Arthritis
Acupuncturists’ communication style affects treatment outcomes – Journal of Chinese Medicine, June 2011
The analgesic benefits of acupuncture may be partially mediated through placebo effects related to the acupuncturist’s behaviour, according to US researchers. The team conducted a three-month randomised clinical trial in patients with knee osteoarthritis to compare the efficacy of traditional Chinese acupuncture (TCA) with sham acupuncture and to examine the effects of acupuncturists’ communication styles. Acupuncturists were trained to interact in one of two communication styles, conveying either high or neutral expectations for the outcome of the treatment. Four hundred and fifty-five patients were randomised to one of three groups, waiting list, high treatment expectation style, or neutral treatment expectation style. Within each style group, participants were further divided into groups that received either TCA or sham acupuncture, twice a week for six weeks. Sham acupuncture was performed at non-acupoints points with shallow needles and minimal stimulation. No statistically significant differences were observed between TCA and sham acupuncture, however both groups had significant reductions in pain scores compared with the waiting list group. The results showed statistically significant differences in pain reduction and satisfaction, favouring the high treatment expectation group, suggesting that acupuncturists’ communication styles have a significant effect on treatment outcomes. (A randomized controlled trial of acupuncture for osteoarthritis of the knee: effects of patient-provider communication. Arthritis Care Res (Hoboken). 2010 Sep;62(9):1229-36).
Tai Chi relieves arthritis pain – Journal of Chinese Medicine, Feb 2011
A randomised controlled trial carried out in the USA has evaluated the effectiveness of a six-week tai chi course in reducing symptoms, increasing function and improving psychosocial status in arthritis patients. In the largest study to date carried out under the Arthritis Foundation Tai Chi program, 332 participants were randomly assigned to treatment or a waiting list control. The tai chi intervention consisted of 12 movements from Sun style tai chi, which included exercises to improve mobility, breathing and relaxation. Participants in the tai chi program showed improvements in pain, fatigue, stiffness, wellbeing and ability to reach. (Evaluation of Tai Chi Course Effectiveness for People with Arthritis. 2010 Annual Scientific Meeting of the American College of Rheumatology, Abstract 690).
Tai chi has multiple benefits in rheumatoid arthritis – Journal of Chinese Medicine, Oct 2010
A Norwegian study has used both quantitative and qualitative methods to examine how group tai chi (TC) exercise impacted on disease activity, physical function, health status and experience in rheumatoid arthritis (RA) patients. Fifteen patients were instructed in TC twice weekly for 12 weeks. TC led to improved lower-limb muscle function at the end of intervention and at 12 weeks follow-up. Qualitative analyses showed that patients experienced improved physical condition, confidence in moving, balance and less pain during exercise and in daily life. Other patient experiences included stress reduction, and increased body awareness and confidence in moving. The authors conclude that TC has beneficial effects on health not related to disease activity or standardised health status assessment. They suggest that this combination of research methods may contribute to an understanding of how TC exerts its effects. (Exploring Tai Chi in rheumatoid arthritis: a quantitative and qualitative study. BMC Musculoskelet Disord. 2010 Mar 5;11:43).
Tai chi effective for knee osteoarthritis – Journal of Chinese Medicine, Feb 2010
Researchers from the USA have found that knee osteoarthritis (OA) patients who practise tai chi show improved physical functioning and experience less pain. Forty individuals (mean age 65) with tibiofemoral OA were randomly assigned to 60 minutes of tai chi or a control intervention (wellness education and stretching) twice weekly for 12 weeks. Each tai chi session included: 10 minutes of self-massage with a review of tai chi principles, 30 minutes of tai chi movement (modified Yang style 10 forms), 10 minutes of breathing exercises and 10 minutes of relaxation. After 12 weeks of treatment, patients practicing tai chi exhibited a significant decrease in knee pain compared with those in the control group (a between group difference of -118.80 on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain scale). The results also showed significant improvements in physical function, self-efficacy, depression and health status in the tai chi group. (Tai Chi is effective in treating knee osteoarthritis: a randomized controlled trial. Arthritis Rheum. 2009 Nov 15;61(11):1545-53).
Acupuncture improves knee osteoarthritis – Journal of Chinese Medicine, Feb 2010
A pilot study carried out to inform the design of a fully-powered pragmatic randomised controlled trial, UK researchers have shown a significant reduction in knee pain at three months for acupuncture compared with usual care. Thirty patients aged over 50 with pain and osteoarthritis of the knee were randomised to acupuncture plus usual care or usual care alone. Although this pilot study was not adequately powered to detect significant changes in outcome, pain scores showed a statistically significant reduction at three months in the acupuncture group compared with usual care. This was not sustained at 12 months. The authors calculated the sample size necessary for a fully powered two-arm trial to be 350. (Acupuncture for pain and osteoarthritis of the knee: a pilot study for an open parallel-arm randomised controlled trial. BMC Musculoskelet Disord. 2009 Oct 24;10:130).
Tai chi benefits arthritis – Journal of Chinese Medicine, Oct 2009
Tai Chi has a small positive effect on pain and disability in people with arthritis. Australian authors carried out a systematic review of tai chi as a treatment for chronic musculoskeletal pain. They found that most trials were typically small and of low methodologic quality. Meta-analysis of the results of seven randomised controlled trials showed that the pooled effect size for arthritic populations on a 0-100 scale was 10.1 points for pain reduction and 9.6 points for disability reduction. Additionally, physical performance and health-related quality of life outcomes favored Tai Chi, but of these outcomes, only the level of tension and satisfaction with general health were statistically significant. (The effectiveness of Tai Chi for chronic musculoskeletal pain conditions: a systematic review and meta-analysis. Arthritis Rheum. 2009 Jun 15;61(6):717-24).
Acupuncture effective for knee osteoarthritis – Journal of Chinese Medicine, Oct 2008
A review, carried out by American researchers, of ten randomised, controlled trials (1456 participants) of acupuncture for osteoarthritis of the knee has concluded that it is an effective treatment for the pain and physical dysfunction caused by the condition. (Acupuncture and osteoarthritis of the knee: a review of randomized, controlled trials. Fam Community Health. 2008 Jul-Sep;31(3):247-54).
Acupuncture cost-effective for osteoarthritis – Journal of Chinese Medicine, Oct 2007
Analysis of the results of a large German randomised, controlled trial (RCT) has led to the conclusion that acupuncture can be a cost-effective adjunctive treatment for chronic osteoarthritis pain. Acupuncture treatment plus routine care was evaluated against routine care alone in 418 cases of chronic pain due to osteoarthritis of the knee or hip, using health insurance providers’ data and standardised questionnaires. Patients receiving acupuncture had an improved QoL associated with significantly higher costs over the three-month treatment period, compared with routine care alone. However, having performed a cost-effectiveness calculation, based on calculating quality-life adjusted years (QALYs) the authors concluded that acupuncture was a cost-effective treatment strategy in this patient group, with female patients achieving a better cost-effectiveness ratio than men. (Quality of life and cost-effectiveness of acupuncture treatment in patients with osteoarthritis pain. Eur J Health Econ. 2007 Jul 19; [Epub ahead of print]).