title: Rehabilitation for the management of knee osteoarthritis using comprehensive traditional Chinese medicine in community health centers: study protocol for a randomized controlled trial.
abstract: BACKGROUND
  It is becoming increasingly necessary for community health centers to make rehabilitation services available to patients with osteoarthritis of the knee. However, for a number of reasons, including a lack of expertise, the small size of community health centers and the availability of only simple medical equipment, conventional rehabilitation therapy has not been widely used in China. Consequently, most patients with knee osteoarthritis seek treatment in high-grade hospitals. However, many patients cannot manage the techniques that they were taught in the hospital. Methods such as acupuncture, tuina, Chinese medical herb fumigation-washing and t'ai chi are easy to do and have been reported to have curative effects in those with knee osteoarthritis. To date, there have been no randomized controlled trials validating comprehensive traditional Chinese medicine for the rehabilitation of knee osteoarthritis in a community health center. Furthermore, there is no standard rehabilitation protocol using traditional Chinese medicine for knee osteoarthritis. The aim of the current study is to develop a comprehensive rehabilitation protocol using traditional Chinese medicine for the management of knee osteoarthritis in a community health center.
  
  
  METHODS
  This will be a randomized controlled clinical trial with blinded assessment. There will be a 4-week intervention utilizing rehabilitation protocols from traditional Chinese medicine and conventional therapy. Follow-up will be conducted for a period of 12 weeks. A total of 722 participants with knee osteoarthritis will be recruited. Participants will be randomly divided into two groups: experimental and control. Primary outcomes will include range of motion, girth measurement, the visual analogue scale, and results from the manual muscle, six-minute walking and stair-climbing tests. Secondary outcomes will include average daily consumption of pain medication, ability to perform daily tasks and health-related quality-of-life assessments. Other outcomes will include rate of adverse events and economic effects. Relative cost-effectiveness will be determined from health service usage and outcome data.
  
  
  CONCLUSIONS
  The primary aim of this trial is to develop a standard protocol for traditional Chinese medicine, which can be adopted by community health centers in China and worldwide, for the rehabilitation of patients with knee osteoarthritis.
  
  
  BACKGROUND
  
  
  
  BACKGROUND
  ChiCTR-TRC-12002538.
authors.forename: Hu
authors.initials: H
authors.lastname: Yan
authors.affiliation: Fujian University of Traditional Chinese Medicine, 1 Huatuo St, Shangjie, Minhou, Fuzhou, Fujian, China. suyouxin777@hotmail.com.
authors.forename: Youxin
authors.initials: Y
authors.lastname: Su
authors.forename: Lidian
authors.initials: L
authors.lastname: Chen
authors.forename: Guohua
authors.initials: G
authors.lastname: Zheng
authors.forename: Xueyi
authors.initials: X
authors.lastname: Lin
authors.forename: Baojun
authors.initials: B
authors.lastname: Chen
authors.forename: Bihong
authors.initials: B
authors.lastname: Zhou
authors.forename: Qing
authors.initials: Q
authors.lastname: Zhang
mesh_terms: D000700:Analgesics / Q000627:therapeutic use; D018771:Arthralgia / Q000175:diagnosis / Q000503:physiopathology / Q000534:rehabilitation*; D001696:Biomechanical Phenomena; D002681:China; D002985:Clinical Protocols; D003151:Community Health Centers / Q000191:economics; D003153:Community Health Services / Q000191:economics / Q000379:methods*; D003362:Cost-Benefit Analysis; D005080:Exercise Test; D017048:Health Care Costs; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology; D008516:Medicine, Chinese Traditional / Q000191:economics / Q000379:methods*; D020370:Osteoarthritis, Knee / Q000175:diagnosis / Q000191:economics / Q000503:physiopathology / Q000534:rehabilitation*; D010147:Pain Measurement; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012107:Research Design; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000700:Analgesics