Electroacupuncture at Nerve Innervation Zones Combined with Exercise Rehabilitation for Early-Stage Knee Osteoarthritis in Older Adults: A Randomized Controlled Trial Protocol

BackgroundEarly-stage knee osteoarthritis (EKOA) is a prevalent degenerative musculoskeletal disorder that impairs lower-limb function in older adults. Its pathogenesis involves both biomechanical imbalance and neuromuscular degeneration. Existing exercise and acupuncture therapies fail to precisely correct biomechanical asymmetries and lack integrated strategies for early-stage management. This randomized controlled trial aims to evaluate and compare the effects of Electroacupuncture at the innervation zones, exercise rehabilitation, and their combination in older adults with EKOA, and to explore their mechanisms on biomechanical balance.MethodsOne hundred eligible participants will be randomly allocated into four parallel groups (A–D). Group A will receive oral celecoxib (200 mg/day); Group B will receive Electroacupuncture targeting the innervation zones using a 5 Hz dense-disperse waves (for 30 minutes per session, three sessions per week). Group C will undergo structured exercise rehabilitation (55 minutes per session, three sessions per week). Group D will receive a combined intervention of Electroacupuncture and exercise rehabilitation. All interventions will be administered over 8 weeks. The primary outcome will be the change in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) total score. Secondary outcomes will include the visual analog scale (VAS) for pain, muscle strength, balance, gait performance, and high-density Electromyography parameters. Outcomes will be assessed at baseline, Week 8, and Week 16 to evaluate intergroup differences and the sustainability of effects.DiscussionThis study will determine whether the combined approach provides superior clinical and biomechanical outcomes, thereby contributing evidence for the integrative management of early-stage knee osteoarthritis.