Clinical Question: Is acupuncture e...

Clinical Question: Is acupuncture effective in decreasing pain and improving function in patients with osteoarthritis of the knee?

Setting: Outpatient (any)

inquiry Design: Randomized controlled trial (double-blinded)

Allocation: Concealed

Synopsis: The authors recorded 570 patients who had radiologic and clinical evidence of osteoarthritis of the knee and who had not had any intra-articular injections. The patients were assigned to undivided of three treatment groups: (1) "true acupuncture" based forward the Traditional Chinese Medicine meridian theory to treat knee-joint pain; (2) a sham treatment that mimicked authentic acupuncture, except that the needle were not actually inserted (i.e., the acupuncture guiding tubes were tapped at sham points, then needle were affixed with adhesive tape at these sites without insertion); and (3) a have the direction of group that received six two-hour form into groups education sessions led by a patient education specialist, with follow-up educational materials sent in the mail. Treatment was supplyed twice a week for eight weeks, tapering through the whole extent of the next month to individual treatment per month, which was continued between the walls of the end of the application of mind This design addresses two issues that have plagued previous acupuncture research according to providing a sham treatment cluster and a no-treatment group.

Initially, pain scores were an average of 89 (of a possible 20) as measured by means of the Western Ontario and McMaster University Osteoarthritis Index. At week 14 the authors noted a 3.6-unit decrease in pain scores (40 percent improvement) in the pure acupuncture group compared with a 2.7-unit decrease in the sham clump and a 1.5-unit decrease in the education form into groups This change with true acupuncture was statistically significant com-pared with the other sum of two units groups. Pain scores continued to improve in all three clusters over the course of the close attention although true acupuncture scores continued to improve statistically more than the other sum of two units groups.

Functional deficit diminished from an average of 32 units (of a possible 68 at base-line) to 19 units at the fall of the curtain of the study. This followed in an almost 40 percent improvement with acupuncture and was statistically better than the other sum of two units groups. Patient global assessment scores also improved in the acupuncture clump to a statistically greater amplitude than in the other sum of two units groups. Distance during the six-minute walk and scores onward the 36-Item Short-Form Health inspect improved more with true and sham acupuncture treatment than with education, if it were not that the results were similar between those couple groups.

Bottom Line: Compared with sham acupuncture treatment or no treatment, acupuncture decreases pain scores by the agency of an average of 40 percent and similarly improves function in patients who stick with it. The acupuncture used in this contemplation was based on the Traditional Chinese Medicine meridian theory and was engrossed for the entire six month of the contemplation (Level of Evidence: 1b)

thought Reference: Berman BM, et al. Effectiveness of acupuncture as adjunctive therapy in osteoarthritis of the knee: a randomized, controll trial. Ann Intern M December 21 2004;141:901-10

Used with permission from Shaughnessy AF. Acupuncture effective for OA of the knee Accessed online January 25 2005 at: http://www.InfoPOEMs.com.

COPYRIGHT 2005 American Academy of Family Physicians

COPYRIGHT 2005 Gale Group