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Knee OsteoarthritisCILM-KOANCT07423182

Effects of Carbon Dioxide Infrared Laser Moxibustion on Pain and Function in Knee Osteoarthritis

A study testing Exercise Program for Knee Osteoarthritis and CO2 Infrared Laser Moxibustion (CILM) in people with Knee Osteoarthritis, run by University of Lahore at 1 site in Pakistan.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Knee osteoarthritis is a prevalent degenerative joint disorder characterized by chronic knee pain, stiffness, reduced range of motion, and limitations in daily functional activities. Read more about this study

Who is it for?
Ages 55 to 65 years
Conditions the study is for
Knee Osteoarthritis
What is being tested?
Exercise Program for Knee Osteoarthritis and CO2 Infrared Laser Moxibustion (CILM)
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
68 participants
Where
1 sitePakistan
Study dates
26 Oct 2025to 30 Jul 2026
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 55 to 65 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Adults aged 55 to 65 years, male or female. Diagnosis of knee osteoarthritis with radiographic evidence (Kellgren-Lawrence grade 2 or higher).
  • Knee osteoarthritis grade II or III according to the American Rheumatism Association (ARA) classification criteria.
  • History of moderate to severe knee pain on most days during the past month. Able and willing to provide written informed consent and comply with study procedures.

Who cannot join

  • Other diseases affecting the knee, such as rheumatoid arthritis, ankylosing spondylitis, fibromyalgia syndrome, or chronic fatigue syndrome.
  • Use of steroid medication or acupuncture or moxibustion treatment within the previous 3 months.
  • Intra-articular hyaluronate injection within the previous 6 months. Arthrocentesis or arthroscopy within the previous 1 year. Knee or hip replacement surgery, or planned joint replacement surgery during the trial period.
  • Use of other external treatments during the trial (e.g., topical medication for knee pain).
  • Body mass index (BMI) greater than 30 kg/m². Lower-limb fracture or injury affecting function. Neurological disorders or nerve root compression affecting the lower limb.

Trial locations and contacts

1 site in 1 country.

Pakistan1 site
  • Rashid Latif Medical College, Lahore, Pakistan

    Lahore, 54000

Other trials in Pakistan

About this study

Official title: Effects of Carbon Dioxide Infrared Laser Moxibustion in Patients With Knee Osteoarthritis: A Double-Blind Randomized Controlled Trial

Knee osteoarthritis is a prevalent degenerative joint disorder characterized by chronic knee pain, stiffness, reduced range of motion, and limitations in daily functional activities. Exercise therapy is widely recommended as a first-line conservative approach to reduce symptoms and improve physical performance; however, a substantial proportion of patients continue to experience persistent pain and functional impairment despite adherence to exercise-based rehabilitation.

Carbon dioxide (CO2) infrared laser moxibustion is a non-invasive far-infrared thermal stimulation modality intended to reproduce the localized heating effects of traditional moxibustion without smoke or odor. It is hypothesized to enhance local microcirculation, support tissue oxygenation, and modulate inflammatory activity, thereby contributing to symptom relief and improved joint function. This double-blind, parallel-group randomized controlled trial will evaluate whether adding carbon dioxide (CO2) infrared laser moxibustion to a standardized knee osteoarthritis exercise program provides greater improvement than exercise alone. Eligible participants with radiographic knee osteoarthritis will be randomly allocated to either (1) an exercise-only program or (2) the same exercise program plus carbon dioxide (CO2) infrared laser moxibustion delivered over an 8-week treatment phase (24 sessions). Outcomes will be measured at baseline and at follow-up visits at Month 3 and Month 6 to determine changes in pain intensity measured by the Numerical Pain Rating Scale (NPRS), knee range of motion measured by goniometry, articular cartilage thickness measured by magnetic resonance imaging (MRI), and biochemical markers including bone alkaline phosphatase (BAP) and serum calcium.

Read the detailed description

This study is a double-blind, parallel-group randomized controlled trial examining the effectiveness of carbon dioxide (CO2) infrared laser moxibustion as an adjunct to exercise therapy in individuals with knee osteoarthritis. Knee osteoarthritis is a multifactorial degenerative condition involving mechanical stress, low-grade inflammation, and progressive joint tissue changes that contribute to pain, restricted movement, and functional limitations. Exercise therapy represents a core component of conservative management; however, residual symptoms are frequently reported, supporting the evaluation of additional non-pharmacological approaches.

Carbon dioxide (CO2) infrared laser moxibustion is a non-invasive modality that delivers far-infrared thermal stimulation to predefined knee-related treatment points, intended to reproduce the therapeutic effects of traditional moxibustion without smoke exposure. Proposed mechanisms include enhancement of local microcirculation, modulation of inflammatory activity, neuromodulatory analgesic effects, and potential support of local tissue metabolism. Participants with radiographic knee osteoarthritis will be allocated to either a standardized exercise program alone or the same exercise program combined with carbon dioxide (CO2) infrared laser moxibustion delivered during an 8-week treatment period.

Participants will be assessed at baseline, at the end of the 8-week intervention period, and during follow-up visits at Month 3 and Month 6 to evaluate short-term and medium-term changes in pain and knee-related outcomes. The findings of this study will contribute to the evidence base for rehabilitation strategies in knee osteoarthritis and inform the potential role of carbon dioxide (CO2) infrared laser moxibustion as an adjunct conservative intervention.

Being tested
Exercise Program for Knee Osteoarthritis, CO2 Infrared Laser Moxibustion (CILM)
Keywords
Carbon dioxide infrared laser moxibustion, Laser moxibustion, Exercise therapy, Physical therapy, Knee rehabilitation, Pain intensity, Numerical Pain Rating Scale, Western Ontario and McMaster Universities Osteoarthritis Index, Range of motion, Cartilage thickness, Randomized controlled trial
Medical subject headings
Osteoarthritis, Knee, Pain

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Exercise Program for Knee OsteoarthritisOther

    Participants receive a standardized knee osteoarthritis exercise program delivered over an 8-week intervention period, with three supervised sessions per week (24 sessions total), with each session lasting approximately 40 minutes. The program includes warm-up activities followed by progressive strengthening and mobility exercises targeting the knee and surrounding musculature, including step-ups, chair sit-to-stand exercises, quadriceps strengthening, isometric thigh activation, and balance or coordination exercises.

  • CO2 Infrared Laser Moxibustion (CILM)Device

    Also called 10.6 μm Infrared Laser Moxibustion, 10.6 μm CO₂ Laser Moxibustion

    CO₂ infrared laser moxibustion is administered using a 10.6 μm CO₂ infrared laser device with an output power range of 160-180 mW. The defocused probe is positioned approximately 2 cm from the skin, producing a light spot with a diameter of approximately 2 cm. Irradiation is applied to predefined knee-related points (ST35, Ex-LE4, and Ashi points) bilaterally, with each point treated for approximately 5 minutes per knee. The total irradiation time per session is approximately 30 minutes, including bilateral point application, with additional time allocated for positioning and safety checks, resulting in a total session duration of approximately 40 minutes. Treatment is delivered three sessions per week for eight weeks (24 sessions total) according to a standardized protocol.

Study groups in NCT07423182
Study groupRoleWhat they receive
Exercise Program Only (Control)Active comparatorParticipants receive a standardized knee osteoarthritis exercise program delivered over an 8-week intervention period, with three supervised sessions per week (24 sessions total). Each session lasts approximately 40 minutes and includes warm-up activities followed by progressive strengthening and mobility exercises targeting the knee and surrounding musculature, including step-ups, chair sit-to-stand exercises, quadriceps strengthening, isometric thigh activation, and balance or coordination exercises. Clinical outcomes are measured at baseline, at the end of the 8-week intervention period, and at follow-up visits at Month 3 and Month 6 according to the study protocol.
Receives: Other: Exercise Program for Knee Osteoarthritis; Device: CO2 Infrared Laser Moxibustion (CILM)
Exercise Program Plus Carbon Dioxide (CO2) Infrared Laser Moxibustion (CILM)ExperimentalParticipants receive the same standardized knee osteoarthritis exercise program delivered over an 8-week intervention period, with three supervised sessions per week (24 sessions total; approximately 40 minutes per session), in combination with carbon dioxide (CO2) infrared laser moxibustion. Carbon dioxide (CO2) infrared laser moxibustion is administered using a 10.6 micrometer CO2 infrared laser device with an output power range of 160 to 180 mW. The defocused probe is positioned approximately 2 cm from the skin, producing a light spot with a diameter of approximately 2 cm. Irradiation is applied to predefined knee-related treatment points including ST35 (Dubi), Ex-LE4 (Neixiyan), and Ashi (tender points), applied bilaterally, with each point treated for approximately 5 minutes per knee. The total irradiation time per session is approximately 30 minutes, with additional time allocated for positioning and safety checks, resulting in a total session duration of approximately 40 minute
Receives: Other: Exercise Program for Knee Osteoarthritis; Device: CO2 Infrared Laser Moxibustion (CILM)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Pain intensity measured by the Numerical Pain Rating Scale (0 to 10)

    Change in knee pain intensity measured using the 0 to 10 Numerical Pain Rating Scale (0 = no pain, 10 = worst possible pain).

    Measured: Baseline and Week 8

Secondary outcomes (4)
  1. Knee range of motion in flexion and extension

    Change in knee joint range of motion in degrees measured using a goniometer.

    Measured: Baseline, Week 8, Month 3, and Month 6

  2. Articular cartilage thickness measured by magnetic resonance imaging (MRI)

    Change in knee articular cartilage thickness measured using magnetic resonance imaging.

    Measured: Baseline and Month 6

  3. Serum bone alkaline phosphatase (BAP)

    Change in serum bone alkaline phosphatase concentration measured from venous blood samples.

    Measured: Baseline, Month 3, and Month 6

  4. Serum calcium concentration

    Change in serum calcium concentration measured from venous blood samples.

    Measured: Baseline, Month 3, and Month 6

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted20 Feb 2026
  2. Study start26 Oct 2025
  3. Primary completion30 Mar 2026
  4. Study completion30 Jul 2026

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Two-arm, parallel-group randomized controlled trial comparing a standardized exercise-only program versus the same exercise program combined with carbon dioxide (CO2) infrared laser moxibustion administered over an 8-week treatment period, with follow-up assessments conducted at Month 3 and Month 6.
Masking
Double blind
Who is masked
Participant, Outcomes assessor
Enrolment
68 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07423182
Sponsor's protocol ID
UOL-IREB-25-12-0037-70137698
Acronym
CILM-KOA
Status last verified
Sep 2026
First submitted
10 Feb 2026
Last updated
22 Sep 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: IPD will not be shared because the study involves identifiable clinical and imaging data collected at local hospital sites, and there is currently no institutional infrastructure or approved data-sharing agreement for external distribution. De-identified data may be made available upon reasonable request to the corresponding investigator, subject to ethics approval and institutional policies.

Publications

  • Zhao L, Cheng K, Wu F, Du J, Chen Y, Tan MT, Lao L, Shen X. Effect of Laser Moxibustion for Knee Osteoarthritis: A Multisite, Double-blind Randomized Controlled Trial. J Rheumatol. 2021 Jun;48(6):924-932. doi: 10.3899/jrheum.200217. Epub 2020 Jul 1.

    PubMed 32611673

Questions about this trial

What is this clinical trial studying?

A study testing Exercise Program for Knee Osteoarthritis and CO2 Infrared Laser Moxibustion (CILM) in people with Knee Osteoarthritis, run by University of Lahore at 1 site in Pakistan.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 22 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Pakistan. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Pain intensity measured by the Numerical Pain Rating Scale (0 to 10) (time frame: Baseline and Week 8). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07423182, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 22 Sep 2026.

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