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Author (up) Chen, L. X.; Mao, J. J.; Fernandes, S.; Galantino, M. L.; Guo, W.; Lariccia, P.; Teal, V. L.; Bowman, M. A.; Schumacher, H. R.; Farrar, J. T. url  doi
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  Title Integrating acupuncture with exercise-based physical therapy for knee osteoarthritis: a randomized controlled trial Type of Study RCT
  Year 2013 Publication Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases Abbreviated Journal J Clin Rheumatol  
  Volume 19 Issue 6 Pages 308-316  
  Keywords AcuTrials; Arthritis; Osteoarthritis, Knee; Acu Versus Sham; Acupuncture; TCM Acupuncture Style; Fixed Acupuncture Protocol; Restricted Modalities, Acupuncture Only; Sham Control; Non Penetrating Sham, Mechanical; Verum Acupoint Control; Pain  
  Abstract BACKGROUND: Knee osteoarthritis is a chronic disease associated with significant morbidity and economic cost. The efficacy of acupuncture in addition to traditional physical therapy has received little study. OBJECTIVE: The objective of this study was to compare the efficacy and safety of integrating a standardized true acupuncture protocol versus nonpenetrating acupuncture into exercise-based physical therapy (EPT). METHODS: This was a randomized, double-blind, controlled trial at 3 physical therapy centers in Philadelphia, PA. We studied 214 patients (66% African Americans) with at least 6 months of chronic knee pain and x-ray-confirmed Kellgren scores of 2 or 3. Patients received 12 sessions of acupuncture directly following EPT over 6 to 12 weeks. Acupuncture was performed at the same 9 points dictated by the traditional Chinese “Bi” syndrome approach to knee pain, using either standard needles or Streitberger non-skin-puncturing needles. The primary outcome was the proportion of patients with at least a 36% improvement in Western Ontario and McMaster Universities Osteoarthritis Index score at 12 weeks. RESULTS: Both treatment groups showed improvement from combined therapy with no difference between true (31.6%) and nonpenetrating acupuncture (30.3%) in Western Ontario and McMaster Universities Osteoarthritis Index response rate (P = 0.5) or report of minor adverse events. A multivariable logistic regression prediction model identified an association between a positive expectation of relief from acupuncture and reported improvement. No differences were noted by race, sex, or age. CONCLUSIONS: Puncturing acupuncture needles did not perform any better than nonpuncturing needles integrated with EPT. Whether EPT, acupuncture, or other factors accounted for any improvement noted in both groups could not be determined in this study. Expectation for relief was a predictor of reported benefit.  
  Address From the *Penn Presbyterian Medical Center; Center for Clinical Epidemiology and Biostatistics; Department of Family Medicine and Community Health; and Division of Rheumatology, University of Pennsylvania, Philadelphia, USA  
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  Language Number of Treatments 11  
  Treatment Follow-up 14 Weeks Frequency <1/WK Number of Participants 214  
  Time in Treatment 12 Weeks Condition Osteoarthritis, Knee
  Disease Category Arthritis OCSI Score  
  Notes Approved no  
  Call Number Serial 141  
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