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Tai chi for osteoarthritis of the knee – a systematic review and meta-analysis
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Poster Presentations / European Journal of Integrative Medicine 4S (2012) 124–201
Conclusion: Results from this pilot study suggest a high acceptability of acupuncture point injection of vitamin K as a treatment for primary dysmenorrhoea among US women. Decreases in pain in both treatment and control groups were observed, with a trend towards greater pain reduction for vitamin K1/Spleen-6 injection. Study findings are consistent with studies conducted in Shanghai, where this treatment protocol was initially developed, and single arm pilot studies in China and Italy conducted between 2001 and 2009.
as treatment for osteoarthritis of the knee. Further RCTs are necessary for conclusive judgement of its long-term effectiveness. http://dx.doi.org/10.1016/j.eujim.2012.07.789 PP-030 Hypnotic treatment for chronic pain: case reports Ciaramella Antonella, Micco Paola, Rossi Stefano Gift Institute, Pisa, Italy
http://dx.doi.org/10.1016/j.eujim.2012.07.788 PP-029 Tai chi for osteoarthritis of the knee – a systematic review and meta-analysis Lauche Romy, Langhorst Jost, Dobos Gustav, Cramer Holger University of Duisburg-Essen, Complementary and Integrative Medicine, Essen, Germany Background: Tai chi, a traditional Chinese mind–body exercise combining movements with meditation, has been considered effective for the treatment of several musculoskeletal conditions. Due to its focus on balance, strength and flexibility, it may also be beneficial for patients with osteoarthritis of the knee, where functional impairment and stiffness are as disabling as pain. Aim: This systematic review aimed to assess and metaanalyse the efficacy of Tai chi for osteoarthritis of the knee. Methods: CAMBASE, the Cochrane Library, EMBASE and MEDLINE via PubMed were screened through March 2012. Randomised controlled trials (RCTs) comparing Tai chi to control conditions in patients with osteoarthritis of the knee were included. Main outcome measures were pain, functional impairment, joint stiffness and quality of life. Psychological well-being and safety were defined as secondary outcome measures. For each outcome, standardised mean differences (SMDs) and 95% confidence intervals (CIs) were calculated. Results: Five RCTs with overall 274 patients with osteoarthritis of the knee were included. Four trials had low risk of bias. There was strong overall evidence for short-term pain reduction (SMD = –0.67 95% CI –0.97 to –0.37 P < 0.01), shortterm improvement of function (SMD = –0.67 95% CI –0.94 to –0.40 P < 0.01) and short-term improvement of physical quality of life (SMD = +0.88 95% CI +0.42 to +1.34 P < 0.01). Moderate evidence was found for short-term effects on stiffness (SMD = –0.42 95% CI –0.74 to –0.10 P = 0.01); this effect did not sustain after exclusion of the high-risk RCT. Subgroup analysis showed significant moderate effects for pain and function in the short term in trials with attention controls as well as with wait-lists and a moderate short-term effect on stiffness; this effect however was not distinguishable from bias. Tai chi was not associated with serious adverse events. Discussion: This systematic review found strong overall evidence for short-term reduction of pain, functional impairment and improvement of physical quality of life. Given the absence of serious adverse events, Tai chi therapy can be recommended
Background: Clinical and experimental research literature indicate that hypnosis is very useful for severe and persistent pain; yet reviews suggest that hypnosis is not widely used. Even though some results show that high hypnotic suggestibility is not necessary for successful hypnotic pain intervention, other studies detected that higher hypnotisability is associated with relatively greater response to the hypnotic analgesia suggestion. Methods: This is a case report series. Subjects were evaluated using a Stanford scale form A (Weitzenhoffer and Hilgard, 1959). Only subjects with high hypnotic susceptibility (total scoring ≥9) were selected for treatment of chronic pain with hypnosis. The treatment consists of a Structured Phenomenological Hypnotic Protocol (SPHP), four sessions every 14 days consisting of: 1) rapid induction analgesia (RIA, Barber, 1977), 2) symptom transformation (ST), 3) symptom modulation (SM) and 4) dissociation (D). Before and after each session, the pain was evaluated using: a) the Questionario Italiano per il dolore (QUID, De Benedictis et al., 1988), a multidimensional assessment tool for pain (sensorial, affective and evaluative) and b) a 0–10 visual one-dimensional scale (visual analogue scale (VAS)), which was used to assess intensity of pain. Results: Five female (two cancer, two fibromyalgia and one migraine) patients with chronic pain, with a mean age of 46.5 (SD = 19.67) years participated. The mean reduction scoring of intensity of pain (VAS) per session was RIA = 2, ST = 3, SM = 2.25, D = 2. The mean reduction scoring of dimensions of pain was respectively sensorial (RIA = 0.12, ST = 0.15, SM = 0.18, D = 0.18), affective (RIA = 0.18, ST = 0.35, SM = 0.16, D = 0.27) and evaluative (RIA = 0.14, ST = 0.15, SM = 0.16, D = 0.43). Conclusions: This is a preliminary evaluation of Structured Phenomenological Hypnotic Protocol (SPHP) for treatment of chronic pain. A significant reduction was observed in the intensity and dimensions of pain in each session. The ST revealed most of all hypnotic treatment that improves chronic pain. However, long-lasting improvement of pain between each session was not shown. http://dx.doi.org/10.1016/j.eujim.2012.07.790
Poster Presentations / European Journal of Integrative Medicine 4S (2012) 124–201
Conclusion: Results from this pilot study suggest a high acceptability of acupuncture point injection of vitamin K as a treatment for primary dysmenorrhoea among US women. Decreases in pain in both treatment and control groups were observed, with a trend towards greater pain reduction for vitamin K1/Spleen-6 injection. Study findings are consistent with studies conducted in Shanghai, where this treatment protocol was initially developed, and single arm pilot studies in China and Italy conducted between 2001 and 2009.
as treatment for osteoarthritis of the knee. Further RCTs are necessary for conclusive judgement of its long-term effectiveness. http://dx.doi.org/10.1016/j.eujim.2012.07.789 PP-030 Hypnotic treatment for chronic pain: case reports Ciaramella Antonella, Micco Paola, Rossi Stefano Gift Institute, Pisa, Italy
http://dx.doi.org/10.1016/j.eujim.2012.07.788 PP-029 Tai chi for osteoarthritis of the knee – a systematic review and meta-analysis Lauche Romy, Langhorst Jost, Dobos Gustav, Cramer Holger University of Duisburg-Essen, Complementary and Integrative Medicine, Essen, Germany Background: Tai chi, a traditional Chinese mind–body exercise combining movements with meditation, has been considered effective for the treatment of several musculoskeletal conditions. Due to its focus on balance, strength and flexibility, it may also be beneficial for patients with osteoarthritis of the knee, where functional impairment and stiffness are as disabling as pain. Aim: This systematic review aimed to assess and metaanalyse the efficacy of Tai chi for osteoarthritis of the knee. Methods: CAMBASE, the Cochrane Library, EMBASE and MEDLINE via PubMed were screened through March 2012. Randomised controlled trials (RCTs) comparing Tai chi to control conditions in patients with osteoarthritis of the knee were included. Main outcome measures were pain, functional impairment, joint stiffness and quality of life. Psychological well-being and safety were defined as secondary outcome measures. For each outcome, standardised mean differences (SMDs) and 95% confidence intervals (CIs) were calculated. Results: Five RCTs with overall 274 patients with osteoarthritis of the knee were included. Four trials had low risk of bias. There was strong overall evidence for short-term pain reduction (SMD = –0.67 95% CI –0.97 to –0.37 P < 0.01), shortterm improvement of function (SMD = –0.67 95% CI –0.94 to –0.40 P < 0.01) and short-term improvement of physical quality of life (SMD = +0.88 95% CI +0.42 to +1.34 P < 0.01). Moderate evidence was found for short-term effects on stiffness (SMD = –0.42 95% CI –0.74 to –0.10 P = 0.01); this effect did not sustain after exclusion of the high-risk RCT. Subgroup analysis showed significant moderate effects for pain and function in the short term in trials with attention controls as well as with wait-lists and a moderate short-term effect on stiffness; this effect however was not distinguishable from bias. Tai chi was not associated with serious adverse events. Discussion: This systematic review found strong overall evidence for short-term reduction of pain, functional impairment and improvement of physical quality of life. Given the absence of serious adverse events, Tai chi therapy can be recommended
Background: Clinical and experimental research literature indicate that hypnosis is very useful for severe and persistent pain; yet reviews suggest that hypnosis is not widely used. Even though some results show that high hypnotic suggestibility is not necessary for successful hypnotic pain intervention, other studies detected that higher hypnotisability is associated with relatively greater response to the hypnotic analgesia suggestion. Methods: This is a case report series. Subjects were evaluated using a Stanford scale form A (Weitzenhoffer and Hilgard, 1959). Only subjects with high hypnotic susceptibility (total scoring ≥9) were selected for treatment of chronic pain with hypnosis. The treatment consists of a Structured Phenomenological Hypnotic Protocol (SPHP), four sessions every 14 days consisting of: 1) rapid induction analgesia (RIA, Barber, 1977), 2) symptom transformation (ST), 3) symptom modulation (SM) and 4) dissociation (D). Before and after each session, the pain was evaluated using: a) the Questionario Italiano per il dolore (QUID, De Benedictis et al., 1988), a multidimensional assessment tool for pain (sensorial, affective and evaluative) and b) a 0–10 visual one-dimensional scale (visual analogue scale (VAS)), which was used to assess intensity of pain. Results: Five female (two cancer, two fibromyalgia and one migraine) patients with chronic pain, with a mean age of 46.5 (SD = 19.67) years participated. The mean reduction scoring of intensity of pain (VAS) per session was RIA = 2, ST = 3, SM = 2.25, D = 2. The mean reduction scoring of dimensions of pain was respectively sensorial (RIA = 0.12, ST = 0.15, SM = 0.18, D = 0.18), affective (RIA = 0.18, ST = 0.35, SM = 0.16, D = 0.27) and evaluative (RIA = 0.14, ST = 0.15, SM = 0.16, D = 0.43). Conclusions: This is a preliminary evaluation of Structured Phenomenological Hypnotic Protocol (SPHP) for treatment of chronic pain. A significant reduction was observed in the intensity and dimensions of pain in each session. The ST revealed most of all hypnotic treatment that improves chronic pain. However, long-lasting improvement of pain between each session was not shown. http://dx.doi.org/10.1016/j.eujim.2012.07.790