The Use of Expertise-Based Randomized Controlled Trials to Assess Spinal Manipulation and Acupuncture for Low Back Pain: A Systematic Review

@article{Johnston2008TheUO,
  title={The Use of Expertise-Based Randomized Controlled Trials to Assess Spinal Manipulation and Acupuncture for Low Back Pain: A Systematic Review},
  author={Bradley C Johnston and Bruno R. da Costa and Philip J Devereaux and Elie A. Akl and Jason Walter Busse},
  journal={Spine},
  year={2008},
  volume={33},
  pages={914-918}
}
Study Design. Systematic review. Objective. To assess current use of expertise-based randomization in trials of acupuncture or spinal manipulation for low back pain. Summary of Background Data. The randomized clinical trial is often referred to as the gold standard for providing evidence to guide therapeutic decisions. Random allocation of participants to intervention and control groups theoretically should balance these groups for both known and unknown prognostic factors; however, when… 
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Review of randomised controlled trials comparing efficacy of acupuncture Vs no acupuncture for chronic non-specific low back pain.
TLDR
None of studies managed to prove dramatic improvement in chronic non-specific back pain, however, all 4 trials proved acupuncture is an effective treatment vs. no acupuncture, which means acupuncture is a safe adjunct to conventional pain relief therapy.
The Chiropractic Hospital-Based Interventions Research Outcomes Study: Consistency of Outcomes Between Doctors of Chiropractic Treating Patients With Acute Lower Back Pain.
TLDR
Overall, DCs differed modestly in their effectiveness in improving LBP-specific disability; however, confidence limits did not exclude clinically negligible effects.
Acupuncture for chronic nonspecific low back pain: An overview of systematic reviews
TLDR
Overall, findings on the effectiveness of acupuncture for cnLBP were consistent and future trials are needed to establish the standardization of acupuncture in terms of the length of treatment sessions, frequency of sessions, number of needles needed per treatment, placement of needle insertion, depth of needle inserted, and whether needle stimulation achieves De Qi.
Blinding in Physical Therapy Trials and Its Association with Treatment Effects: A Meta-epidemiological Study
TLDR
The lack of statistical significance between blinding and effect sizes should not be interpreted as meaning that an impact of blinding on effect size is not present in PT.
Evaluating the Characteristics, Reporting and Methodological Quality of Systematic Reviews of Acupuncture for Low Back Pain by Using the Veritas Plot
TLDR
The quality of SRs on acupuncture for low back pain should be improved, mainly by strengthening the methodological quality and reporting quality, and the Veritas plot is an effective graphical evaluation method that is worth popularizing.
PEDro or Cochrane to Assess the Quality of Clinical Trials? A Meta-Epidemiological Study
TLDR
The PeDro and Cochrane approaches lead to different sets of trials of adequate quality, and different combined treatment estimates from meta-analyses of these trials.
Dry needling: a literature review with implications for clinical practice guidelines1
TLDR
The insertion of dry needles into asymptomatic body areas proximal and/or distal to the primary source of pain is supported by the myofascial pain syndrome literature, and physical therapists should not ignore the findings of the Western or biomedical ‘acupuncture’ literature.
CENTRAL, PEDro, PubMed, and EMBASE Are the Most Comprehensive Databases Indexing Randomized Controlled Trials of Physical Therapy Interventions
TLDR
The 4 most comprehensive databases of trial reports evaluating physical therapy interventions were CENTRAL, PEDro, PubMed, and EMBASE, which were found to be reasonably comprehensive.
Effect of standardized training on the reliability of the Cochrane risk of bias assessment tool: a prospective study
TLDR
Intensive, standardized training onrisk of bias assessment may significantly improve the reliability of the Cochrane risk of bias tool.
PEDro's bias: summary quality scores should not be used in meta-analysis.
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References

SHOWING 1-10 OF 27 REFERENCES
Acupuncture for Chronic Low Back Pain: A Randomized Placebo-Controlled Study With Long-Term Follow-Up
TLDR
A long-term pain-relieving effect of needle acupuncture compared with true placebo in some patients with chronic nociceptive low back pain is found.
Clinical trials of acupuncture: consensus recommendations for optimal treatment, sham controls and blinding.
TLDR
This consensus document considers issues with the aim of improving the design of efficacy trials of acupuncture in order that they are more likely to be conclusive and more meaningfully interpreted.
A randomized clinical trial of manual versus mechanical force manipulation in the treatment of sacroiliac joint syndrome.
TLDR
The results indicate that a short regimen of either mechanical-force, manually-assisted or high-velocity, low-amplitude chiropractic adjustments were associated with a beneficial effect of a reduction in pain and disability in patients diagnosed with sacroiliac joint syndrome.
Need for expertise based randomised controlled trials
TLDR
Evidence is presented to support the argument that increased use of the expertise based design will enhance the validity, applicability, feasibility, and ethical integrity of randomised controlled trials in surgery, as well as in other areas.
The immediate effect of activator vs. meric adjustment on acute low back pain: a randomized controlled trial.
TLDR
The results indicate that there is no significant difference between Meric and Activator adjustments in reducing acute LBP (F = .005, df = 2, 27, p = .941).
Comparison of Superficial and Deep Acupuncture in the Treatment of Lumbar Myofascial Pain: A Double-Blind Randomized Controlled Study
TLDR
Clinical results show that deep stimulation has a better analgesic effect when compared with superficial stimulation, with a better result in the deeply stimulated group.
Trigger Point Acupuncture Treatment of Chronic Low Back Pain in Elderly Patients – a Blinded Rct
TLDR
Evaluating the effects of two different modes of trigger point acupuncture on pain and quality of life in elderly patients suggests that deep needling to trigger points may be more effective in the treatment of low back pain in elderly Patients than either standard acupuncture therapy, or superficial needlingto trigger points.
The Short- and Long-Term Benefit in Chronic Low Back Pain Through Adjuvant Electrical Versus Manual Auricular Acupuncture
TLDR
These results are the first to demonstrate that continuous EA stimulation of auricular acupuncture points improves the treatment of chronic low back pain in an outpatient population.
Acupuncture and chronic pain mechanisms
TLDR
DSB was found to be complimentary to acupuncture therapy in that it facilitated patient selection for the therapy and resulted in maximum subjective improvement following acupuncture therapy performed at a later time.
Patterns and perceptions of care for treatment of back and neck pain: results of a national survey.
TLDR
Chiropractic, massage, relaxation techniques, and other complementary methods all play an important role in the care of patients with back or neck pain.
...
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