History
# Registration date Revision Id
3 2026-06-30, 1405/04/09 386323
2 2025-07-08, 1404/04/17 346570
1 2024-03-22, 1403/01/03 297736
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  • Protocol summary

    Patients referred to the neurology clinic of Mashhad Qaem Hospital, suffering from RRMS in the recovery phase, according to the inclusion criteria and the approval of the MS fellowship, are referred to the acupuncture clinic of Imam Reza hospital. After signing the informed consent form, first evaluations are performed. In addition to the routine neurological treatment, the participants are placed in two groups and 30 acupoints are intervented. In True Embedding intervention group, after disinfection, 2cm PDO threads are embedded in the acupoints by a 20 gauge needle. In the Sham control group, the needle is inserted in the same points for blinding, but the thread is not embedded in the tissue. To prevent infection, cephalexin and to control pain, cold compress or Ibuprofen are prescribed. After 4 and 12 weeks, the outcomes are evaluated.
    Patients referred to the neurology clinic of Mashhad Qaem Hospital, suffering from MS, according to the inclusion criteria and the approval of the MS fellowship, are referred to the acupuncture clinic of Imam Reza hospital. After signing the informed consent form, first evaluations are performed. In addition to the routine neurological treatment, the participants are placed in two groups and 30 acupoints are intervented. In True Embedding intervention group, after disinfection, 2cm PDO threads are embedded in the acupoints by a 20 gauge needle. In the Sham control group, the needle is inserted in the same points for blinding, but the thread is not embedded in the tissue. To prevent infection, cephalexin and to control pain, cold compress or Ibuprofen are prescribed. After 4 and 12 weeks, the outcomes are evaluated.
    بیماران مراجعه کننده به کلینیک نورولوژی بیمارستان قائم (عج) مشهد، مبتلا به RRMS در فاز بهبودی با تایید فلوشیپ MS با توجه به معیارهای ورود به کلینیک طب سوزنی بیمارستان امام رضا(ع) ارجاع میشوند. بعد از معرفی طرح و امضای فرم رضایت آگاهانه، اطلاعات دموگرافیک و داروهای مصرفی ثبت و تکمیل پرسشنامه ها و تست ها انجام میگیرد. شرکت کنندگان علاوه بر دریافت درمان تجویز شده توسط نورولوژیست، در دو گروه مورد مداخله در 30 نقطه طب سوزنی واقع خواهند شد. در گروه مداخله امبدینگ واقعی، پس از ضدعفونی، نخ های 2 سانتیمتری PDO بوسیله نیدل گیج 20 در نقاط تعبیه میگردد. در گروه کنترل شم امبدینگ، جهت کورسازی در همان نقاط سوزن زده، اما نخ در بافت تعبیه نمیگردد. جهت پیشگیری از عفونت، سفالکسین و جهت کنترل درد، کمپرس سرد یا ایبوپروفن تجویز میشود. پس از 4 و 12 هفته، پیامدها ارزیابی میگردد.
    بیماران مراجعه کننده به کلینیک نورولوژی بیمارستان قائم (عج) مشهد، مبتلا به MS با تایید فلوشیپ MS با توجه به معیارهای ورود به کلینیک طب سوزنی بیمارستان امام رضا(ع) ارجاع میشوند. بعد از معرفی طرح و امضای فرم رضایت آگاهانه، اطلاعات دموگرافیک و داروهای مصرفی ثبت و تکمیل پرسشنامه ها و تست ها انجام میگیرد. شرکت کنندگان علاوه بر دریافت درمان تجویز شده توسط نورولوژیست، در دو گروه مورد مداخله در 30 نقطه طب سوزنی واقع خواهند شد. در گروه مداخله امبدینگ واقعی، پس از ضدعفونی، نخ های 2 سانتیمتری PDO بوسیله نیدل گیج 20 در نقاط تعبیه میگردد. در گروه کنترل شم امبدینگ، جهت کورسازی در همان نقاط سوزن زده، اما نخ در بافت تعبیه نمیگردد. جهت پیشگیری از عفونت، سفالکسین و جهت کنترل درد، کمپرس سرد یا ایبوپروفن تجویز میشود. پس از 4 و 12 هفته، پیامدها ارزیابی میگردد.
  • General information

    2024-08-21, 1403/05/31
    2025-12-22, 1404/10/01
    empty
    تخصیص در خط آخر شفاف سازی شد. تاریخ پایان بیمارگیری آپدیت شد.
    empty
    Allocation made clarified. Expected recruitment end date updated.
    Using the online site www.sealedenvelope.com, random allocation is done in two groups A (intervention) and group B (control). Block Randomization will be done with block sizes of 4 and 6 for random allocation. The prepared blocks will be placed inside the envelope. One of the envelopes will be randomly selected according to the order of patients' arrival, and patients will be assigned to groups. Allocation concealment is done using sealed opaque envelopes. By one of the team members, random numbers will be prepared and placed inside the envelope. The envelopes will be closed and their contents will not be visible from the outside. First, the purpose of the study is explained to the person with entry requirement critrias. Then, the person signs the informed consent form and takes an envelope, opens it and entered into one of the two groups.
    Using the online site www.sealedenvelope.com, random allocation is done in two groups A (intervention) and group B (control). Block Randomization will be done with block sizes of 4 and 6 for random allocation. The prepared blocks will be placed inside the envelope. One of the envelopes will be randomly selected according to the order of patients' arrival, and patients will be assigned to groups. Allocation concealment is done using sealed opaque envelopes. By one of the team members, random numbers will be prepared and placed inside the envelope. The envelopes will be closed and their contents will not be visible from the outside. First, the purpose of the study is explained to the person with entry requirement critrias. Then, the person signs the informed consent form and one envelope will be taken and opened and patient will be entered into one of the two groups.
  • Secondary outcomes

    #1
    empty
    Intervention Satisfaction Score
    empty
    نمره رضایت از مداخله
    empty
    Before intervention and 4 and 12 weeks after intervention
    empty
    قبل از شروع مداخله و 4 و 12 هفته پس از مداخله
    empty
    Scoring (1-10) for satisfaction with the treatment outcomes, willingness to repeat the treatment, and recommendation to other patients
    empty
    نمره دهی (1-10) برای رضایت از نتیجه درمان، تمایل به انجام مجدد و توصیه به سایر بیماران
  • Intervention groups

    #1
    Intervention group: True 2cm Polydioxanon Thread Embedding Acupuncture in 30 acupoints (GV14, GV20, CV4, CV14, BL18, BL20, BL23, SP6, SP9, ST36, KI3, GB20, GB34, LI11 , LR3, LI4, BL57) in one session after disinfection
    Intervention group: True 2cm Polydioxanon Thread Embedding Acupuncture in 30 acupoints (GV14, GV20, CV4, CV12, BL18, BL20, BL23, SP6, SP9, ST36, KI3, GB20, GB34, LI11 , LR3, LI4, BL57) in one session after disinfection
    گروه مداخله: کاشت واقعی نخ 2 سانتیمتری پلی دیوکسانون در 30 نقطه طب سوزنی (GV14, GV20, CV4, CV14, BL18, BL20, BL23, SP6, SP9, ST36, KI3, GB20, GB34, LI11 , LR3, LI4, BL57) در یک جلسه پس از ضدعفونی
    گروه مداخله: کاشت واقعی نخ 2 سانتیمتری پلی دیوکسانون در 30 نقطه طب سوزنی (GV14, GV20, CV4, CV12, BL18, BL20, BL23, SP6, SP9, ST36, KI3, GB20, GB34, LI11 , LR3, LI4, BL57) در یک جلسه پس از ضدعفونی
  • Person responsible for general inquiries


    Name of organization / entity - English:
    Name of organization / entity - Persian:
    Full name of responsible person - English: Hamidreza Bahrami Taghanaki
    Full name of responsible person - Persian: حمیدرضا بهرامی طاقانکی
    Position - English: Professor
    Position - Persian: استاد
    Latest degree: phd
    Area of specialty/work: 88
    Area of specialty/work title - English: Acupuncture and Massage
    Area of specialty/work title - Persian: طب سوزنی و ماساژ
    Street address - English: Traditional and Complementary Medicine Faculty, Shahid Kharazmi Complex, Mashhad University of Medical Science Campus, Azadi Square
    Street address - Persian: میدان آزادی، پردیس دانشگاه علوم پزشکی مشهد، مجتمع شهید خوارزمی، دانشکده طب سنتی و مکمل
    City - English: Mashhad
    City - Persian: مشهد
    Province: Razavi Khorasan
    Province - English:
    Province - Persian:
    contact.provinces_available: 1
    Country: Iran (Islamic Republic of)
    Postal code: 9177899191
    Phone: +98 51 3884 8931-6
    Mobile: +98 915 307 9125
    Fax: +98 51 3882 9279
    Email: bahramihr@mums.ac.ir
    Web page address:

    Name of organization / entity - English:
    Name of organization / entity - Persian:
    Full name of responsible person - English: Malika Vaez Tehrani
    Full name of responsible person - Persian: ملیکا واعظ تهرانی
    Position - English: PhD Candidate
    Position - Persian: دانشجوی دکترا
    Latest degree: med_doctor
    Area of specialty/work: 88
    Area of specialty/work title - English: Acupuncture
    Area of specialty/work title - Persian: طب سوزنی
    Street address - English: Traditional and Complementary Medicine Faculty, Shahid Kharazmi Complex, Mashhad University of Medical Science Campus, Azadi Square
    Street address - Persian: میدان آزادی، پردیس دانشگاه علوم پزشکی مشهد، مجتمع شهید خوارزمی، دانشکده طب سنتی و مکمل
    City - English: Mashhad
    City - Persian: مشهد
    Province: Razavi Khorasan
    Province - English:
    Province - Persian:
    contact.provinces_available: 1
    Country: Iran (Islamic Republic of)
    Postal code: 9177899191
    Phone: +98 51 3884 8931-6
    Mobile: +98 913 115 6704
    Fax: +98 51 3882 9279
    Email: Vaeztehrany@gmail.com
    Web page address:

Protocol summary

Study aim
Evaluation the effectiveness and comparing of True and Sham Thread Embedding in acupoints on Spasticity in Multiple Sclerosis
Design
A concealed, block randomized, double-blinded, 3rd phase of sham controlled clinical trial with a parallel group design of 38 patients
Settings and conduct
Patients referred to the neurology clinic of Mashhad Qaem Hospital, suffering from MS, according to the inclusion criteria and the approval of the MS fellowship, are referred to the acupuncture clinic of Imam Reza hospital. After signing the informed consent form, first evaluations are performed. In addition to the routine neurological treatment, the participants are placed in two groups and 30 acupoints are intervented. In True Embedding intervention group, after disinfection, 2cm PDO threads are embedded in the acupoints by a 20 gauge needle. In the Sham control group, the needle is inserted in the same points for blinding, but the thread is not embedded in the tissue. To prevent infection, cephalexin and to control pain, cold compress or Ibuprofen are prescribed. After 4 and 12 weeks, the outcomes are evaluated.
Participants/Inclusion and exclusion criteria
Inclusion Criteria: Definite diagnosis of MS; EDSS<7; Age>18; Resistant spasticity; Signing informed consent. Non-Inclusion Criteria: Receiving acupuncture in the last 6 months; Relapse or changing maintenance treatment in the last 2 months; Severe chronic systemic disease, cancers and coagulopathy; Sensitivity to Cephalosporins or thread; Pregnancy, Breastfeeding or uncertain contraception
Intervention groups
Intervention group: True Embedding of Polydioxanone Threads in 30 Acupoints. Sham control group: Needling in 30 Acupoints Without inserting Threads
Main outcome variables
Disability, Spasm, Walking quality, Daily life activities, Pain, Fatigue, Sleep, Urinary symptoms, Depression, Anxiety and Quality of life score

General information

Reason for update
تخصیص در خط آخر شفاف سازی شد. تاریخ پایان بیمارگیری آپدیت شد.
Acronym
IRCT registration information
IRCT registration number: IRCT20121228011912N8
Registration date: 2024-03-22, 1403/01/03
Registration timing: prospective

Last update: 2025-07-08, 1404/04/17
Update count: 2
Registration date
2024-03-22, 1403/01/03
Registrant information
Name
Hamidreza Bahrami Taghanaki
Name of organization / entity
Mashhad University of Medical Sciences
Country
Iran (Islamic Republic of)
Phone
+98 51 1841 5666
Email address
bahramihr@mums.ac.ir
Recruitment status
Recruitment complete
Funding source
Expected recruitment start date
2024-04-03, 1403/01/15
Expected recruitment end date
2025-12-22, 1404/10/01
Actual recruitment start date
empty
Actual recruitment end date
empty
Trial completion date
empty
Scientific title
Comparison of the Effectiveness of True and Sham Thread Embedding Acupuncture on Spasticity in Multiple Sclerosis Patients
Public title
Effect of Thread Embedding Acupuncture on Spasticity of M.S
Purpose
Supportive
Inclusion/Exclusion criteria
Inclusion criteria:
Definitive diagnosis of MS based on McDonald's 2017 criteria by a neurologist EDSS<7 Moderate to severe spasticity reported by the patient as NRS score≥4 with poor response to usual antispasmodics Willingness to participate in the study and sign informed consent Not taking anticoagulants No history of any coagulopathy No history of acupuncture in the last 6 months No history of relapse phase in the last 2 months No change in maintenance treatments during the last 2 months No history of sensivity to cephalosporins No history of sensivity to each components of the thread No history of incurable chronic systemic diseases and cancers Not being pregnant or breastfeeding and using a safe contraceptive method
Exclusion criteria:
Imbalance to continue cooperation with the study Incidence of sensivity reaction to the embedded thread Incidence of resistant bleeding requires medicinal intervention Incidence of the relapse phase requires receiving a medicinal pulse
Age
From 18 years old
Gender
Both
Phase
3
Groups that have been masked
  • Participant
  • Data analyser
Sample size
Target sample size: 38
Randomization (investigator's opinion)
Randomized
Randomization description
Using the online site www.sealedenvelope.com, random allocation is done in two groups A (intervention) and group B (control). Block Randomization will be done with block sizes of 4 and 6 for random allocation. The prepared blocks will be placed inside the envelope. One of the envelopes will be randomly selected according to the order of patients' arrival, and patients will be assigned to groups. Allocation concealment is done using sealed opaque envelopes. By one of the team members, random numbers will be prepared and placed inside the envelope. The envelopes will be closed and their contents will not be visible from the outside. First, the purpose of the study is explained to the person with entry requirement critrias. Then, the person signs the informed consent form and one envelope will be taken and opened and patient will be entered into one of the two groups.
Blinding (investigator's opinion)
Double blinded
Blinding description
In this study, the intervention group is True embedding group and the Sham group is designed as a control group, and the participants are thus blinded. The statistical analyst evaluates the information based on group A and B and is blinded to which group is belongs to A or B.
Placebo
Used
Assignment
Parallel
Other design features
The control group in acupuncture studies is called sham. Embedding studies are limited and the use of sham is not common in them. In this study, the sham is designed in such a way that all the embedding steps are performed, but the thread is not placed in the body tissue.

Secondary Ids

empty

Ethics committees

1

Ethics committee
Name of ethics committee
Ethics committee of Mashhad University of Medical Sciences
Street address
Ghoreyshi complex, University Ave
City
Mashhad
Province
Razavi Khorasan
Postal code
9138813944
Approval date
2024-03-09, 1402/12/19
Ethics committee reference number
IR.MUMS.REC.1402.345

Health conditions studied

1

Description of health condition studied
Multiple sclerosis (M.S)
ICD-10 code
G35
ICD-10 code description
Multiple sclerosis

Primary outcomes

1

Description
Disability Status Score
Timepoint
Before intervention and 4 and 12 weeks after intervention
Method of measurement
Expanded Disability Status Scale (EDSS)

2

Description
Spasticity Score
Timepoint
Before intervention and 4 and 12 weeks after intervention
Method of measurement
Numerical Rating Scale (NRS)

3

Description
Quality of Walking Score
Timepoint
Before intervention and 4 and 12 weeks after intervention
Method of measurement
Multiple Sclerosis Walking Scale-12 (MSWS-12)

4

Description
Activities of Daily Living (ADL) Score
Timepoint
Before intervention and 4 and 12 weeks after intervention
Method of measurement
Barthel Index

5

Description
Pain Score
Timepoint
Before intervention and 4 and 12 weeks after intervention
Method of measurement
McGill pain questionnaire

Secondary outcomes

1

Description
Fatigue Score
Timepoint
Before intervention and 4 and 12 weeks after intervention
Method of measurement
Modified Fatigue Impact Scale (MFIS) questionnaire

2

Description
Quality of Sleep score
Timepoint
Before intervention and 4 and 12 weeks after intervention
Method of measurement
Pittsburgh Sleep Quality Index (PSQI-P)

3

Description
Urinary Symptoms Score
Timepoint
Before intervention and 4 and 12 weeks after intervention
Method of measurement
Actionable Bladder Symptom Screening Tool (ABSST)

4

Description
Depression Score
Timepoint
Before intervention and 4 and 12 weeks after intervention
Method of measurement
Hospital Anxiety and Depression Scale (HADS) questionnaire

5

Description
Quality of Life Score
Timepoint
Before intervention and 4 and 12 weeks after intervention
Method of measurement
EuroQoL Quality of Life questionnaire

6

Description
Intervention Satisfaction Score
Timepoint
Before intervention and 4 and 12 weeks after intervention
Method of measurement
Scoring (1-10) for satisfaction with the treatment outcomes, willingness to repeat the treatment, and recommendation to other patients

Intervention groups

1

Description
Intervention group: True 2cm Polydioxanon Thread Embedding Acupuncture in 30 acupoints (GV14, GV20, CV4, CV12, BL18, BL20, BL23, SP6, SP9, ST36, KI3, GB20, GB34, LI11 , LR3, LI4, BL57) in one session after disinfection
Category
Rehabilitation

2

Description
Control group: Sham group, Needling of 30 acupoints mentioned above without embedded thread in one session
Category
Placebo

Recruitment centers

1

Recruitment center
Name of recruitment center
Neurology Clinic, Qaem Hospital
Full name of responsible person
Mohammad Ali Nahyati
Street address
Ahmad Abad Blvd
City
Mashhad
Province
Razavi Khorasan
Postal code
9176699199
Phone
+98 51 3840 0000
Email
nahayatia@mums.ac.ir

2

Recruitment center
Name of recruitment center
Acupuncture Clinic, Imam Reza Hospital
Full name of responsible person
Hamidreza Bahrami Taghanaki
Street address
University Ave
City
Mashhad
Province
Razavi Khorasan
Postal code
9137913316
Phone
+98 51 3802 2035
Email
bahramihr@mums.ac.ir

Sponsors / Funding sources

1

Sponsor
Name of organization / entity
Mashhad University of Medical Sciences
Full name of responsible person
Mohsen Tafaghodi
Street address
Ghoreyshi Complex, University Ave
City
Mashhad
Province
Razavi Khorasan
Postal code
9138813944
Phone
+98 51 3841 2081
Email
tafaghodim@mums.ac.ir
Grant name
Grant code / Reference number
Is the source of funding the same sponsor organization/entity?
Yes
Title of funding source
Mashhad University of Medical Sciences
Proportion provided by this source
100
Public or private sector
Public
Domestic or foreign origin
Domestic
Category of foreign source of funding
empty
Country of origin
Type of organization providing the funding
Academic

Person responsible for general inquiries

Contact
Name of organization / entity
Mashhad University of Medical Sciences
Full name of responsible person
Malika Vaez Tehrani
Position
PhD Candidate
Latest degree
Medical doctor
Other areas of specialty/work
Acupuncture
Street address
Traditional and Complementary Medicine Faculty, Shahid Kharazmi Complex, Mashhad University of Medical Science Campus, Azadi Square
City
Mashhad
Province
Razavi Khorasan
Postal code
9177899191
Phone
+98 51 3884 8931-6
Fax
+98 51 3882 9279
Email
Vaeztehrany@gmail.com

Person responsible for scientific inquiries

Contact
Name of organization / entity
Mashhad University of Medical Sciences
Full name of responsible person
Hamidreza Bahrami Taghanaki
Position
Professor
Latest degree
Ph.D.
Other areas of specialty/work
Acupuncture and Massage
Street address
Traditional and Complementary Medicine Faculty, Shahid Kharazmi Complex, Mashhad University of Medical Science Campus, Azadi Square
City
Mashhad
Province
Razavi Khorasan
Postal code
9177899191
Phone
+98 51 3884 8931-6
Fax
+98 51 3882 9279
Email
bahramihr@mums.ac.ir

Person responsible for updating data

Contact
Name of organization / entity
Mashhad University of Medical Sciences
Full name of responsible person
Hamidreza Bahrami Taghanaki
Position
Professor
Latest degree
Ph.D.
Other areas of specialty/work
Acupuncture and Massage
Street address
Traditional and Complementary Medicine Faculty, Shahid Kharazmi Complex, Mashhad University of Medical Science Campus, Azadi Square
City
Mashhad
Province
Razavi Khorasan
Postal code
9177899191
Phone
+98 51 3884 8931-6
Fax
+98 51 3882 9279
Email
Bahramihr@mums.ac.ir

Sharing plan

Deidentified Individual Participant Data Set (IPD)
Undecided - It is not yet known if there will be a plan to make this available
Study Protocol
Undecided - It is not yet known if there will be a plan to make this available
Statistical Analysis Plan
Undecided - It is not yet known if there will be a plan to make this available
Informed Consent Form
Undecided - It is not yet known if there will be a plan to make this available
Clinical Study Report
Undecided - It is not yet known if there will be a plan to make this available
Analytic Code
Undecided - It is not yet known if there will be a plan to make this available
Data Dictionary
Undecided - It is not yet known if there will be a plan to make this available
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