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

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Analysis 5.2.<br />

Comparison 5 acupuncture versus placebo or sham intervention (Chronic LBP: > 3 months),<br />

Outcome 2 global improvement (higher values are better).<br />

<strong>Review</strong>:<br />

<strong>Acupuncture</strong> <strong>and</strong> <strong>dry</strong>-<strong>needling</strong> <strong>for</strong> <strong>low</strong> <strong>back</strong> <strong>pain</strong><br />

Comparison:<br />

5 acupuncture versus placebo or sham intervention (Chronic LBP: > 3 months)<br />

Outcome:<br />

2 global improvement (higher values are better)<br />

Study or subgroup <strong>Acupuncture</strong> placebo / sham Risk Ratio Weight Risk Ratio<br />

n/N n/N M-H,R<strong>and</strong>om,95% CI M-H,R<strong>and</strong>om,95% CI<br />

1 Immediately after the end of the sessions<br />

Lopacz 1979 13/18 9/16 11.2 % 1.28 [ 0.76, 2.16 ]<br />

Mendelson 1983 21/36 21/41 18.2 % 1.14 [ 0.76, 1.71 ]<br />

Molsberger 2002 52/62 41/61 70.6 % 1.25 [ 1.02, 1.53 ]<br />

Subtotal (95% CI) 116 118 100.0 % 1.23 [ 1.04, 1.46 ]<br />

Total events: 86 (<strong>Acupuncture</strong>), 71 (placebo / sham)<br />

Heterogeneity: Tau 2 = 0.0; Chi 2 = 0.19, df = 2 (P = 0.91); I 2 =0.0%<br />

Test <strong>for</strong> overall effect: Z = 2.35 (P = 0.019)<br />

2 Short-term fol<strong>low</strong>-up (up to 3 months after the end of the sessions)<br />

Carlsson 2001 16/34 2/16 9.8 % 3.76 [ 0.98, 14.44 ]<br />

Edelist 1976 7/15 6/15 22.7 % 1.17 [ 0.51, 2.66 ]<br />

Molsberger 2002 36/49 23/42 67.5 % 1.34 [ 0.97, 1.85 ]<br />

Subtotal (95% CI) 98 73 100.0 % 1.44 [ 0.92, 2.24 ]<br />

Total events: 59 (<strong>Acupuncture</strong>), 31 (placebo / sham)<br />

Heterogeneity: Tau 2 = 0.05; Chi 2 = 2.65, df = 2 (P = 0.27); I 2 =25%<br />

Test <strong>for</strong> overall effect: Z = 1.61 (P = 0.11)<br />

3 Intermediate-term fol<strong>low</strong>-up (3 months to 1 year)<br />

Kerr 2003 21/23 13/17 100.0 % 1.19 [ 0.89, 1.60 ]<br />

Subtotal (95% CI) 23 17 100.0 % 1.19 [ 0.89, 1.60 ]<br />

Total events: 21 (<strong>Acupuncture</strong>), 13 (placebo / sham)<br />

Heterogeneity: not applicable<br />

Test <strong>for</strong> overall effect: Z = 1.19 (P = 0.23)<br />

4 Long-term fol<strong>low</strong>-up (more than 1 year)<br />

Carlsson 2001 14/34 2/16 100.0 % 3.29 [ 0.85, 12.80 ]<br />

Subtotal (95% CI) 34 16 100.0 % 3.29 [ 0.85, 12.80 ]<br />

Total events: 14 (<strong>Acupuncture</strong>), 2 (placebo / sham)<br />

Heterogeneity: not applicable<br />

Test <strong>for</strong> overall effect: Z = 1.72 (P = 0.085)<br />

0.05 0.2 1 5 20<br />

favours control<br />

favours acupuncture<br />

<strong>Acupuncture</strong> <strong>and</strong> <strong>dry</strong>-<strong>needling</strong> <strong>for</strong> <strong>low</strong> <strong>back</strong> <strong>pain</strong> (<strong>Review</strong>)<br />

Copyright © 2011 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.<br />

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