Integrative package for low back pain with leg pain in Korea: A prospective cohort study

Park, Jongbae J.; Shin, Joon‐Shik; Choi, Youngkwon; Youn, Yousuk; Lee, Sang-Ho; Kwon, Seung Ro; Lee, Hyangsook; Kang, Man Ho; Ha, In‐Hyuk; Shin, Im-Hee

doi:10.1016/j.ctim.2010.02.003

Cited by 32 publications

(30 citation statements)

References 42 publications

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“…Clinically significant improvements in LBP also became apparent and most patients no longer presented neurological disorders from week 24. We found moderate time by group interaction difference in VAS for LBP and ODI scores in subgrouping by duration of LBP and significant time by group interactions in VAS for LBP when subgrouped by operation recommendation 7. In additional investigations over 3 years, patients showed further improvement or maintained their improved state.…”

Section: Discussionmentioning

confidence: 61%

“…A prospective cohort study was conducted and this study is a report of the 3-year follow-up analysis of a previous trial 7. The protocol has been registered at ClinicalTrials.gov under the registration number NCT01989403 8…”

Section: Methodsmentioning

confidence: 99%

“…Korea has a dual medical system where western and Korean traditional medical doctors (KMDs) have equal individual treatment rights and the patient usually decides the means of primary healthcare. We recruited participants from consecutive outpatients visiting for treatment purposes and administered CAM treatment, excluding conventional treatment (eg, analgesics, physical therapy, injections) and published the 6-month results 7. The participants had severe leg pain, and 60% had previously been diagnosed as needing surgery for LHD at other hospitals or clinics.…”

Section: Introductionmentioning

confidence: 99%

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The long-term course of patients undergoing alternative and integrative therapy for lumbar disc herniation: 3-year results of a prospective observational study

et al. 2014

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ObjectivesThis study aimed to assess the efficacy and safety of an integrative complementary and alternative medicine (CAM) approach in the management of lumbar herniated disc (LHD) with sciatic pain and investigate pain relapse, use of medical care and surgery rates in patients who actively chose non-surgical CAM treatment for LHD.Study design/SettingThis prospective observational study was undertaken at a Korean medicine hospital outpatient setting in Korea.ParticipantsA total of 128 consecutive patients with LHD with a numeric rating scale for leg pain of ≥5 completed 6 months of CAM treatment after recruitment from November 2006, and 73/128 participants (57%) attended follow-up 3 years later.Interventions6 months of CAM treatment (herbal medicine, acupuncture, bee venom pharmacopuncture, and Chuna manipulation).Primary outcome measuresVisual analogue scale (VAS) for low back and leg pain, Oswestry Disability Index (ODI), and Short Form (SF)-36 Health Survey.Secondary outcome measuresNeurological impairment (muscular weakness, sensory loss, Straight Leg Raise test), MRIs, recurrence of low back pain and/or radiating pain, and use of medical care.Results92 patients could be assessed for surgical state, of whom 4 replied that they had received surgery. 73 patients attended the 3-year follow-up. The baseline VAS of back pain (4.37±2.70) decreased after treatment (0.90±1.01; p<0.001) and was maintained at 3 years (1.12±1.64; p=0.19). The baseline VAS of leg pain (7.57±1.40) also decreased on treatment (0.82±1.18; p<0.001) and was sustained at 3 years (0.99±1.58; p=0.34). ODI scores declined from 40.74±16.15 to 9.84±9.67 (p<0.001), then decreased further to 6.30±7.19 (p<0.01). SF-36 scores increased from 34.96±13.30 to 69.20±14.96 (p<0.001), reaching 76.19±14.45 (p<0.001) at 3 years. 37 patients reported recurrence of pain and most chose CAM treatment for management of relapse symptoms.ConclusionsAlthough the absence of a control group prevents validation of effectiveness, many patients showed favourable long-term outcomes.Trial registration numberClinicalTrials.gov Identifier: NCT01989403.

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Section: Discussionmentioning

confidence: 61%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The long-term course of patients undergoing alternative and integrative therapy for lumbar disc herniation: 3-year results of a prospective observational study

et al. 2014

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“…The UK National Health Service (NHS) website cites the US National Center for Complementary and Alternative Medicine (NCCAM) and states that when a treatment is used alongside conventional treatments to help a patient deal with a certain health condition, but not as an alternative, this use of treatment is called “complementary medicine” and when a treatment is used instead of conventional treatments with the intention of curing or treating a health condition, the use is called “alternative medicine” [10]. Traditional Chinese medicine (TCM) and traditional Korean medicine (TKM) treatment [11–15] which began in non-Western cultures are also regionally categorized and described as CAM and mainly consist of acupuncture, moxibustion, and herbal medicine and are widely used for the treatment of pain related to spinal disorders. We therefore report the comprehensive results of our review of the demographic characteristics of patients who visited 2 spine specialty Korean medicine hospitals, to provide basic data needed to establish the etiology of FBSS and describe treatment approaches employed in actual clinical settings.…”

Section: Introductionmentioning

confidence: 99%

Demographic Characteristics and Medical Service Use of Failed Back Surgery Syndrome Patients at an Integrated Treatment Hospital Focusing on Complementary and Alternative Medicine: A Retrospective Review of Electronic Medical Records

Choi

Hya

Kim

et al. 2014

Evidence-Based Complementary and Alternative Medicine

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Objective. To report the patient demographics and nonsurgical complementary and alternative medicine treatment used at a Korean medicine hospital for low back pain (LBP) and/or sciatica after surgery. Methods. Medical records of patients who visited a spine-specialized Korean medicine hospital at 2 separate sites for continuous or recurrent LBP or sciatica following back surgery were reviewed. The demographics, MRI and/or CT scans, and treatments were assessed. Results. Of the total 707 patients, 62% were male and the average age was 50.20 years. Ninety percent of patients presented with LBP and 67% with sciatica. Eighty-four percent were diagnosed with herniated nucleus pulposus at time of surgery. Of these patients, 70% had pain recurrence 6 months or later, but 19% experienced no relief or immediate aggravation of pain after surgery. Many patients selected traditional Korean medicine treatment as primary means of postsurgery care (47%). When time to pain recurrence was short or pain persisted after surgery, return of symptoms at the same disc level and side was frequent. Conclusion. An integrative treatment model focusing on Korean medicine and used in conjunction with radiological diagnostics and conventional medicine is currently used as a treatment option for patients with pain after lumbar spine surgery.

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“…The physicians administering Chuna in this trial will be KMDs with 3+ years’ clinical experience of Chuna manual therapy use, and will be deployed after receiving Chuna protocol training sessions (two sessions, 4+ h/session) for standardized application. Chuna covers a wide variety of techniques including high-velocity, low-amplitude thrusts to joints, slightly further than the passive range of motion, and mobilization which applies manual force to joints in the passive range of motion [16]. The Chuna techniques utilized in this study are divided into lumbar and pelvic regions, and mandatory or selective techniques will be performed following physician judgement (Table 2).…”

Section: Methodsmentioning

confidence: 99%

Comparative effectiveness and cost-effectiveness of Chuna manual therapy versus conventional usual care for nonacute low back pain: study protocol for a pilot multicenter, pragmatic randomized controlled trial (pCRN study)

Shin

Kim

Cho

et al. 2017

Trials

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BackgroundWhile Chuna manual therapy is a Korean manual therapy widely used primarily for low back pain (LBP)-related disorders in Korea, well-designed studies on the comparative effectiveness of Chuna manual therapy are scarce.Methods/designThis study is the protocol for a three-armed, multicenter, pragmatic randomized controlled pilot trial. Sixty severe nonacute LBP patients (pain duration of at least 3 weeks, Numeric Rating Scale (NRS) ≥5) will be recruited at four Korean medicine hospitals. Participants will be randomly allocated to the Chuna group (n = 20), usual care group (n = 20), or Chuna plus usual care group (n = 20) for 6 weeks of treatment. Usual care will consist of orally administered conventional medicine, physical therapy, and back pain care education. The trial will be conducted with outcome assessor and statistician blinding. The primary endpoint will be NRS of LBP at week 7 post randomization. Secondary outcomes include NRS of leg pain, the Oswestry Disability Index (ODI), the Patient Global Impression of Change (PGIC), the Credibility and Expectancy Questionnaire, lumbar range of motion (ROM), the EuroQol-5 Dimension (EQ-5D) health survey, the Health Utility Index III (HUI-III), and economic evaluation and safety data. Post-treatment follow-ups will be conducted at 1, 4, and 10 weeks after conclusion of treatment.DiscussionThis study will assess the comparative effectiveness of Chuna manual therapy compared to conventional usual care. Costs and effectiveness (utility) data will be analyzed for exploratory cost-effectiveness analysis. If this pilot study does not reach a definite conclusion due to its small sample size, these results will be used as preliminary results to calculate sample size for future large-scale clinical trials and contribute in the assessment of feasibility of a full-scale multicenter trial.Trial registrationClinical Research Information Service (CRIS), KCT0001850. Registered on 17 March 2016.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-016-1756-8) contains supplementary material, which is available to authorized users.

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Integrative package for low back pain with leg pain in Korea: A prospective cohort study

Cited by 32 publications

References 42 publications

The long-term course of patients undergoing alternative and integrative therapy for lumbar disc herniation: 3-year results of a prospective observational study

The long-term course of patients undergoing alternative and integrative therapy for lumbar disc herniation: 3-year results of a prospective observational study

Demographic Characteristics and Medical Service Use of Failed Back Surgery Syndrome Patients at an Integrated Treatment Hospital Focusing on Complementary and Alternative Medicine: A Retrospective Review of Electronic Medical Records

Comparative effectiveness and cost-effectiveness of Chuna manual therapy versus conventional usual care for nonacute low back pain: study protocol for a pilot multicenter, pragmatic randomized controlled trial (pCRN study)

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