18. April 2017 · Comments Off · Categories: Acupuncture, Arthritis, Osteoarthritis

A study by investigators from the UK suggests that both group and individual acupuncture may be effective for treating the symptoms of knee osteoarthritis. In a pilot randomised trial, 120 patients received either a standardised advice/exercise booklet, the booklet plus group acupuncture, or the booklet plus individual acupuncture. Both acupuncture groups received up to ten treatments over 12 weeks using four local standard points (Yinglingquan SP-9, Xuehai SP-10, Yinshi ST-33, Zusanli ST-36) plus up to four ahshi points, with manual stimulation applied unless no pain relief was reported, in which case electro-acupuncture was used. Mean reductions in osteoarthritis symptom scores from baseline to 14 week follow-up were greatest for group acupuncture (-3.2), followed by individual acupuncture (-2.4), both of which were significantly better than the booklet group (who experienced a mean increase in symptom scores of 0.4).
Western medical acupuncture in a group setting for knee osteoarthritis: results of a pilot randomised controlled trial. Pilot Feasibility Stud. 2016 Feb 16;2:10.

05. July 2016 · Comments Off · Categories: Arthritis, Rheumatoid Arthritis, Tai Chi Chuan

Tai chi can improve endothelial dysfunction and arterial stiffness in elderly women with rheumatoid arthritis (RA). Korean investigators assigned 56 female RA patients to either a weekly tai chi exercise group, or a control group who received general information about the benefits of exercise. At the end of the three-month intervention period, flow-mediated dilatation (FMD, a measure of endothelial function) was found to have significantly increased in the tai chi group compared with the control group. In addition, brachial-ankle pulse wave velocity (baPWV, a measure of arterial stiffness) and total serum cholesterol also decreased significantly in the tai chi group.
The beneficial effects of Tai Chi exercise on endothelial function and arterial stiffness in elderly women with rheumatoid arthritis. Arthritis Res Ther. 2015 Dec 24;17(1):380.

Participating in tai chi (TC) leads to significant improvements in physical and mental health among older adults with arthritis, according to a Canadian cohort study. A 16-week intervention was conducted among 102 older adults from low-income neighbourhoods with self-reported arthritis. Participants were encouraged to attend two moderate-intensity TC sessions per week for a total of 120 minutes. Functional fitness assessment results indicated that grip strength, 30-second arm curl, timed up-and-go and 30-second chair stand improved significantly from baseline to 16 weeks. Physical functioning, general health, vitality, and mental health also improved significantly over the intervention period. These improvements in physical health and physical function scores were judged to be clinically meaningful. (Effectiveness of a Tai Chi Intervention for Improving Functional Fitness and General Health Among Ethnically Diverse Older Adults With Self-Reported Arthritis Living in Low-Income Neighborhoods: A Cohort Study. J Geriatr Phys Ther. 2014 Apr 23. [Epub ahead of print]).

http:/ /www.ncbi.nlm.nih.gov / pubmed /24762392

Acupuncture is the most effective CAM for treating musculoskeletal conditions and one of only a few therapies that is supported by current medical evidence, according to a report commissioned by the charity Arthritis Research. UK. The report, which examined trial data on 25 therapies, was aimed at helping people with musculoskeletal conditions and healthcare professionals choose safe and effective therapies. Very little evidence was found in support of commonly-used therapies such as copper or magnets for musculoskeletal disorders. The therapies that were shown to be the most effective were: acupuncture for osteoarthritis, low back pain and fibromyalgia, massage for fibromyalgia and low back pain, tai chi for osteoarthritis and yoga for back pain. (Practitioner-based complementary and alternative therapies for the treatment of rheumatoid arthritis, osteoarthritis, fibromyalgia and low back pain. http:/ / www.arthritisresearchuk.org/ news / press-releases / 2013 / march /january / new-report-on-complementary-therapies-for-arthritis-reveals-lack-of-scientific-evidence.aspx).

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).

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).

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).

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).

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 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).