BACKGROUND: To assess the efficacy of electroacupuncture (EA) stimulation with high-intensity compared with low-intensity on knee osteoarthritis (KOA). METHODS: Participants with KOA were randomized to either high-intensity EA group or low-intensity EA group. EA was applied unilaterally on the affected leg with the local points GB34, ST34, EX-LE4, EX-LE5, ST36, and SP9. The visual analogue scale (VAS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were measured before and after participation. Plasma TNFalpha, IL-1beta, IL-6, and apelin levels were also assessed by enzyme immunoassay (ELA) before and after treatment. RESULTS: Of 80 participants who consented to study participation, 77 completed the program. The patients showed a significant improvement in their pain, stiffness, and physical function on the VAS and WOMAC, accompanying with a significantly reduction in plasma levels of apelin and TNFalpha. Furthermore, high-intensity group exhibited statistically significant improvements in stiffness and physical function symptoms compared with low-intensity group. Plasma level of IL-6 was significantly decreased only after high-intensity EA treatment. Furthermore, apelin level was significantly inhibited in high-intensity EA group than in low-intensity EA group. CONCLUSIONS: Both high- and low-intensity EA treatments alleviate the clinical symptoms of KOA patients. High-intensity EA is more effective than low-intensity EA. Changes in plasma levels of TNFalpha, apelin and IL-6 may be involved in the therapeutic effect of EA on KOA.

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