Clinical critical qualitative evaluation of the selected randomized controlled trials in current acupuncture researches for low back pain

Miao, Edwin Yong

doi:10.3736/jcim20101205

Cited by 4 publications

(3 citation statements)

References 16 publications

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“…In fact, external validity has increasingly become an issue of concern and has been raised by several acupuncture researchers. [19][20][21][22][23] Miao 23 conducted a systematic review to determine the external validity of the RCTs of acupuncture for low back pain and found major problems in the external validity of all cases. Ahmad et al 15 conducted a review and reported inadequate reporting data related to external validity specifi cally from RCTs assessing pharmacological and non-pharmacological treatments for hip and knee osteoarthritis (OA).…”

Section: Introductionmentioning

confidence: 99%

External Validity in Randomised Controlled Trials of Acupuncture for Osteoarthritis Knee Pain

et al. 2012

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Objectives To assess two aspects of the external validity of acupuncture research for osteoarthritis knee pain and determine the common acupoints and treatment parameters used. Methods The external validity of 16 randomised controlled trials (RCTs) was investigated using a scale consisting of two aspects: reporting and performance. The reporting aspect included acupuncturist's background, study location, treatment detailed, patient characteristics, positive trial results, adverse effects and between-group statistical differences, whereas treatment appropriateness, appropriate controls and outcomes were classifi ed as the performance aspect. Acupuncture treatment in RCTs was compared with common practice according to the literature sources and survey of acupuncturists working in different parts of Thailand. Results The levels of external validity for the reporting and performance aspects were in the range of 31.3% to 100%. Statistic values such as mean difference and confi dence interval were reported by the minority of trials (43.8%). Patient satisfaction and quality of life were seldom used (31.3%). There were minor differences between research and practice in terms of the points used (25.0%), number of treatment sessions (6.3%) and frequency (12.5%). The most frequently used points were ST34, ST35, ST36, SP6, SP9, SP10, GB34, Xiyan and ah shi points, and the commonly used treatment parameters were 20 minutes, 10-15 sessions and two treatments weekly. Conclusions Reporting of the external validity of acupuncture RCTs for knee pain was notably inadequate in terms of trial setting, treatment provider and statistical reporting. The majority of studies involved appropriate controls and outcomes and applied acupuncture treatments in line with practice.

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Section: Introductionmentioning

confidence: 99%

External Validity in Randomised Controlled Trials of Acupuncture for Osteoarthritis Knee Pain

et al. 2012

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“…Secondly, central opioid mechanisms present no evident mechanism through which needling an acupuncture point adjacent to a painful area may be able to reduce pain; however, central sensitization includes the malfunction of descending pain inhibitory pathways, which may result in dysfunctional endogenous analgesia (38). Thirdly, in clinical practice, acupuncture is generally more effective in relieving local pain compared with needling distal areas, a phenomenon that is comparable with the presence of a localized analgesic mechanism (39)(40)(41). Due to the lack of endogenous analgesia, increased temporal summation of secondary pain may contribute to the development or maintenance of central sensitization in patients with chronic pain (42).…”

Section: Proposed Mechanisms Of Acupuncture-induced Analgesiamentioning

confidence: 99%

Acupuncture: Emerging evidence for its use as an analgesic (Review)

Gao

et al. 2015

Experimental and Therapeutic Medicine

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Abstract. Acupuncture is an ancient Chinese technique, developed over >3,000 years, in which ʻacupointsʼ are stimulated with the aim of treating various diseases. A number of previous studies have indicated that acupuncture may play a role in inducing analgesia. Acupuncture-induced analgesia has been hypothesized to act on various parts of the central nervous system, including the spinal cord, brain stem, cerebral ganglia and cerebral cortex. The mechanisms underlying the effects of acupuncture have been purported to include neurohumors and neurotransmitters, such as opioids and γ-aminobutyric acid, signaling pathways and the immune response, which are all involved in the induction of analgesia.

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“…However, the placebo treatment had higher clinical effects than no treatment when measured by a subjective continuous outcome variable [ 10 ]. Moreover, in pain treatment, subjective outcomes cannot avoid the risk of bias [ 11 ]. Second, while there are several reviews on the effectiveness of acupuncture in chronic neck pain, no accepted mechanism is known; though, the chronic neck pain might be related with immunologic or stress factors.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of Myofascial-meridian Release Acupuncture (MMRA) for chronic neck pain: a study protocol for randomized, patient- and assessor-blinded, sham controlled trial

Lee

Nam

Leem

et al. 2015

BMC Complement Altern Med

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BackgroundThe purpose of this study is to evaluate the efficacy and safety of myofascial-meridian release acupuncture (MMRA) in the treatment of chronic neck pain compared with sham acupuncture.Methods/designA protocol for a randomized, patient- and assessor-blinded, sham controlled parallel trial is presented. Seventy-four participants with a ≥3 month history of neck pain and a score of ≥4 on the 11-point pain intensity numerical rating scale (PI-NRS) will be randomly assigned to the MMRA group (n = 37) or sham acupuncture group (n = 37). The participants will receive the MMRA treatment or sham acupuncture treatment twice per week for 4 weeks. The primary outcome is the mean change in the PI-NRS (0 = no pain and 10 = worst possible pain, 11-point Likert scale) from baseline to 4 weeks. The secondary outcomes are the mean change from baseline on the clinical relevance of the pain (ratio of changes greater than 1.5 or with percentiles greater than 30 % and 50 % in the PI-NRS), function (Neck Disability Index and Cervical Range of Motion), autonomic and psychometric measurements (Heart Rate Variability and Perceived Stress Scale), quality of life (EuroQol), global assessment (Patient Global Impression of Change), semi-objective outcomes (pressure pain threshold, consumption of rescue medicine and days of restricted activity) and immunologic/stress biomarkers. Adverse events will be evaluated at every visit.DiscussionThe results of this trial will provide evidence to confirm the efficacy and safety of acupuncture for chronic neck pain.Trial registrationThe trial is registered with the Clinical Research Information Service (CRiS), Republic of Korea: KCT0001573.

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Clinical critical qualitative evaluation of the selected randomized controlled trials in current acupuncture researches for low back pain

Cited by 4 publications

References 16 publications

External Validity in Randomised Controlled Trials of Acupuncture for Osteoarthritis Knee Pain

External Validity in Randomised Controlled Trials of Acupuncture for Osteoarthritis Knee Pain

Acupuncture: Emerging evidence for its use as an analgesic (Review)

Efficacy and safety of Myofascial-meridian Release Acupuncture (MMRA) for chronic neck pain: a study protocol for randomized, patient- and assessor-blinded, sham controlled trial

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