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Lee JH, Lee HJ, Woo SH, Park YK, Han JH, Choi GY, Heo ES, Kim JS, Park CA, Lee WD, Yang CS, Kim AR, Han CH. Effectiveness and Safety of Acupotomy on Lumbar Spinal Stenosis: A Pragmatic, Pilot, Randomized Controlled Trial. J Pain Res 2023; 16:659-668. [PMID: 36908927 PMCID: PMC9999720 DOI: 10.2147/jpr.s399132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 02/14/2023] [Indexed: 03/08/2023] Open
Abstract
Purpose In Korea, complex treatments such as acupotomy, acupuncture, and physical therapy are performed for lumbar spinal stenosis (LSS). Although there are reports of acupotomy as monotherapy or acupuncture treatment for LSS, pragmatic studies are lacking. Therefore, this study aimed to determine the effectiveness and safety of acupotomy for LSS to provide baseline evidence for a large-scale study. Materials and Methods This pragmatic randomized controlled pilot study enrolled 34 participants and randomly assigned them to two groups (n=17/group). The intervention was conducted for 8 weeks. Acupotomy plus and usual care groups received acupuncture (17 acupoints) and interferential current therapy (ICT) twice weekly; however, the acupotomy plus group received an additional acupotomy (7 acupoints) for treatment of the usual care group. The primary outcome was measured using visual analog scales (VAS), and secondary outcomes were assessed using the self-rated walking distance, short-form McGill Pain Questionnaire (SF-MPQ), and the Oswestry Disability Index (ODI). Outcome measurements were conducted at baseline and 4, 8, and 12 weeks after the commencement of the intervention. Adverse events were assessed at each visit. Hematological and biochemical examinations were performed at screening and week 8. Results Overall, 33 of the 34 participants completed the study, and one participant in the usual care group dropped out. In both groups, VAS scores at weeks 4, 8, and 12 significantly improved compared to baseline. Also, self-rated walking distance, SF-MPQ, and ODI scores were significantly improved at weeks 4, 8, and 12 than at baseline. However, there were no significant differences in the time-dependent and group-to-time interactions between the two groups. In addition, no severe adverse reactions were reported, and there were no significant differences in hematological and biochemical results. Conclusion This study provides baseline data for large-scale studies on the effectiveness and safety of acupotomy in LSS. Clinical Trial Number KCT0006234.
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Affiliation(s)
- Jung Hee Lee
- Department of Acupuncture & Moxibustion, College of Korean Medicine, Daegu Haany University, Daegu, Republic of Korea
| | - Hyun-Jong Lee
- Department of Acupuncture & Moxibustion, College of Korean Medicine, Daegu Haany University, Daegu, Republic of Korea
| | - Sang Ha Woo
- Department of Acupuncture & Moxibustion, College of Korean Medicine, Daegu Haany University, Daegu, Republic of Korea
| | - Yu-Kyeong Park
- Department of Acupuncture & Moxibustion, College of Korean Medicine, Daegu Haany University, Daegu, Republic of Korea
| | - Ji Hoon Han
- Department of Acupuncture & Moxibustion, College of Korean Medicine, Daegu Haany University, Daegu, Republic of Korea
| | - Ga-Young Choi
- Department of Acupuncture & Moxibustion, College of Korean Medicine, Daegu Haany University, Daegu, Republic of Korea
| | - Eun Sil Heo
- Department of Acupuncture & Moxibustion, College of Korean Medicine, Daegu Haany University, Daegu, Republic of Korea
| | - Jae Soo Kim
- Department of Acupuncture & Moxibustion, College of Korean Medicine, Daegu Haany University, Daegu, Republic of Korea
| | - Chung A Park
- Department of Diagnostics, College of Korean Medicine, Daegu Haany University, Daegu, Republic of Korea
| | - Woo Dong Lee
- Pre-Major of Cosmetics and Pharmaceutics, College of Herbal Bio-Industry, Daegu Haany University, Daegu, Republic of Korea
| | - Chang Sop Yang
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Ae-Ran Kim
- Clinical Research Coordinating Team, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Chang-Hyun Han
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
- Korean Convergence Medicine, University of Science & Technology (UST), Campus of Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
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Guan H, Wu Q, Zhou Y, Fan X, Zheng K, Si T, Zhao J. A retrospective study of ultrasound-guided intervention for frozen shoulder in the frozen stage. Front Surg 2022; 9:998590. [PMID: 36329976 PMCID: PMC9622776 DOI: 10.3389/fsurg.2022.998590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 09/28/2022] [Indexed: 11/05/2022] Open
Abstract
Background To investigate the clinical value of ultrasound (US)-guided intervention for frozen shoulder (FS) in the frozen stage. Methods This study included 40 patients who had primary FS in the frozen stage and were evaluated by US. These 40 patients have all received conservative treatment elsewhere, and no satisfactory results have been achieved, with no improvement in active and passive movement angles, and no improvement in scores within 3 months. Therefore, their previous treatment was set as comparison. All patients underwent US-guided shoulder joint capsule distension by injection of sterilized water. Of these participants, 22 patients with scapulohumeral periarthritis received a compound betamethasone injection, and 14 patients with thickened coracohumeral ligaments (CHLs) underwent acupotomy lysis, and the remaining 4 patients had no extra treatments. The Constant-Murley score (CMS) was evaluated before and after the operation and analysed for each patient. Results Before treatment, the indices for the thickening of the subaxillary joint capsule, subacromial bursa (with or without effusion), long head of the biceps brachii tendon (LHBBT) and CHL were 40, 22, 16 and 14, respectively. After treatment, all the indices were significantly decreased (all P < 0.010) except for that of the LHBBT (P = 0.123). The patients' CMSs improved, with the median total CMS increasing from 59 points (interquartile range: 53–64 points) to 86 points (interquartile range: 78–90 points) (P < 0.010). While the internal rotation (Ir) of the shoulder joint did not improve (FDRs < 0.50), abduction, forward flexion (Ff) and external rotation (Er) improved significantly (all FDRs = 1.00). Conclusion Compared with conservative treatment, US-guided intervention for FS in the frozen stage is highly effective and of great clinical value.
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Affiliation(s)
- Haitao Guan
- Department of Ultrasonography, Suzhou Science / Technology Town Hospital, Suzhou, China,Department of Ultrasonography, Nantong Third People's Hospital, Nantong, China
| | - Qinfeng Wu
- Department of Rehabilitation, Suzhou Science / Technology Town Hospital, Suzhou, China
| | - Yuan Zhou
- Department of Pain, Affiliated Hospital of Nantong University, Nantong, China
| | - Xing Fan
- Department of Ultrasonography, Suzhou Science / Technology Town Hospital, Suzhou, China
| | - Kun Zheng
- Department of Ultrasonography, Suzhou Science / Technology Town Hospital, Suzhou, China
| | - Tong Si
- Department of Ultrasonography, Nantong Third People's Hospital, Nantong, China
| | - Jinli Zhao
- Department of Imaging, Affiliated Hospital of Nantong University, Nantong, China,Correspondence: Jinli Zhao
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