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

Yeung 2003
Methods
Participants
Interventions
Outcomes
-Randomized in blocks (method not described). Randomization was blinded.
-Outcome assessors blinded.
-Funding: The Hong Kong Development Fund and Tung Wah Board Fund
-Setting: Outpatient clinic in a hospital. Hong Kong.
-The aims and procedures of the study were explained before written consent was obtained.
Ethical approval from the Ethics Committee of the Hong Kong Hospital Authority and the Human Subject Ethics
Subcommittee of the Hong Kong Polytechnic University was obtained prior to the start of the study.
-Follow-up: 49 of 52 patients randomised (94%)
-Analysis: 2-factor mixed repeated measures ANOVA. Intention-to-treat analysis. Dropping patients for reasons other
than the treatment were given baseline values. Dropping patients for reasons related to the treatments were given
worst score
52 patients with chronic low-back pain (>6 months) with or without radiation. Age between 18 and 75 years
Diagnoses: non-specific low-back pain.
Excluded: 1. Structural deformity (ankylosing spondylitis, scoliosis) 2. Lower limb fracture 3. Tumours 4. Spinal
infection 5. Cauda equina syndrome 6. Pregnancy 7. Spinal cord compression 8. Subjects who were unable to keep the
appointments 9. Receiving acupuncture treatment within the past 6 months 10. Receiving physiotherapy treatment
within the past 3 months
Mean age: 53 years old
Gender: 9 males and 43 females
Working status: not described
Previous treatments: tui na, massage, chiropractor, bone setter or corset
1) Electro-acupuncture: 3/week for 4 weeks by a physiotherapist certificated in acupuncture. Points were chosen
according to the literature: BL23, BL25, BL40 and SP6. Acupuncture was applied to the side on which patients
reported pain. If the reported pain was bilateral, EA was applied to the more painful side. Sterilised disposable needles,
number 30 (0.3 mm) 40-mm long needles were inserted and manipulated until Teh Chi was obtained. Electrical
stimulation on needles at a frequency of 2 Hz for 30 minutes. The intensity of the stimulation was set at the level
that the patient could tolerate and often with evoked visible muscle contractions. The current had biphasic waveform
to the four selected acupoints in two pairs. In addition, all patients also received exercise therapy, the same as in the
control group.
Randomized to this group: 26. Lost to follow-up: 1
2) Standard group exercise program led by the same physiotherapist.
The program consisted of an hourly session each week for 4 consecutive weeks, and comprised back strengthening
and stretching exercises
In addition, patients were advised on spinal anatomy and body mechanics, back care and postural correction, lifting
and ergonomic advice, and behavioural modification, as well as a series of home exercises (15 min/day).
Randomized to this group: 26. Lost to follow-up: 2
1) Pain: Numerical rating scale for “average” and for “worst” pain intensity during the last week, by asking the patient
to rate perceived level of pain on a scale from 0 to 10, where 0 represents no pain and 10 represents pain as bad as it
could be.
2) Disability: The Aberdeen LBP scale (19-item) was used to measure low-back pain disability, because it is the only
LBP-specific functional disability scale validated for Chinese subjects. Responses to the questions were summed and
converted to a score percentage between 0 and 100, with 0 representing the least disabled and 100 the most severely
disabled
These outcomes were measured immediately after, 1 month and 3 months after
Costs: not reported
Complications: no adverse reaction or complication.
Acupuncture and dry-needling for low back pain (Review)
Copyright © 2011 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
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