Physiospot CAM

A randomized controlled trial of acupuncture added to usual treatment for fibromyalgia.

Targino RA, Imamura M, Kaziyama HH, Souza LP, Hsing WT, Furlan AD, Imamura ST, Azevedo Neto RS

This study evaluated the effectiveness of acupuncture for fibromyalgia. Fifty-eight women with fibromyalgia were allocated randomly to receive either acupuncture together with tricyclic antidepressants and exercise or tricyclic antidepressants and exercise only. At the end of 20 sessions, patients who received acupuncture were significantly better than the control group in all measures of pain and in 5 of the SF-36 subscales. After 6 months, the acupuncture group was significantly better than the control group in numbers of tender points, mean pressure pain threshold at the 18 tender points and 3 subscales of SF-36. After one year, the acupuncture group showed significance in one subscale of the SF-36; at 2 years there were no significant differences in any outcome measures.

Addition of acupuncture to usual treatments for fibromyalgia may be beneficial for pain and quality of life for 3 months after the end of treatment.

Journal of Rehabilitation Medicine, 2008, 40(7), 582-8

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Tension neck syndrome treated by acupuncture combined with physiotherapy: A comparative clinical trial (pilot study).

França DL, Senna-Fernandes V, Cortez CM, Jackson MN, Bernardo-Filho M, Guimarães MA

The purpose of this study was to evaluate the effect of acupuncture combined with physiotherapy in comparison with acupuncture and physiotherapy performed alone in different parameters; pain intensity, muscle tension, functional disability and muscle strength in the treatment of tension neck syndrome (TNS). Forty-six patients with TNS were allocated into three groups: Group-1 received physiotherapy (therapeutic exercises) combined with acupuncture; Group-2, acupuncture alone, and Group-3, physiotherapy alone; over a period of 10 weeks, with one or two sessions weekly.  All groups showed significant improvement  in outcome measures after 10 weeks of treatment and after 6 months of follow-up. After 6 months of follow-up, the improvements of all groups were maintained.

This research suggests that acupuncture effect may facilitate and/or enhance physiotherapy performance in musculoskeletal rehabilitation for tension neck syndrome.

Complementary Therapies in Medicine, 2008, 16(5), 268-77

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Tai Chi improves balance and mobility in people with Parkinson disease

Madeleine E. Hackney, Gammon M. Earhart

This pilot study examines the effects of Tai Chi on balance, gait and mobility in people with Parkinson disease (PD). Thirty-three people with PD were randomly assigned to either a Tai Chi group or a control group. The Tai Chi group participated in 20 1-h long training sessions completed within 10–13 weeks; whereas, the control group had two testing sessions between 10 and 13 weeks apart without interposed training. The Tai Chi group improved more than the control group on the Berg Balance Scale, UPDRS, Timed Up and Go, tandem stance test, six-minute walk, and backward walking. Neither group improved in forward walking or the one leg stance test. All Tai Chi participants reported satisfaction with the program and improvements in well-being.

Tai Chi appears to be an appropriate, safe and effective form of exercise for some individuals with mild–moderately severe PD.

Gait & Posture, 2008, 28(3), 456-460

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Massage Reduces Pain Perception and Hyperalgesia in Experimental Muscle Pain: A Randomized, Controlled Trial

Laura A. Frey Law, Stephanie Evans, Jill Knudtson, Steven Nus, Kerri Scholl, Kathleen A. Sluka

The purpose of this study was to evaluate the effects of massage on mechanical hyperalgesia and perceived pain using delayed onset muscle soreness as an endogenous model of myalgia. The participants (no-treatment control, superficial touch, or deep-tissue massage groups) performed eccentric wrist extension exercises at visit 1 to induce DOMS 48 hours later at visit 2. Pain, assessed using VAS and PPT were measured at baseline, after exercise, before treatment, and after treatment. Deep massage decreased pain during muscle stretch. Mechanical hyperalgesia was reduced after both the deep massage and superficial touch groups relative to control.

This randomized, controlled trial suggests that massage is capable of reducing myalgia symptoms by approximately 25% to 50%, varying with assessment technique. Thus, potential analgesia may depend on the pain assessment used. This information may assist clinicians in determining conservative treatment options for patients with myalgia.

The Journal of Pain, 9(8), 714-721

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Comparison of a targeted and general massage protocol on strength, function, and symptoms associated with carpal tunnel syndrome: a randomized pilot study.

Moraska A, Chandler C, Edmiston-Schaetzel A, Franklin G, Calenda EL, Enebo B

This study aimed to evaluate the effectiveness of two distinct massage therapy protocols on strength, function, and symptoms associated with CTS. 27 subjects with a clinical diagnosis of CTS were randomly assigned to receive 6 weeks of twice-weekly massage consisting of either a general (GM) or CTS-targeted (TM) massage treatment program. Both GM and TM treatments resulted in an improvement of subjective measures associated with CTS, but improvement in grip strength was only detected with the TM protocol.

Massage therapy may be a practical conservative intervention for compression neuropathies, such as CTS, although additional research is needed.

Journal of Alternative and Complementary Medicine,2008, 14(3), 259-67

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Tai chi for osteoarthritis: a systematic review.

Lee MS, Pittler MH, Ernst E

The aim of this study was to evaluate data from controlled clinical trials testing the effectiveness of tai chi for treating osteoarthritis. All controlled trials of tai chi for patients with osteoarthritis were considered for inclusion. Five randomised clinical trials (RCTs) and seven non-randomised controlled clinical trials (CCTs) met all inclusion criteria. Five RCTs assessed the effectiveness of tai chi on pain of osteoarthritis (OA). Two RCTs suggested significant pain reduction compared to routine treatment and an attention control program in knee OA. Three RCTs did not report significant pain reduction on multiple sites pain. Four RCTs tested tai chi for physical functions. Two of these RCTs suggested improvement of physical function on activity of daily living compared to routine treatment or wait-list control, whilst two other RCTs failed to do so.

There is some encouraging evidence suggesting that tai chi may be effective for pain control in patients with knee OA. However, the evidence is not convincing for pain reduction or improvement of physical function. Future RCTs should assess larger patient samples for longer treatment periods and use appropriate controls.

Clinical Rheumatology, 2008, 27(2), 211-8

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Cost-effectiveness of naturopathic care for chronic low back pain.

Herman PM, Szczurko O, Cooley K, Mills EJ

The purpose of this study was to determine the cost-effectiveness of naturopathic care (acupuncture, relaxation exercises, exercise and dietary advice, and a back care booklet) compared to standardized physiotherapy education and a back care booklet (control treatment) for low back pain. The results showed that naturopathic care significantly improved quality-adjusted life-years over the 6-month study period and also significantly reduced costs of adjunctive care per participant and reduced costs for the employer.

This economic evaluation alongside a pragmatic randomized control trial shows naturopathic care to be more cost-effective than a standardized physiotherapy education regimen in the treatment of chronic low back pain.

Alternative Therapies in Health and Medicine, 2008, 14(2), 32-9

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Mindfulness meditation for the treatment of chronic low back pain in older adults: A randomized controlled pilot studystar, open

Natalia E. Morone, Carol M. Greco and Debra K. Weiner 

The objectives of this pilot study were to assess the feasibility of recruitment and adherence to an eight-session mindfulness meditation program for community-dwelling older adults with chronic low back pain (CLBP) and to develop initial estimates of treatment effects. 37 community-dwelling older adults aged 65 years and older with CLBP were randomized to an 8-week mindfulness-based meditation program or to a wait-list control group. At the end of the intervention 30/37 (81%) participants completed 8-week assessments. Average class attendance of the intervention arm was 6.7 out of 8. They meditated an average of 4.3 days a week and the average minutes per day was 31.6. Compared to the control group, the intervention group displayed significant improvement.

An 8-week mindfulness-based meditation program is feasible for older adults with CLBP. The program may lead to improvement in pain acceptance and physical function.

Pain, 2008, 134(3), 310-319

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An evaluation of the effect of differing lengths of spa therapy upon patients with osteoarthritis (OA)

Vaht, M., Birkenfeldt, R. and Ubner, M. (2007)

Spa therapy is commonly used in Estonia in the management of rheumatic diseases, which usually consists of a course of up to 3-4 weeks in duration.  This study sought to determine whethere there was any difference in the alleviation of symptoms between a 6 day and 23 day course of spa therapy in the management of osteoarthritis (OA).  296 patients participated in the research which included treatments such as mud and paraffin-ozokerite applications, pearl baths, underwater shower-massage, manual massage, and therapeutic exercises in the gym and pool.  The aim was not to consider the effectiveness of a specific therapy but to gain an insight into the length of time required to obtain positive symptom relief.

In both the 6 day and 12 day group, there was a significant decrease in VAS and Lequesne Index scores, and while there were no significant differences found between the groups, this study does suggest that spa therapy has a positive effect by reducing pain and improving clinical status in patients suffering from osteoarthritis.

Complementary Therapies in Clinical Practice (2007) Article in Press Corrected Proof

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