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European Journal of Medical Research
Published in: European Journal of Medical Research 3/2011

01-12-2011 | Research

An international expert survey on acupuncture in randomized controlled trials for low back pain and a validation of the low back pain acupuncture score

Authors: AF Molsberger, J Zhou, L Boewing, D Arndt, M Karst, W Teske, A Drabik

Published in: European Journal of Medical Research | Issue 3/2011

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Abstract

Background

Acupuncture is a promising treatment approach in patients with chronic low back pain (cLBP) but little is known about the quality of acupuncture in randomized controlled trials (RCT) of acupuncture cLBP.

Objective

To determine how international experts (IES) rate the quality of acupuncture in RCTs of cLBP; independent international validation of the Low Back Pain Acupuncture Score (LBPAS).

Methodology

Fifteen experts from 9 different countries outside China were surveyed (IES). They were asked to read anonymized excerpts of 24 RCTs of cLBP and answer a three-item questionnaire on how the method of acupuncture conformed to 1) Chinese textbook standards, 2) the expert's personally preferred style, and 3) how acupuncture is performed in the expert's country. Likert scale rating, calculation of the mode for each answer, and Spearman's rank correlation coefficient between all three answers and the LBPAS were calculated.

Results

On comparison with Chinese textbook standards (question 1), 6 RCTs received a good rating, 8 trials a fair and 10 trials a poor or very poor rating. 5 of the 6 trials rated good, received at least a good rating also in question 2 or 3. We found a high correlation of 0.85 (p < 0.0001) between the IES and LBPAS ratings for question 1 and question 2, and a correlation of 0.66 (p < 0.0001) for question 3.

Conclusion

The international expert survey (IES) revealed that only 6 out of 24 (25%) RCTs of acupuncture for cLBP were rated "good" in respect to Chinese textbook acupuncture standards. There were only small differences in how the acupuncture quality was rated in comparison to Chinese textbook acupuncture, personally preferred and local styles of acupuncture. The rating showed a high correlation with the Low Back Pain Acupuncture Score LBPAS.
Literature
1.
Anonym: China's New Needling Treatment. Hongkong; 1985.
2.
Brinkhaus B, Becker-Witt C, Jena S, Linde K, Streng A, Wagenpfeil S, Irnich D, Hummelsberger J, Melchart D, Willich SN: Acupuncture Randomized Trials (ART) in patients with chronic low back pain and osteoarthritis of the knee - design and protocols. Forsch Komplementarmed Klass Natarheilkd 2003,10(4):185–191. 10.1159/000073474CrossRef
3.
Brinkhaus B, Witt CM, Jena S, Linde K, Streng A, Wagenpfeil S, Irnich D, Walther HU, Melchart D, Willich SN: Acupuncture in patients with chronic low back pain: a randomized controlled trial. Arch Intern Med 2006,166(4):450–457. 10.1001/.450PubMed
4.
Carlsson CP, Sjolund BH: Acupuncture for chronic low back pain: a randomized placebo-controlled study with long-term follow-up. Clin J Pain 2001,17(4):296–305. 10.1097/00002508-200112000-00003PubMedCrossRef
5.
Cheong , Yang : Synopsis of Chinese Acupuncture. Hongkong; 1985.
6.
Cherkin DC, Eisenberg D, Sherman KJ, Barlow W, Kaptchuk TJ, Street J, Deyo RA: Randomized trial comparing traditional Chinese medical acupuncture, therapeutic massage, and self-care education for chronic low back pain. Arch Intern Med 2001,161(8):1081–1088. 10.1001/archinte.161.8.1081PubMedCrossRef
7.
Coan RM, Wong G, Ku SL, Chan YC, Wang L, Ozer FT, Coan PL: The acupuncture treatment of low back pain: a randomized controlled study. Am J Chin Med 1980,8(1–2):181–189.PubMedCrossRef
8.
Dawes J: Do Data Characteristics Change According to the number of scale points used? An experiment using 5-point, 7-point and 10-point scales. International Journal of Market Research 2008,50(1):61–77.
9.
Edelist G, Gross AE, Langer F: Treatment of low back pain with acupuncture. Can Anaesth Soc J 1976,23(3):303–306. 10.1007/BF03005706PubMedCrossRef
10.
Furlan AD, van Tulder M, Cherkin D, Tsukayama H, Lao L, Koes B, Berman B: Acupuncture and dry-needling for low back pain: an updated systematic review within the framework of the cochrane collaboration. Spine 2005,30(8):944–963. 10.1097/01.brs.0000158941.21571.01PubMedCrossRef
11.
Gallacchi G, Müller W, Plattner GR, Schnorrenberger CC: [Acupuncture and laser treatment in cervical and lumbar syndrome]. Schweizerische medizinische Wochenschrift 1981,111(37):1360–1366.PubMed
12.
Garvey TA, Marks MR, Wiesel SW: A prospective, randomized, double-blind evaluation of trigger-point injection therapy for low-back pain. Spine 1989,14(9):962–964. 10.1097/00007632-198909000-00008PubMedCrossRef
13.
Geng : Selecting the Right Acupoints. Peking; 1995.
14.
Giles L, Müller R: Chronic pinal pain syndromes: A clinical pilot trial comparing acupuncture, a nonsteroidal antiinflammatory drug, and spinal manipulation. Journal of Manipulative and Physiological Therapeutics 1999,22(6):376–381. 10.1016/S0161-4754(99)70082-5PubMedCrossRef
15.
Giles LG, Muller R: Chronic spinal pain: a randomized clinical trial comparing medication, acupuncture, and spinal manipulation. Spine 2003,28(14):1490–1502. discussion 1502–1493PubMed
16.
Grant DJ, Bishop-Miller J, Winchester DM, Anderson M, Faulkner S: A randomized comparative trial of acupuncture versus transcutaneous electrical nerve stimulation for chronic back pain in the elderly. Pain 1999,82(1):9–13. 10.1016/S0304-3959(99)00027-5PubMedCrossRef
17.
Gunn CC, Milbrandt WE, Little AS, Mason KE: Dry needling of muscle motor points for chronic low-back pain: a randomized clinical trial with long-term follow-up. Spine 1980,5(3):279–291. 10.1097/00007632-198005000-00011PubMedCrossRef
18.
Haake M, Muller HH, Schade-Brittinger C, Basler HD, Schafer H, Maier C, Endres HG, Trampisch HJ, Molsberger A: German Acupuncture Trials (GERAC) for chronic low back pain: randomized, multicenter, blinded, parallel-group trial with 3 groups. Arch Intern Med 2007,167(17):1892–1898. 10.1001/archinte.167.17.1892PubMedCrossRef
19.
Itoh K, Katsumi Y, Kitakoji H: Trigger point acupuncture treatment of chronic low back pain in elderly patients--a blinded RCT. Acupuncture in medicine: journal of the British Medical Acupuncture Society 2004,22(4):170–177. 10.1136/aim.22.4.170CrossRef
20.
Jiyou Z: Practical Handbook on Acupuncture and Moxibustion. Changchun; 1988.
21.
Kerr DP, Walsh DM, Baxter D: Acupuncture in the management of chronic low back pain: a blinded randomized controlled trial. The Clinical journal of pain 2003,19(6):364–370. 10.1097/00002508-200311000-00004PubMedCrossRef
22.
Cheung , Lee : Current Acupuncture Therapy. Hongkong; 1978.
23.
Lehmann HJ: Akupunkturpraxis, Chinesische Standardtherapie mit Relevanzkarten. Munchen, Jena: Urban & Fischer; 1999.
24.
Lehmann TR, Russell DW, Spratt KF, Colby H, Liu YK, Fairchild ML, Christensen S: Efficacy of electroacupuncture and TENS in the rehabilitation of chronic low back pain patients. Pain 1986,26(3):277–290. 10.1016/0304-3959(86)90057-6PubMedCrossRef
25.
Leibing E, Leonhardt U, Koster G, Goerlitz A, Rosenfeldt JA, Hilgers R, Ramadori G: Acupuncture treatment of chronic low-back pain--a randomized, blinded, placebo-controlled trial with 9-month follow-up. Pain 2002,96(1–2):189–196. 10.1016/S0304-3959(01)00444-4PubMedCrossRef
26.
Likert R: A technique for the Measurement of Attitudes. Archives of Psycholog 1932, 140: 1–55.
27.
Liu : Clinical Acupuncture and Moxibustion. Tianjin; 1996.
28.
Macdonald AJ, Macrae KD, Master BR, Rubin AP: Superficial acupuncture in the relief of chronic low back pain. Ann R coll Surg Engl 1983,65(1):44–46.PubMedCentralPubMed
29.
MacPherson H, Thomas K, Brazier J, Fitter M, Thorpe L, Campbell M, Nicholl J, Roman M, Morgan A: Acupuncture and low back pain: results from a pragmatic randomised controlled trialof he Conference Name.
30.
MacPherson H, White A, Cummings M, Jobst K, Rose K, Niemtzow R: Standards for reporting interventions in controlled trials of acupuncture: the STRICTA recommendations. Complement. Ther Med 2001,9(4):246–249. 10.1054/ctim.2001.0488CrossRef
31.
Manheimer E, White A, Berman B, Forys K, Ernst E: Meta-analysis: acupuncture for low back pain. Ann Intern Med 2005,142(8):651–663.PubMedCrossRef
32.
Mendelson G, Selwood TS, Kranz H, Loh TS, Kidson MA, Scott DS: Acupuncture treatment of chronic back pain. A double-blind placebo-controlled trial. Am J Med 1983,74(1):49–55. 10.1016/0002-9343(83)91117-8PubMedCrossRef
33.
Meng CF, Wang D, Ngeow J, Lao L, Peterson M, Paget S: Acupuncture for chronic low back pain in older patients: a randomized, controlled trial. Rheumatology (Oxford) 2003,42(12):1508–1517. 10.1093/rheumatology/keg405CrossRef
34.
Molsberger AF, Boewing G, Diener HC, Endres HG, Kraehmer N, Kronfeld K, Zenz M: Designing an acupuncture study: the nationwide, randomized, controlled, german acupuncture trials on migraine and tension-type headache. J Altern Complement Med 2006,12(3):237–245. 10.1089/acm.2006.12.237PubMedCrossRef
35.
Molsberger AF, Mau J, Pawelec DB, Winkler J: Does acupuncture improve the orthopedic management of chronic low back pain--a randomized, blinded, controlled trial with 3 months follow up. Pain 2002,99(3):579–587. 10.1016/S0304-3959(02)00269-5PubMedCrossRef
36.
Molsberger AF, Zhou J, Arndt D, Teske W: Chinese acupuncture for chronic low back pain: an international expert survey. J Altern Complement Med 2008,14(9):1089–1095. 10.1089/acm.2008.0138.APubMedCrossRef
37.
Stux G, Stiller N, Berman B, Pomeranz B Akupunktur Lehrbuch und Atlas. Berlin, Heidelberg, New York, Hongkong, London, Mailand, Paris: Springer; 2003.
38.
TCM Ao: An Outline of Chinese Acupuncture. Peking; 1975.
39.
TCM Bco: Essentials of Chinese Acupuncture. Peking; 1980.
40.
Thomas KJ, MacPherson H, Thorpe L, Brazier J, Fitter M, Campbell MJ, Roman M, Walters SJ, Nicholl J: Randomised controlled trial of a short course of traditional acupuncture compared with usual care for persistent non-specific low back pain. Bmj 2006,333(7569):623. 10.1136/bmj.38878.907361.7CPubMedCentralPubMedCrossRef
41.
Thomas M, Lundberg T: Importance of modes of acupuncture in the treatment of chronic nociceptive low back pain. Acta Anaesthesiol Scand 1994,38(1):63–69. 10.1111/j.1399-6576.1994.tb03839.xPubMedCrossRef
42.
Tsukayama H, Yamashita H, Amagai H, Tanno Y: Randomised controlled trial comparing the effectiveness of electroacupuncture and TENS for low back pain: a preliminary study for a pragmatic trial. Acupuncture in medicine: journal of the British Medical Acupuncture Society 2002,20(4):175–180. 10.1136/aim.20.4.175CrossRef
43.
van Tulder MW, Cherkin DC, Berman B, Lao L, Koes BW: The effectiveness of acupuncture in the management of acute and chronic low back pain. A systematic review within the framework of the Cochrane Collaboration Back Review Group. Spine 1999,24(11):1113–1123. 10.1097/00007632-199906010-00011PubMedCrossRef
44.
Wedenberg K, Moen B, Norling A: A prospective randomized study comparing acupuncture with physiotherapy for low-back and pelvic pain in pregnancy. Acta obstetricia et gynecologica Scandinavica 2000,79(5):331–335. 10.1080/j.1600-0412.2000.079005331.xPubMedCrossRef
45.
White AR, Ernst E: A trial method for assessing the adequacy of acupuncture treatments. Altern Ther Health Med 1998,4(6):66–71.PubMed
46.
Xinnong C editor Title|, Vol. Volume|. City|: Publisher|, Year|.
47.
Xue-Quan S: Applied Chinese Acupuncture for Clinical Practitioners. Shandong; 1985.
48.
Yeung OK, Leung MC, Chow DH: The use of electroacupuncture in conjunction with exercise for the treatment of chronic low-back pain. Journal of alternative and complementary medicine (New York, NY) 2003,9(4):479–490. 10.1089/107555303322284767CrossRef
49.
Yuan J, Kerr D, Park J, Liu XH, McDonough S: Treatment regimens of acupuncture for low back pain--a systematic review. Complement Ther Med 2008,16(5):295–304. 10.1016/j.ctim.2008.04.006PubMedCrossRef
50.
Zhang , Bai , Chen : Integrating Chinese and Western Medicine. Peking; 1993.
51.
Zhang Du: Acupuncture-Moxibustion Therapy. Jinan; 1996.
Metadata
Title
An international expert survey on acupuncture in randomized controlled trials for low back pain and a validation of the low back pain acupuncture score
Authors
AF Molsberger
J Zhou
L Boewing
D Arndt
M Karst
W Teske
A Drabik
Publication date
01-12-2011
Publisher
BioMed Central
Published in
European Journal of Medical Research / Issue 3/2011
Electronic ISSN: 2047-783X
DOI
https://doi.org/10.1186/2047-783X-16-3-133

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