Physician and treatment characteristics in a randomised multicentre trial of acupuncture in patients with osteoarthritis of the knee.
ABSTRACT The aim of this paper is to describe the treatment and physician characteristics in a randomised trial of acupuncture for osteoarthritis of the knee.
Three-armed, randomised, controlled multicentre trial with 1-year follow-up.
Twenty-eight outpatient centres in Germany.
A total of 294 patients with osteoarthritis of the knee were randomised to 12 sessions of semi-standardised acupuncture (at least 6 local and 2 distant points needled per affected knee from a selection of predefined points, but individual choice of additional body or ear acupuncture points possible), 12 sessions of minimal acupuncture (superficial needling of at least 8 of 10 predefined, bilateral, distant non-acupuncture points) or a waiting list control (2 months no acupuncture).
Participating trial physicians and interventions.
Forty-seven physicians specialised in acupuncture (mean age 43+/-8 years, 26 females) provided study interventions in 28 outpatient centres in Germany. The median duration of acupuncture training completed by participating physicians was 350 h (range 140-2508). The total number of needles used was 17.4+/-4.8 in the acupuncture group compared to 12.9+/-3.3 in the minimal acupuncture group. In total, 39 physicians (83%) stated that they would have treated patients in either a similar or in exactly the same way outside of the trial, whereas 7 (15%) stated that they would have treated patients differently (1 missing).
Our documentation of the trial interventions shows that semi-standardised acupuncture strategy represents an acceptable compromise for efficacy studies. However, a substantial minority of participating trial physicians stated that they would have treated patients differently outside of the trial.
- SourceAvailable from: ocean.kisti.re.kr[Show abstract] [Hide abstract]
ABSTRACT: Objective This study was performed to investigate whether Bee Venom Pharmacopuncture(BVP) could be a more effective modality than Warm Needling(WN) in relieving pain and symptoms of knee osteoarthritis(OA). Design Prospective, randomized and controlled clinical trial. Setting Single center trial in Korea Patients 49 volunteers with knee OA participated in the study. All the participants were screened through an inclusion and exclusion criteria. 33 participants were completed the clinical trial. Intervention The subjects were randomly assigned to one of two groups. One group received BVP(n=18), while the other group received WN(n=15). Sixteen sessions of BVP or WN were given at the pain region of the problematic knee for 8 weeks. Primary outcome measure is the Korean translation of Western Ontario and McMaster Universities Osteoarthritis Index scores(Korean WOMAC, KWOMAC). Secondary outcome measure is the physical health scores based on the 36-Item Short-Form Health Survey(SF-36) and Patient Global Assessment(PGA). KWOMAC and SF-36 were measured third (baseline, 4 and 8 weeks). PGA was measured twice(4 and 8 weeks). Results BVP group showed significant decrease compared to WN group in pain, function and total scores of KWOMAC according to the Mann-Whitney U-test. In the PGA, BVP group, compared to WN group, showed a significant increase. Conclusions BVP was more effective in relieving pain of knee OA than WN. These findings suggest that BVP is a promising alternative for treating knee OA.Journal of Korean Pharmacopuncture Institute. 06/2008; 11(2):21-31.
- [Show abstract] [Hide abstract]
ABSTRACT: The glassy translucent material found at the ends of bones, within synovial joints, is termed articular cartilage. While healthy, it provides a low-friction bearing surface, preventing bone-to-bone contact, and to an extent, absorb shock during vigorous activities. However, when damaged could lead to pain, deformity and reduced mobility; the social impact of which, entails high costs in terms of therapeutic treatments and loss of income. The present chapter reviews the common knowledge of the constraints to articular cartilage regeneration; namely cartilage structure, composition and major diseases. The first of the three sections detail the major constituents of the tissue and their structural organisation; the tissues mechanical properties, and ends with a brief description of how these features change in an unhealthy cartilage; be it mechanical or disease. In the second section, both clinical and academic approaches are pooled together, to review the current strategies in restoring health to joints with diseased or damaged cartilage. The final section highlights the fact that progression of cartilage disease affects not only the cartilage, but its underlying bone. The implications of the subchondral bone in the propagation of cartilage degeneration are discussed, and finally, their considerations in cartilage defect healing.
- [Show abstract] [Hide abstract]
ABSTRACT: Medical acupuncture is a term given to a pragmatic treatment approach used within the public health services in North Western Europe and other Western countries. Its rationale and methods are derived from, but distinct from, classical traditional Chinese medicine as it is practiced in China and in Europe. The article summarizes 9 principles of the medical acupuncture modality, offers an explanatory model, and reviews international research during 2005 to 2012.Journal of Acupuncture and Tuina Science 08/2013; 11(4).