Acupuncture and dry-needling for low back pain (Review)

Lehmann 1986
(Continued)
Conclusions: “There were no significant differences between treatment groups with respect to their overall rehabilitation”.
“The electroacupuncture group demonstrated slightly better results than the other groups.”
Leibing 2002
Methods
Participants
Interventions
-Computer-based randomisation method.
-Patients and outcome assessors were blinded. (Patients were blinded only between two types of acupuncture)
-Funding: Ministry of Education, Science, Research and Technology, Federal Republic of Germany.
-Setting: Outpatient clinic. Department of Orthopaedics, University Goettingen, Germany
-Informed consent and ethics approval were obtained.
-Follow-up: 150 patients were randomised. 131 initiated treatment. 114 (76%) were followed at the end of the
treatment and 94 (63%) at 9 months.
-Analysis: ANOVA with post-hoc comparisons using Tukey studentized range tests when significant overall effects
observed. No intention-to-treat analysis, but used last observation carried forward from the 131 patients that initiated
treatment
150 patients with chronic (> 6 months) non-radiating low-back pain
Excluded: Abnormal neurological status, concomitant severe disease, psychiatric illness, current psychotherapy, pathological
lumbosacral anterior-posterior and lateral X-rays (except for minor degenerative changes), rheumatic inflammatory
disease, planned hospitalisation and refusal of participation
Mean age: 48.1 years old
Gender: 58% female
76% married
Mean BMI: 26.3
Working status: 82% employed
Current treatments: 8.4% surgery. 50% analgesics
1) All patients received standardized active physiotherapy of 26 sessions (each 30 minutes) over 12 weeks. It was
performed by trained physiotherapists according to the Bruegger-concept. In addition, 20 sessions (each 30 minutes)
by an experienced Taiwanese physician over 12 weeks. In the first 2 weeks, acupuncture was done 5/week, and in the
next 10 weeks, 1/week.
Combined traditional body and ear acupuncture. Twenty fixed body acupoints (9 bilateral, two single points) and
six on the ear (alternately on one ear) were selected according to their function in TCM and were needled in every
patient. No diagnostic procedure was done to determine individual acupoints.
Body points were manually stimulated until Teh Chi and left in place for 30 minutes: GV3, GV4, BL23, BL25,
BL31, BL32, BL40, BL60, GB34, SP6, Yautungdien (extra meridian, at the back of the hand).
Ear points (left in for one week): 38, 51, 52, 54, 55, 95
Randomized to this group: 50, but only 40 initiated treatment. Ten were lost before first session. Reasons: withdrew
consent=3; exclusion criteria appeared prior to treatment=5; relocated=2
2) No additional treatment. Only active physiotherapy (as described above)
Randomized to this group: 50, but only 46 started treatment. Four were lost before first treatment. Reasons: withdrew
consent=2; exclusion criteria=2
3) Sham acupuncture plus physiotherapy. Sham acupuncture received 20 sessions (each 30 minutes) of minimal
acupuncture by the same physician over 12 weeks. Sham acupuncture was done following the standards of minimal
acupuncture. Needles were inserted superficially, 10 to 20 mm distant to the verum-acupoints, outside the meridians,
and were not stimulated (no Teh Chi).
Randomized to this group: 50, but only 45 started treatment. Reasons: withdrew consent=1; exclusion criteria=4
Acupuncture and dry-needling for low back pain (Review)
Copyright © 2011 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
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