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Journal of Orthopaedic Surgery and Research

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Open Access 01-12-2022 | Acupuncture | Systematic Review

Acupuncture in chronic aspecific low back pain: a Bayesian network meta-analysis

Authors: Alice Baroncini, Nicola Maffulli, Jörg Eschweiler, Friedrich Molsberger, Alexandra Klimuch, Filippo Migliorini

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2022

Abstract

Background

This Bayesian network meta-analysis investigated the available randomized control trials (RCTs) to point out which acupuncture protocol is the most effective for chronic aspecific low back pain (LBP). Efficacy was measured in terms of pain (Visual Analogic Scale, VAS) and disability (Roland Morris Disability Questionnaire, RMQ), Transcutaneous Electrical Nerve Stimulation (TENS).

Methods

PubMed, Google scholar, Embase, and Scopus were accessed in March 2022. All the RCTs comparing two or more acupuncture modalities for aspecific chronic LBP were accessed. Only studies which investigated the efficacy of acupuncture on patients with symptoms lasting a minimum of 1.5 months, or with at least three episodes in the previous 12 months, were considered eligible. The Review Manager Software (The Nordic Cochrane Collaboration, Copenhagen) was used for the methodological quality assessment. The STATA Software/MP, Version 14.1 (StataCorporation, College Station, Texas, USA), was used for the statistical analyses. The NMA was performed through the STATA routine for Bayesian hierarchical random-effects model analysis.

Results

Data from 44 RCTs (8338 procedures) were retrieved. 56% of patients were women. The mean age of the patients was 48 ± 10.6 years. The mean BMI was 26.3 ± 2.2 kg/m². The individual group (95% confidence interval (CI) 2.02, 7.98) and the standard combined with TENS (95% CI 2.03, 7.97) demonstrated the highest improvement of the RMQ. The VAS score was lower in the standard combined with TENS group (95% CI 3.28, 4.56). Considering the standard acupuncture group, different studies used similar protocols and acupuncture points and the results could thus be compared. The equation for global linearity did not find any statistically significant inconsistency in any of the network comparison.

Conclusion

Verum acupuncture is more effective than sham treatment for the non-pharmacological management of LBP. Among the verum protocols, individualized acupuncture and standard acupuncture with TENS were the protocols that resulted in the highest improvement in pain and quality of life.

Level of Evidence

Level I, Bayesian network meta-analysis of RCTs.

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Title: Acupuncture in chronic aspecific low back pain: a Bayesian network meta-analysis
Authors: Alice Baroncini
Nicola Maffulli
Jörg Eschweiler
Friedrich Molsberger
Alexandra Klimuch
Filippo Migliorini
Publication date: 01-12-2022
Publisher: BioMed Central
Keywords: Acupuncture
Back Pain
Back Pain
Back Pain
Published in: Journal of Orthopaedic Surgery and Research / Issue 1/2022
Electronic ISSN: 1749-799X
DOI: https://doi.org/10.1186/s13018-022-03212-3

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Acupuncture in chronic aspecific low back pain: a Bayesian network meta-analysis

Abstract

Background

Methods

Results

Conclusion

Level of Evidence

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Level of Evidence

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