Electroacupuncture with extensor exercise improves the contraction elastic density of quadriceps in short and long term for knee osteoarthritis

Extensor training improves the quadriceps contraction intensity of knee osteoarthritis. But the duration of effects is limited. This study aimed to assess whether electroacupuncture (EA) with extensor training (EA + E) has better short-and long-term effects than simple extensor training (E). Fifty-four patients were categorized into EA + E and E groups. Elastic shear wave imaging was employed to ascertain the quadriceps elastic modulus values (EMV) at different time points and extension angles. WOMAC scale was used to measure knee function. Compared to before EA, the vastus lateralis (VL) EMV with 180° knee extension immediately after EA increased significantly. After 1 month, the vastus medialis (VM) EMV with 180° extension increased and WOMAC scores decreased significantly than immediately after EA. The EMV of the VM and VL of group EA + E increased, and WOMAC scores decreased significantly compared to group E after 1 month. After 6 months, EMV of the VM and VL in EA + E group significantly increased, and WOMAC scores significantly decreased compared to E group. In short- and long-term, EA with extensor training enhances the contraction strength of the quadriceps and knee function for OA. This prospective single-center randomized controlled trial was approved by the Review Committee of the First Affiliated Hospital of Sun Yat-sen University (Registration date: 28/02/2023, Ethical Number: [2023] 005; The Clinical trial registration number: ChiCTR2300076651. • The contraction strength of the quadriceps femoris muscle in OA was detected with shear wave elastic ultrasound, and electroacupuncture immediately enhanced the contraction strength. • After the completion of electroacupuncture treatment, the quadriceps strength and the function of knee joint in OA can be continuously improved, which will last for 6 months. • In short and long term, electroacupuncture with extensor training has better enhancement of quadriceps contraction strength of and knee function for OA than extention only.