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Jun H, Lee H, Yoon SH, Kwon CY, Jeon D, Lee JH, Leem J. Delphi study for developing a checklist of adverse events associated with acupotomy. JOURNAL OF INTEGRATIVE MEDICINE 2024:S2095-4964(24)00373-X. [PMID: 39183098 DOI: 10.1016/j.joim.2024.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 06/21/2024] [Indexed: 08/27/2024]
Abstract
BACKGROUND Acupotomy, a more invasive procedure than acupuncture, involves the use of a thicker needle with an integrated knife at the tip, necessitating safety research. We aimed to define relevant adverse events (AEs) and create a standardized form of the ACUPOtomy-related AEs CHECKlist (ACUPOCHECK). METHODS Before conducting the Delphi process, a systematic review and pilot prospective study were conducted to gather information on previously reported AEs. Using these data, pilot versions of the ACUPOCHECK and Delphi questionnaires were developed. The Delphi questionnaire involved selecting types of AE for inclusion, establishing separate criteria for acupotomy-related AEs, and achieving a consensus on AE assessment. Thirteen Korean doctors with experience in acupotomy or AE research were recruited to participate in each Delphi round. Consensus was considered to have been reached if the critical value for the content validity ratio met or exceeded 0.538. RESULTS The final ACUPOCHECK was developed using four rounds of the Delphi method and one face-to-face consensus meeting. It included 12 local AEs (pain, hemorrhage, bruise, hematoma, edema, pruritus, rash, infection, nerve damage, dysesthesia, movement impairment, and pneumothorax) and 14 systemic AEs (disease aggravation, needle fatigue, sleepiness, procedural nausea, procedural vomiting, procedural headache, procedural dizziness, sweating, procedural shock, syncope, dyspnea, procedural pain, sleep disorder, and postprocedural infection). Separate criteria were established for pain, hemorrhage and bruising: pain was defined as pain that occurrs during daily activities and persists for longer than 72 h, hemorrhage as bleeding that continues for ≥ 3 min despite pressure application, and bruising as having a bruise with a diameter of ≥ 3 cm. Open-ended descriptions were allowed for AEs not covered by the checklist, and severity and causality were assessed using the Common Terminology Criteria for Adverse Events and modified World Health Organization-Uppsala Monitoring Center criteria. CONCLUSION ACUPOCHECK provides a standardization framework that can help research on traditional practices as well as new tools and techniques that are more invasive and may cause more severe AEs. Subsequent studies will use ACUPOCHECK to develop rational safety guidelines for acupotomy techniques. Please cite this article as: Jun H, Lee H, Yoon SH, Kwon CY, Jeon D, Lee JH, Leem J. Delphi study for developing a checklist of adverse events associated with acupotomy. J Integr Med. 2024; Epub ahead of print.
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Affiliation(s)
- Hyungsun Jun
- Department of Diagnostics, College of Korean Medicine, Wonkwang University, Iksan 54538, Republic of Korea
| | | | - Sang-Hoon Yoon
- Chung-Yeon Korean Medicine Clinic, Seoul 06224, Republic of Korea
| | - Chan-Young Kwon
- Department of Oriental Neuropsychiatry, Dong-Eui University College of Korean Medicine, Busan 47227, Republic of Korea
| | - Damin Jeon
- Chonnam National University Hwasun Hospital, Hwasun 58128, Republic of Korea
| | - Jun-Hwan Lee
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea; Department of Korean Convergence Medical Science, KIOM School, University of Science & Technology (UST), Daejeon 34054, Republic of Korea; Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA 02115, USA.
| | - Jungtae Leem
- Department of Diagnostics, College of Korean Medicine, Wonkwang University, Iksan 54538, Republic of Korea; Research Center of Traditional Korean Medicine, College of Korean Medicine, Wonkwang University, Iksan 54538, Republic of Korea.
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Chen K, Shu S, Yang M, Zhong S, Xu F. Meridian acupuncture plus massage for children with spastic cerebral palsy. Am J Transl Res 2021; 13:6415-6422. [PMID: 34306381 PMCID: PMC8290740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 02/01/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To evaluate the effect of combination therapy of meridian acupuncture and massage on motor development in children with spastic cerebral palsy (SCP). METHODS A total of 113 children with SCP in our hospital were allocated into research group (63 cases, treated with meridian acupuncture plus massage) and control group (50 cases, treated with routine rehabilitation measures). Clinical efficacy and alterations of inflammatory factors were observed. Peabody Developmental Motor Scale (PDMS) and gross motor function measure (GMFM-88; sitting, standing, walking) were employed for the assessment of motor ability. Changes in muscle tension were monitored with the Ashworth scale (AS), and modified Barthel index (MBI) and Gesell's Developmental Schedule (GDS) were used to evaluate children's daily activities, language, fine motor skills, and adaptability. Finally, the development of children in the two groups was monitored. RESULTS The research group had higher total effective rate than the control group (P=0.018). After treatment, the levels of interleukin 6 (IL-6) and tumor necrosis factor-α (TNF-α) in the research group were lower than those in the control group (P<0.05); the PDMS and AS scores were reduced in both groups, and the reduction was greater in research group (P<0.05); GFMF-88, Barthel and GDS scores increased in both groups, especially in the research group; children in research group were better developed than those in control group (P<0.05). CONCLUSION Meridian acupuncture plus massage contributes to a significant improvement of motor development in children with SCP.
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Affiliation(s)
- Kunzhi Chen
- Department of Traditional Chinese Medicine, Guiyang Maternal and Child Health HospitalGuiyang 550003, Guizhou Province, China
| | - Shiju Shu
- Department of Traditional Chinese Medicine, Guiyang Maternal and Child Health HospitalGuiyang 550003, Guizhou Province, China
| | - Mei Yang
- Department of Traditional Chinese Medicine, Guiyang Maternal and Child Health HospitalGuiyang 550003, Guizhou Province, China
| | - Shengbing Zhong
- Department of Traditional Chinese Medicine, Guiyang Maternal and Child Health HospitalGuiyang 550003, Guizhou Province, China
| | - Feng Xu
- Department of Radiology, Guiyang Maternal and Child Health HospitalGuiyang 550003, Guizhou Province, China
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Novak I, Morgan C, Fahey M, Finch-Edmondson M, Galea C, Hines A, Langdon K, Namara MM, Paton MC, Popat H, Shore B, Khamis A, Stanton E, Finemore OP, Tricks A, Te Velde A, Dark L, Morton N, Badawi N. State of the Evidence Traffic Lights 2019: Systematic Review of Interventions for Preventing and Treating Children with Cerebral Palsy. Curr Neurol Neurosci Rep 2020; 20:3. [PMID: 32086598 PMCID: PMC7035308 DOI: 10.1007/s11910-020-1022-z] [Citation(s) in RCA: 431] [Impact Index Per Article: 107.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE OF REVIEW Cerebral palsy is the most common physical disability of childhood, but the rate is falling, and severity is lessening. We conducted a systematic overview of best available evidence (2012-2019), appraising evidence using GRADE and the Evidence Alert Traffic Light System and then aggregated the new findings with our previous 2013 findings. This article summarizes the best available evidence interventions for preventing and managing cerebral palsy in 2019. RECENT FINDINGS Effective prevention strategies include antenatal corticosteroids, magnesium sulfate, caffeine, and neonatal hypothermia. Effective allied health interventions include acceptance and commitment therapy, action observations, bimanual training, casting, constraint-induced movement therapy, environmental enrichment, fitness training, goal-directed training, hippotherapy, home programs, literacy interventions, mobility training, oral sensorimotor, oral sensorimotor plus electrical stimulation, pressure care, stepping stones triple P, strength training, task-specific training, treadmill training, partial body weight support treadmill training, and weight-bearing. Effective medical and surgical interventions include anti-convulsants, bisphosphonates, botulinum toxin, botulinum toxin plus occupational therapy, botulinum toxin plus casting, diazepam, dentistry, hip surveillance, intrathecal baclofen, scoliosis correction, selective dorsal rhizotomy, and umbilical cord blood cell therapy. We have provided guidance about what works and what does not to inform decision-making, and highlighted areas for more research.
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Affiliation(s)
- Iona Novak
- Cerebral Palsy Alliance Research Institute, Discipline of Child & Adolescent Health, Faculty of Medicine & Health, The University of Sydney, PO Box 6427, Frenchs Forest, Sydney, NSW, 2086, Australia.
| | - Catherine Morgan
- Cerebral Palsy Alliance Research Institute, Discipline of Child & Adolescent Health, Faculty of Medicine & Health, The University of Sydney, PO Box 6427, Frenchs Forest, Sydney, NSW, 2086, Australia
| | - Michael Fahey
- Department of Paediatric Neurology, Monash Health, Clayton, Victoria, Australia
- Department of Paediatrics, Monash University, Clayton, Victoria, Australia
| | - Megan Finch-Edmondson
- Cerebral Palsy Alliance Research Institute, Discipline of Child & Adolescent Health, Faculty of Medicine & Health, The University of Sydney, PO Box 6427, Frenchs Forest, Sydney, NSW, 2086, Australia
| | - Claire Galea
- Cerebral Palsy Alliance Research Institute, Discipline of Child & Adolescent Health, Faculty of Medicine & Health, The University of Sydney, PO Box 6427, Frenchs Forest, Sydney, NSW, 2086, Australia
- Grace Centre for Newborn Care, Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Ashleigh Hines
- Cerebral Palsy Alliance Research Institute, Discipline of Child & Adolescent Health, Faculty of Medicine & Health, The University of Sydney, PO Box 6427, Frenchs Forest, Sydney, NSW, 2086, Australia
| | - Katherine Langdon
- Department of Paediatric Rehabilitation, Kids Rehab WA, Perth Children's Hospital, Perth, Australia
| | - Maria Mc Namara
- Cerebral Palsy Alliance Research Institute, Discipline of Child & Adolescent Health, Faculty of Medicine & Health, The University of Sydney, PO Box 6427, Frenchs Forest, Sydney, NSW, 2086, Australia
| | - Madison Cb Paton
- Cerebral Palsy Alliance Research Institute, Discipline of Child & Adolescent Health, Faculty of Medicine & Health, The University of Sydney, PO Box 6427, Frenchs Forest, Sydney, NSW, 2086, Australia
| | - Himanshu Popat
- Cerebral Palsy Alliance Research Institute, Discipline of Child & Adolescent Health, Faculty of Medicine & Health, The University of Sydney, PO Box 6427, Frenchs Forest, Sydney, NSW, 2086, Australia
- Grace Centre for Newborn Care, Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Benjamin Shore
- Department of Orthopedic Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Amanda Khamis
- Cerebral Palsy Alliance Research Institute, Discipline of Child & Adolescent Health, Faculty of Medicine & Health, The University of Sydney, PO Box 6427, Frenchs Forest, Sydney, NSW, 2086, Australia
| | - Emma Stanton
- Cerebral Palsy Alliance Research Institute, Discipline of Child & Adolescent Health, Faculty of Medicine & Health, The University of Sydney, PO Box 6427, Frenchs Forest, Sydney, NSW, 2086, Australia
| | - Olivia P Finemore
- Cerebral Palsy Alliance Research Institute, Discipline of Child & Adolescent Health, Faculty of Medicine & Health, The University of Sydney, PO Box 6427, Frenchs Forest, Sydney, NSW, 2086, Australia
| | - Alice Tricks
- Cerebral Palsy Alliance Research Institute, Discipline of Child & Adolescent Health, Faculty of Medicine & Health, The University of Sydney, PO Box 6427, Frenchs Forest, Sydney, NSW, 2086, Australia
| | - Anna Te Velde
- Cerebral Palsy Alliance Research Institute, Discipline of Child & Adolescent Health, Faculty of Medicine & Health, The University of Sydney, PO Box 6427, Frenchs Forest, Sydney, NSW, 2086, Australia
| | - Leigha Dark
- Allied and Public Helath, Faculty of Health Sciences, Western Sydney University, Sydney, New South Wales, Australia
| | - Natalie Morton
- Allied and Public Helath, Faculty of Health Sciences, Western Sydney University, Sydney, New South Wales, Australia
- School of Allied Health, Australian Catholic University, North Sydney, New South Wales, Australia
| | - Nadia Badawi
- Cerebral Palsy Alliance Research Institute, Discipline of Child & Adolescent Health, Faculty of Medicine & Health, The University of Sydney, PO Box 6427, Frenchs Forest, Sydney, NSW, 2086, Australia
- Grace Centre for Newborn Care, Children's Hospital at Westmead, Westmead, New South Wales, Australia
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Zhang R, Li L, Chen B, Liu H, Liu J, Zhang L, Xiu Z. Acupotomy versus nonsteroidal anti-inflammatory drugs for knee osteoarthritis: Protocol for a systematic review and meta-analysis. Medicine (Baltimore) 2019; 98:e17051. [PMID: 31490401 PMCID: PMC6739018 DOI: 10.1097/md.0000000000017051] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Knee osteoarthritis (KOA), a common clinical chronic osteoarthropathy, has adverse effects on the working ability and life quality of patients. At present, acupotomy and nonsteroidal anti-inflammatory drugs (NSAIDs) have been widely applied on KOA in China and has achieved satisfactory results. However, there is no systematic review comparing the effectiveness of these two therapies for KOA. Therefore, this study will assess the efficacy and safety of acupotomy in treating KOA. METHODS AND ANALYSIS Several databases including CNKI, Wanfang Database, CBM, VIP, PubMed, Cochrane library, Web of Science, and Embase will be used by two independent researchers to search the related clinical RCTs about acupotomy therapy for KOA patients until May 2019. Subsequently, meta-analysis will be conducted by using Review Manager 5.3, and the related data will be analyzed by using the method for GRADE. The continuous data will be presented as the WMD or SMD with 95% CI, while dichotomous data will be shown as the RR with 95% CI. CONCLUSION Our results review will provide evidence to determine whether acupotomy can achieve the effect of NSAIDs, or whether it has advantages and safety compared with NSAIDs for patients with KOA. ETHICS AND DISSEMINATION This study will not involve personal information. The ethical approval will not be required. This systematic review will be disseminated electronically through a peer-reviewed journal or international conference presentations. PROSPERO REGISTRATION NUMBER CRD42019129089.
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Affiliation(s)
- Renpan Zhang
- The Affiliated People's Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou 350004
- Fujian University of Traditional Chinese Medicine, Fuzhou 350122, Fujian Province, China
| | - Lixiang Li
- Fujian University of Traditional Chinese Medicine, Fuzhou 350122, Fujian Province, China
| | - Bin Chen
- The Affiliated People's Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou 350004
| | - Hong Liu
- The Affiliated People's Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou 350004
| | - Jing Liu
- The Affiliated People's Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou 350004
| | - Liangzhi Zhang
- The Affiliated People's Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou 350004
| | - Zhongbiao Xiu
- The Affiliated People's Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou 350004
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Chen B, Zhang C, Zhang RP, Lin AY, Xiu ZB, Liu J, Zhao HJ. Acupotomy versus acupuncture for cervical spondylotic radiculopathy: protocol of a systematic review and meta-analysis. BMJ Open 2019; 9:e029052. [PMID: 31399459 PMCID: PMC6701683 DOI: 10.1136/bmjopen-2019-029052] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION Cervical spondylotic radiculopathy (CSR) is the most common pattern of cervical spondylosis, which is a serious and common degenerative disease. Both acupotomy and acupuncture have been widely used clinically to treat CSR in China with satisfied efficacy. However, there is no systematic review comparing the effectiveness of these two therapies. The aim of this study is to compare the therapeutic efficacy and safety between acupotomy and acupuncture for patients with CSR to provide evidence for clinical practice. METHODS AND ANALYSIS The following electronic databases will be searched: Web of Science, PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure , China Biology Medicine disc, Wanfang Database and Chinese Scientific Journal Database (VIP). The randomised controlled trials of acupotomy versus acupuncture with/without additional treatment for CSR will be searched in the databases from their inception to December 2018 by two researchers independently. Visual analogue scale, symptom score and neck disability index will be assessed as the primary outcomes. The total effective rate, curative rate, adverse events and amount of rescue medication used will be assessed as the secondary outcomes. The Review Manager 5.3 will be used for meta-analysis and the evidence level will be assessed by using the method for Grading of Recommendations Assessment, Development and Evaluation. Continuous outcomes will be presented as the weighted mean difference or standardised mean difference with 95% CI, whereas dichotomous data will be expressed as relative risk with 95% CI. If the included studies have existing heterogeneity (p<0.05), then a random-effects model will be used. Otherwise, we will calculate using a fixed-effects model. ETHICS AND DISSEMINATION Ethical approval is not required because no primary data are collected. This review will be published in a peer-reviewed journal and will be presented at an international academic conference for dissemination. PROSPERO REGISTRATION NUMBER CRD42019117348.
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Affiliation(s)
- Bin Chen
- Department of Rehabilitation, The Affiliated People’s Hospital, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Cai Zhang
- Graduate School, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Ren-Pan Zhang
- Department of Rehabilitation, The Affiliated People’s Hospital, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Graduate School, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - An-Yang Lin
- Department of Rehabilitation, The Affiliated People’s Hospital, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Graduate School, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Zhong-Biao Xiu
- Department of Rehabilitation, The Affiliated People’s Hospital, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Jing Liu
- Department of Rehabilitation, The Affiliated People’s Hospital, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Hong-Jia Zhao
- Department of Rehabilitation, The Affiliated People’s Hospital, Fujian University of Traditional Chinese Medicine, Fuzhou, China
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