The effectiveness of electro-acupuncture versus electrical heat acupuncture in the management of chronic low back pain

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The effectiveness of electro-acupuncture versus electrical heat acupuncture in the management of chronic low back pain

 

Author: Tsui, Lai-kuen
Title: The effectiveness of electro-acupuncture versus electrical heat acupuncture in the management of chronic low back pain
Degree: M.Sc.
Year: 2003
Subject: Hong Kong Polytechnic University -- Dissertations
Backache -- Acupuncture
Backache -- Treatment
Acupuncture
Department: Multi-disciplinary Studies
Dept. of Rehabilitation Sciences
Pages: xii, 94 leaves : col. ill. ; 30 cm
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b1710670
URI: http://theses.lib.polyu.edu.hk/handle/200/2630
Abstract: The prevalence of chronic low back pain is high in the general population over the world. It exerts a great burden on the medical cost. Various treatments have been using for managing pain, and to improve the associated stiffness, weakness and reduce the disability level. Acupuncture has been used for the treatment of chronic low back pain. Previous study done by Thomas and Lundeberg (1994) showed that Electro-acupuncture (EA) was more effective in treating chronic low back pain as compared with pure needle acupuncture. Ishimaru et al (1993) also demonstrated that electrical heat acupuncture (EH) was superior than needle acupuncture in improving pain and range of motion for chronic low back pain patients. However, the relative effectiveness of EA and EH has not been examined. This study was a double-blinded, randomized controlled trial to investigate the relative effectiveness of EA and EH in reducing pain for chronic low back pain patient. Forty-two subjects (30 women and 12 men) with the mean age of 39.9 suffering from chronic low back pain were recruited from United Christian Hospital. They were matched with the nature of their occupation, and then randomly allocated into three groups (EA, EN and Control). Subjects in the EA group (n=14) received EA (2/15 Hz) on a total of 6 acupuncture points. Four local acupuncture points over the BL 25, BL 26 on both sides, plus two extra distal points GB 30 and BL 40 or ST 36. Distal points were selected based on whether the painful site located at the posterior or lateral aspect of thigh. The treatment duration was 20 minutes. The treatment frequency was twice per week for 4 weeks (a total of 8 sessions). Subjects in the EH group (n=14) received intermittent electrical heat with 42C on the same acupuncture points for 20 minutes, twice per week for 4 weeks. Both the treatment groups and the control group (n=14) received conventional back exercise as a home program. The acupuncture treatments were preformed by a registered physiotherapist who had been accredited for acupuncture practice in Hong Kong. Two other assessors when preformed the assessments were blinded to the group allocation. Baseline measurement was performed before intervention, then assessed again after the 4th session, after the 8th session and at the 1-month follow-up session. The outcome measures included numerical rating scale of pain (NPRS), straight leg raise (SLR) and Roland Morris Disability Questionnaire (RMDQ). Repeated measures analysis of variance (ANOVA) was used to analyze the time effect as well as the group effect on the outcomes. The results showed that there were significant reduction of pain in the EA (p=0.000), EH (P=0.000) and the control (p=0.013) groups across sessions. For the between-group comparisons, significant differences were shown after session 4 (p=0.006), after session 8 (p=0.001) and 1-month follow-up session (p=0.001). Post-hoc tests showed that the NPRS of the EH group was significantly lower than that of the EA group and the control group after session 4 (p=0.004). After session 8, the NPRS of both the EA group (P=0.003) and the EH group (0.001) were significantly lower than that of the control group. At 1-month follow-up, the NPRS of both the EA group (p=0.001) and the EH group (p=0.004) were still significantly lower than that of the control group. For SLR measurement, only the EA group showed significant improvement across sessions (p=0.000). For the between-group differences, there were significant differences between-groups in session 8 (p=0.001) and 1-month follow-up (p=0.002). Post-hoc tests showed that EA produced significantly greater gain than the EH group and the control group in SLR after session 8 (p=0.000) and at the 1-month follow-up (p=0.002). For the RMDQ score, the improvement within each of the three groups was statistically significant (p= 0.000). EA showed a slightly greater improvement across sessions (the EA group decreased by 44.63%, EH group decreased by 28.64% and the control group decreased by 22.58%), however, the difference did not reach statistical significance. In conclusion, both the EA and EH groups demonstrated significant pain alleviating effect on chronic low back pain. Our findings suggest that after 4 sessions of EH treatment over 2 weeks produced significantly greater reduction in the NPRS then the EA or the control. Therefore, EH is an alternative technique when applying needle acupuncture when a more immediate pain relieving effect is required. Interestingly, EA demonstrated greater effects when compared to the EH and the control in improving SLR and reduce disability level as reflected by the RMDQ score.

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