- Email: [email protected]
Physiotherapy: other
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E. TREATMENT APPROACHES (Physical) E01 - Acupuncture (917) Acupuncture for low-back pain: An updated Cochrane systematic review A. Furlan, M. Van Tulder, D. Cherkin, H. Tsukayama, L. Lao, B. Koes, B. Berman; Cochrane Back Review Group, Toronto, ON This is an updated systematic review with the objective to assess the efficacy of acupuncture for the management of nonspecific low back pain. We searched Medline, Embase, CENTRAL, LILACS and databases of Chinese and Japanese articles. Only randomized controlled trials assessing acupuncture (with needles) for acute, subacute and chronic nonspecific low back pain in adults were included. Studies of acupuncture for sciatica, low back pain during pregnancy and specific causes of low back pain (neoplasm, infections, fractures or inflammation) were excluded. We assessed each included study for methodological quality using the 11 criteria recommended by the Cochrane Back Review Group (Spine, 2003). Each study was also assessed for clinical relevance and adequacy of acupuncture and control treatments. Two independent reviewers extracted the data and performed the quality assessment. Trials in languages other than English were extracted by one reviewer only. We extracted data (when available) for the following clinically relevant outcomes: pain, function, global improvement, satisfaction, well-being, work status, physical examination, complications and costs. In total, we included 35 randomized controlled trials (2861 patients). Twenty were published in English, seven in Japanese, five in Chinese, one in Norwegian, one in Polish and one in Dutch. The population included in these trials was in the majority comprised of chronic low back pain (24 studies, 1718 patients). The control groups were the following: no treatment, sham acupuncture, sham TENS, Chinese herbal medicine, education, exercise, massage, moxibustion, non-steroidal anti-inflammatory drugs, physiotherapy, spinal manipulation, TENS, trigger point injections and usual treatment by a general practitioner. Six included studies compared the effectiveness of two different acupuncture techniques. The results regarding effectiveness of acupuncture for low back pain will be available at the time of the meeting.
(918) Effectiveness of electroacupuncture in the management of knee osteoarthritis R. Chau, P. Lau, G. Ho, K. Wong, A. Chan, A. Leung; Queen Elizabeth Hospital, Hong Kong SAR Electroacupuncture is believed to be effective in alleviating osteoarthritic pain, but its effectiveness on physical function and quality of life remains obscure. A single-blind randomized controlled trial was conducted to investigate the treatment effectiveness of electroacupuncture on people with knee osteoarthritis. 138 patients diagnosed with knee osteoarthritis were recruited and randomly assigned to either (i) electroacupuncture and knee exercise, (ii) sham electroacupuncture and knee exercise, and (iii) the control group received knee exercise alone. Electroacupuncture were applied at four acupuncture points namely, ST 35, ST 36, SP10 & EX-LE4, while another four sham points were used in the sham electroacupuncture group. Subjects received treatment for ten sessions over four weeks. Each electroacupuncture treatment lasted for 20 minutes. Outcome parameters including visual analogue scale (VAS), range of knee motion, quadriceps strength, Timed-Up-and-Go test and Short Form 36(SF36) were recorded at the baseline, in session10, and at the 4-week and 6-month follow-up. Repeated measure ANOVA was used for data analysis. All subjects demonstrated improvement in the pain parameter and some domains in SF36 (p⬍0.05). When compared to sham group, the acupuncture group demonstrated greater improvements in VAS score and domains of physical functioning, bodily pain domain in SF36 over time. There was no statistical significant difference in the pain score and functioning domains between sham electroacupuncture and exercise groups and among the three groups upon 6-month follow-up (p⬎0.05, ANOVA). Electroacupuncture is an effective adjunct treatment to exercise training for people with knee osteoarthritis. Our findings demonstrated that electroacupuncture helped in relief of knee pain, restoring physical function, and improving the quality of life among patients with knee osteoarthritis. No adverse reaction was reported throughout the study.
Abstracts (919) Acupuncture for pediatric pain management Y. Lin; Children‘s Hospital Boston, Harvard Medical School, Boston, MA Acupuncture as a therapeutic intervention is widely practiced in the United States. This study reports our experience in integrating acupuncture into a pediatric pain and symptom management program. This study was approved by the IRB. The patients received weekly acupuncture treatments. The VAS pain score was obtained from the patient at the start of each visit by an associate other than the acupuncturist. We compared the patients’ VAS pain scores from before the first acupuncture treatment with the pain score collected at the conclusion of the sixth therapy. A paired t-test was utilized for statistical analysis. 191 pediatric patients received acupuncture treatments over the period of two years. The female: male ration was 2:1. The patients’ average age was 13.1 ⫾ 4.2 (mean ⫾ S.D.) years. Regions of the chief complaint at the initial consultation include: headache (21%); neck, shoulder, arm pain (8%); chest pain (3%); abdominal pain (20%); nausea and vomiting (6%); pelvic pain (2%); low back, hips and lower extremity pain (30%); and others (10%). The mean VAS pain score at the initial consultation was 8.3 ⫾ 1.4. The mean VAS pain score at the conclusion of the acupuncture treatment was 3.3 ⫾ 1.6. The overall VAS pain score was significantly reduced by 5.0 ⫾ 1.5 (p⬍0.01). There were no reported side effects or complications related to the acupuncture treatment. Patients reported attending more school days, having better sleep patterns, and were able to participate in more extracurricular activities. This report indicates that acupuncture can be safely and successfully incorporated into pediatric pain management practice. Pediatric patients experienced a reduction of pain, and overall improvement of well-being while having acupuncture treatments. Further prospective randomized studies are needed to evaluate the effectiveness of acupuncture pain management in the pediatric population.
E07 - Physiotherapy: Other (920) Would the addition of pulsed electromagnetic field to ice therapy produce greater reduction in pain and swelling after distal radius fracture? G. Cheing, J. Wan; The Hong Kong Polytechnic University, Hong Kong Ice therapy is a standard physiotherapy treatment for controlling acute swelling and pain after the immobilization period of distal radius fracture. In the recent decades, pulsed electromagnetic field (PEMF) is recognized as an effective treatment modality in promoting fracture healing. Many physiotherapists add PEMF to ice and hope that this combined treatment would enhance the treatment effects of ice therapy. However, no previous study has investigated the treatment efficacy of this combined treatment. This study examined whether the addition of pulsed electromagnetic field to ice therapy produces greater reduction in pain and swelling after distal radius fracture. Eighty-three subjects were randomly allocated into four groups, received 30 minutes of either i) ice plus PEMF; ii) ice plus placebo PEMF; iii) PEMF alone and iv) placebo PEMF for five consecutive days. The stimulation frequency of PEMF was 50 Hz with field intensity of 99 gauss. Outcome measures included a visual analogue scale, volumetric displacement for measuring the forearm swelling and the measurement of the range of motion at the wrist. Assessment was performed before treatment on Day 1, 3 and 5. Repeated measures analysis of variance was used for data analysis. By Day 5, the ice group demonstrated a significantly greater cumulative reduction in the scores of visual analogue scale, volumetric measurement, joint range of pronation and ulnar deviation than the groups receiving PEMF treatment or ice plus PEMF treatment (all p ⬍ 0.05). We found no significant difference between the PEMF groups versus the non-PEMF groups on any outcome measures. Ice therapy alone is effective in reducing pain and swelling for patients after the post-immobilization of distal radius fracture. The addition of PEMF to Ice treatment was not better than ice alone or PEMF.
E. TREATMENT APPROACHES (Physical) E01 - Acupuncture (917) Acupuncture for low-back pain: An updated Cochrane systematic review A. Furlan, M. Van Tulder, D. Cherkin, H. Tsukayama, L. Lao, B. Koes, B. Berman; Cochrane Back Review Group, Toronto, ON This is an updated systematic review with the objective to assess the efficacy of acupuncture for the management of nonspecific low back pain. We searched Medline, Embase, CENTRAL, LILACS and databases of Chinese and Japanese articles. Only randomized controlled trials assessing acupuncture (with needles) for acute, subacute and chronic nonspecific low back pain in adults were included. Studies of acupuncture for sciatica, low back pain during pregnancy and specific causes of low back pain (neoplasm, infections, fractures or inflammation) were excluded. We assessed each included study for methodological quality using the 11 criteria recommended by the Cochrane Back Review Group (Spine, 2003). Each study was also assessed for clinical relevance and adequacy of acupuncture and control treatments. Two independent reviewers extracted the data and performed the quality assessment. Trials in languages other than English were extracted by one reviewer only. We extracted data (when available) for the following clinically relevant outcomes: pain, function, global improvement, satisfaction, well-being, work status, physical examination, complications and costs. In total, we included 35 randomized controlled trials (2861 patients). Twenty were published in English, seven in Japanese, five in Chinese, one in Norwegian, one in Polish and one in Dutch. The population included in these trials was in the majority comprised of chronic low back pain (24 studies, 1718 patients). The control groups were the following: no treatment, sham acupuncture, sham TENS, Chinese herbal medicine, education, exercise, massage, moxibustion, non-steroidal anti-inflammatory drugs, physiotherapy, spinal manipulation, TENS, trigger point injections and usual treatment by a general practitioner. Six included studies compared the effectiveness of two different acupuncture techniques. The results regarding effectiveness of acupuncture for low back pain will be available at the time of the meeting.
(918) Effectiveness of electroacupuncture in the management of knee osteoarthritis R. Chau, P. Lau, G. Ho, K. Wong, A. Chan, A. Leung; Queen Elizabeth Hospital, Hong Kong SAR Electroacupuncture is believed to be effective in alleviating osteoarthritic pain, but its effectiveness on physical function and quality of life remains obscure. A single-blind randomized controlled trial was conducted to investigate the treatment effectiveness of electroacupuncture on people with knee osteoarthritis. 138 patients diagnosed with knee osteoarthritis were recruited and randomly assigned to either (i) electroacupuncture and knee exercise, (ii) sham electroacupuncture and knee exercise, and (iii) the control group received knee exercise alone. Electroacupuncture were applied at four acupuncture points namely, ST 35, ST 36, SP10 & EX-LE4, while another four sham points were used in the sham electroacupuncture group. Subjects received treatment for ten sessions over four weeks. Each electroacupuncture treatment lasted for 20 minutes. Outcome parameters including visual analogue scale (VAS), range of knee motion, quadriceps strength, Timed-Up-and-Go test and Short Form 36(SF36) were recorded at the baseline, in session10, and at the 4-week and 6-month follow-up. Repeated measure ANOVA was used for data analysis. All subjects demonstrated improvement in the pain parameter and some domains in SF36 (p⬍0.05). When compared to sham group, the acupuncture group demonstrated greater improvements in VAS score and domains of physical functioning, bodily pain domain in SF36 over time. There was no statistical significant difference in the pain score and functioning domains between sham electroacupuncture and exercise groups and among the three groups upon 6-month follow-up (p⬎0.05, ANOVA). Electroacupuncture is an effective adjunct treatment to exercise training for people with knee osteoarthritis. Our findings demonstrated that electroacupuncture helped in relief of knee pain, restoring physical function, and improving the quality of life among patients with knee osteoarthritis. No adverse reaction was reported throughout the study.
Abstracts (919) Acupuncture for pediatric pain management Y. Lin; Children‘s Hospital Boston, Harvard Medical School, Boston, MA Acupuncture as a therapeutic intervention is widely practiced in the United States. This study reports our experience in integrating acupuncture into a pediatric pain and symptom management program. This study was approved by the IRB. The patients received weekly acupuncture treatments. The VAS pain score was obtained from the patient at the start of each visit by an associate other than the acupuncturist. We compared the patients’ VAS pain scores from before the first acupuncture treatment with the pain score collected at the conclusion of the sixth therapy. A paired t-test was utilized for statistical analysis. 191 pediatric patients received acupuncture treatments over the period of two years. The female: male ration was 2:1. The patients’ average age was 13.1 ⫾ 4.2 (mean ⫾ S.D.) years. Regions of the chief complaint at the initial consultation include: headache (21%); neck, shoulder, arm pain (8%); chest pain (3%); abdominal pain (20%); nausea and vomiting (6%); pelvic pain (2%); low back, hips and lower extremity pain (30%); and others (10%). The mean VAS pain score at the initial consultation was 8.3 ⫾ 1.4. The mean VAS pain score at the conclusion of the acupuncture treatment was 3.3 ⫾ 1.6. The overall VAS pain score was significantly reduced by 5.0 ⫾ 1.5 (p⬍0.01). There were no reported side effects or complications related to the acupuncture treatment. Patients reported attending more school days, having better sleep patterns, and were able to participate in more extracurricular activities. This report indicates that acupuncture can be safely and successfully incorporated into pediatric pain management practice. Pediatric patients experienced a reduction of pain, and overall improvement of well-being while having acupuncture treatments. Further prospective randomized studies are needed to evaluate the effectiveness of acupuncture pain management in the pediatric population.
E07 - Physiotherapy: Other (920) Would the addition of pulsed electromagnetic field to ice therapy produce greater reduction in pain and swelling after distal radius fracture? G. Cheing, J. Wan; The Hong Kong Polytechnic University, Hong Kong Ice therapy is a standard physiotherapy treatment for controlling acute swelling and pain after the immobilization period of distal radius fracture. In the recent decades, pulsed electromagnetic field (PEMF) is recognized as an effective treatment modality in promoting fracture healing. Many physiotherapists add PEMF to ice and hope that this combined treatment would enhance the treatment effects of ice therapy. However, no previous study has investigated the treatment efficacy of this combined treatment. This study examined whether the addition of pulsed electromagnetic field to ice therapy produces greater reduction in pain and swelling after distal radius fracture. Eighty-three subjects were randomly allocated into four groups, received 30 minutes of either i) ice plus PEMF; ii) ice plus placebo PEMF; iii) PEMF alone and iv) placebo PEMF for five consecutive days. The stimulation frequency of PEMF was 50 Hz with field intensity of 99 gauss. Outcome measures included a visual analogue scale, volumetric displacement for measuring the forearm swelling and the measurement of the range of motion at the wrist. Assessment was performed before treatment on Day 1, 3 and 5. Repeated measures analysis of variance was used for data analysis. By Day 5, the ice group demonstrated a significantly greater cumulative reduction in the scores of visual analogue scale, volumetric measurement, joint range of pronation and ulnar deviation than the groups receiving PEMF treatment or ice plus PEMF treatment (all p ⬍ 0.05). We found no significant difference between the PEMF groups versus the non-PEMF groups on any outcome measures. Ice therapy alone is effective in reducing pain and swelling for patients after the post-immobilization of distal radius fracture. The addition of PEMF to Ice treatment was not better than ice alone or PEMF.