not yet known if there will be a plan to make this available
Analytic Code
Undecided - It is not yet known if there will be a plan to make this available
Data Dictionary
Undecided - It is not yet known if there will be a plan to make this available