Acupuncture for Knee Osteoarthritis – a Randomised Trial Using a Novel Sham

Manheimer, Eric; Byung-Mook, Lim，; Lao, Lixing; Berman, Brian M.

doi:10.1136/aim.24.suppl.7

Cited by 26 publications

(22 citation statements)

References 24 publications

(23 reference statements)

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“…Several trials have reported that acupuncture is efficacious in decreasing pain and improving function in patients with knee or hip OA [30][31][32][33][34][35][36]. However, controversy exists regarding the appropriate control group for these trials.…”

Section: Acupuncturementioning

confidence: 99%

The benefit of nonpharmacologic therapy to treat symptomatic osteoarthritis

Lee¹,

Shmerling²

2008

Curr Rheumatol Rep

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Osteoarthritis affects a large proportion of the population, especially the elderly, leading to pain and disability. To relieve pain, many patients are turning toward nonpharmacologic therapies. Conventional nonpharmacologic treatments such as weight loss and exercise are well accepted by the medical community, and some randomized controlled trials support the use of these treatments in patients with knee osteoarthritis. However, little information exists regarding the efficacy of these treatments for osteoarthritis at other sites. Less conventional treatments such as acupuncture and massage are emerging as promising options for osteoarthritis treatment, but the magnitude of benefit has varied between studies. More investigation is necessary to reach a conclusion regarding the efficacy of these treatments.

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Section: Acupuncturementioning

confidence: 99%

The benefit of nonpharmacologic therapy to treat symptomatic osteoarthritis

Lee¹,

Shmerling²

2008

Curr Rheumatol Rep

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“…56 Regarding other potential sources of bias (including lack of intention-to-treat analysis, information about cointerventions, compliance, acceptability and baseline comparisons), 16 studies were found to demonstrate an unclear risk of bias due to the lack of intention-to-treat analysis, insufficient information about cointerventions, compliance and acceptability. [45][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60][61] Additionally, one of these trials failed to report baseline WOMAC and VAS information. 56 The completeness of the STRICTA checklist for each study is detailed in table 2.…”

Section: Study Qualitymentioning

confidence: 99%

“…43-53 55-58 All studies reported the treatment regimen very well. [43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60][61] Only two trials applied cointerventions. 52 53 As for practitioner background, five studies reported the duration of relevant training 46 51 52 58 59 ; six studies the length of clinical experience 44-46 50-52 ; and only one study reported the therapists' expertise in the specific condition.…”

Section: Study Qualitymentioning

confidence: 99%

“…These 19 studies were published between 1992 and 2014. [43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60][61] The number of participants in the studies varied from 20 to 712. Two studies were conducted in the USA, [43][44][45] three in Germany, 46 58 59 four in China, 47-49 61 three in the UK, 52 56 57 and one each in Australia, 50 Japan, 51 Greece, 53 Iran, 54 Thailand 55 and Denmark.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…[43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60][61] The number of participants in the studies varied from 20 to 712. Two studies were conducted in the USA, [43][44][45] three in Germany, 46 58 59 four in China, 47-49 61 three in the UK, 52 56 57 and one each in Australia, 50 Japan, 51 Greece, 53 Iran, 54 Thailand 55 and Denmark. 60 Thirteen studies compared acupuncture as a primary treatment against different types of control intervention, 43-45 47 48 50-52 56-60 of which two consisted of no treatment, 50 56 three used allocation to a waiting list, [58][59][60] two used pharmaceutical interventions (namely sodium hyaluronate 47 and glucosamine hydrochloride capsules 48 ), and one each used standard care (oral therapy), 43 usual care (medications and interventions), 52 education, 44 45 topical poultices, 51 isometric exercises 54 and home exercises.…”

Section: Study Characteristicsmentioning

confidence: 99%

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Updated Systematic Review and Meta-Analysis of Acupuncture for Chronic Knee Pain

et al. 2017

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Objective To assess the effectiveness and safety of acupuncture for the treatment of chronic knee pain (CKP). Methods We searched the MEDLINE, EMBASE, Cochrane CENTERAL, CINAHL and four Chinese medical databases from their inception to June 2017. We included randomised controlled trials of acupuncture as the sole treatment or as an adjunctive treatment for CKP. The primary outcome was pain intensity measured by visual analogue scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale and 11-point numeric rating scale. Secondary outcome measurements included the 36-Item Short Form Health Survey and adverse events. The quality of all included studies was evaluated using the Cochrane risk-of-bias criteria and the STRICTA (Standards for Reporting Interventions in Controlled Trials of Acupuncture) checklist. Results Nineteen trials were included in this systematic review. Of these, data from 17 studies were available for analysis. Regarding the effectiveness of acupuncture alone or combined with other treatment, the results of the metaanalysis showed that acupuncture was associated with significantly reduced CKP at 12 weeks on WOMAC pain subscale (mean difference (MD) −1.12, 95% confidence interval (CI) −1.98 to −0.26, I

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Divergent neural processes specific to the acute and sustained phases of verum and SHAM acupuncture

Liu

Qin

Guo

et al. 2010

Magnetic Resonance Imaging

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Purpose: To discuss which brain region potentially functioned and switched between the immediate and delayed response of acupuncture. Materials and Methods:A nonrepeated event-related functional MRI (fMRI) design was used to investigate the spatial and temporal patterns of acupuncture effects induced by needling an acupoint ST36 (ACU) and a nonmeridian point (SHAM). The standard general linear model was used to detect the immediate neural responses of acupuncture. Graph theory analysis was used to characterize the functional integrated network of the acupuncture delayed effect.Results: Acupuncture induced significant signal changes in the limbic/paralimbic areas, neocortical regions, brainstem, and cerebellum for immediate effect both in ACU and SHAM. Some of these brain regions showed strong functional connectivity for a delayed effect in ACU. Conjunction analysis showed that the insula played a critical role during the overall process of ACU. No overlapping brain regions were found in SHAM. Conclusion:The findings of this study suggested that the delayed effects may reflect a more significant characteristic underlying acupuncture. Given that the insula as a relay station switched between the immediate and delayed response, it suggested that divergent functional connectivity patterns may mediate the acupuncture-related effects for ACU and SHAM.

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Acupuncture for Knee Osteoarthritis – a Randomised Trial Using a Novel Sham

Cited by 26 publications

References 24 publications

The benefit of nonpharmacologic therapy to treat symptomatic osteoarthritis

The benefit of nonpharmacologic therapy to treat symptomatic osteoarthritis

Updated Systematic Review and Meta-Analysis of Acupuncture for Chronic Knee Pain

Divergent neural processes specific to the acute and sustained phases of verum and SHAM acupuncture

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