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IRCT20150519022320N38 IRCT 2026-07-21 Rafsanjan University of Medical Sciences Effect of Self-Administered Acupressure and Isometric Exercises on Pain and Quality of Life in Elderly with Knee Osteoarthritis Comparing the Effect of Self-Administered Acupressure and Isometric Exercises on Pain and Quality of Life in Elderly with Knee Osteoarthritis 2026-08-24 anticipated 126 Recruiting https://irct.ir/trial/91621 interventional Randomization: Randomized, Blinding: Not blinded, Placebo: Not used, Assignment: Parallel, Purpose: Supportive, 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. N/A Knee osteoarthritis pain. Intervention 1: 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). Intervention 2: 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. Intervention 3: Control group: This group, with conditions similar to the intervention groups, receives no intervention and is told to continue their usual daily activities. Undecided - It is not yet known if there will be a plan to make this available Justification or reason for indecision in sharing IPD is There is no further information.
public Dr Tayebeh Mirzaei khalilabadi
Rafsanjan, Jomhouri Street,Nurse Boulevard, School of Nursing
rafsanjan Iran (Islamic Republic of) 7718796755 +98 34 3425 5900 t.mirzaei@rums.ac.ir Rafsanjan University of Medical Sciences scientific Dr.Tayebeh Mirzaei khailabadi
Rafsanjan, Jomhouri Street, Nurse Boulevard, School of Nursing
rafsanjan Iran (Islamic Republic of) 7718796755 +98 34 3425 5900 t.mirzaei@rums.ac.ir Rafsanjan University of Medical Sciences Iran (Islamic Republic of) 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. 60 days no limit Both Worsening of disease symptoms Non-adherence to interventions for 3 or more sessions Unwillingness to continue cooperation in this study Treatment - Other Treatment - Other Treatment - Other 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). 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. Control group: This group, with conditions similar to the intervention groups, receives no intervention and is told to continue their usual daily activities. Pain in elderly. Timepoint: All participants complete the visual pain scale before, during, and after the intervention. Method of measurement: visual pain scale(VAS). 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). Rafsanjan University of Medical Sciences Approved 2026-07-12 Research Ethics Committee of Rafsanjan University of Medical Sciences Rafsanjan, Nurse Street, Rafsanjan School of Nursing and Midwifery rafsanjan Kerman Iran (Islamic Republic of)