Auricular acupuncture for chronic back pain in adults a

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Auricular acupuncture for chronic back pain in adults a systematic review and metanalysis. INTRODUCTION sciences was carried out using the following databases. Medline via PUBMED Web of Science the Cumulative, Chronic back pain which may affect cervical thoracic. Index to Nursing and Allied Health Literature CINAHL. and or lumbar regions presents a considerable individual. Physiotherapy Evidence Database PEDro Embase Scopus. and social impact on public health 1 Between the 1990s. and databases indexed in the Virtual Health Library VHL. and 2013 lower back pain ranked first and cervical fourth. such as the Latin American and Caribbean Center on Health. among the 25 overall causes of years living with a disability. Sciences Information LILACS the Brazilian Nursing,according to the Global Burden of Disease Study 2. Database BDENF and the National Center of Information. In the last 10 years lower back pain increased 18, of Medical Sciences of Cuba CUMED Reference lists of. being considered one of the most common musculoskel. systematic reviews were also used for searching relevant stud. etal disorders in current society 3 Regarding cervical pain. ies related to the guiding question All searches in the elec. yearly prevalence is higher than 30 4 As for the thoracic. tronic databases were carried out in May 2018, region however epidemiological characteristics have not. Controlled descriptors extracted from the Health Sciences. been well documented yet this prevalence varies from 4 8. Descriptors DeCS and from the Medical Subject Headings. to 7 approximately 5, MeSH and uncontrolled descriptors were combined using.
The most current international guidelines recommend. Boolean operators OR and AND as follows Back Pain, drug management for relieving back pain However most. OR Low Back Pain OR Sciatica OR Chronic Pain OR, drugs produce limited relief and several serious side effects. Musculoskeletal Pain OR Myalgia OR Neck Pain OR, In this regard a movement towards non pharmacological. Lumbago OR lumbar pain OR Low Back Pains OR, approaches becomes necessary including multidisciplinary. Musculoskeletal Pains OR Muscle Pain OR Neck Pains. rehabilitation based on physical therapy massage therapy. OR Cervical Pain OR Cervical Pains AND Auricular, cognitive behavior therapy acupuncture among others 3.
Acupuncture OR Ear Acupuncture OR Auricular, Auricular acupuncture AA is an adjuvant therapy to Acupunctures OR auriculopressure The search strategy was. the regular acupuncture treatment It has been used as a adapted for each electronic database and the terminologies. therapeutic approach in China since the Han dynasty and were searched in all fields title abstract descriptors text. a modern version of the technique was developed at the end The eligibility criteria for selection of articles based on. of the 1950s 6 which consists of a method for diagnosis and the PICO strategy were RCT with adults 18 years or over. treatment of physical and psychosomatic disorders by stimu population use of auricular acupuncture puncture pressure. lating specific areas of the ear 7 The effects of the intervention electrical stimulation magnetic stimulation among others. have been explained by neurophysiology and reflexology 7 The intervention comparison with one or more of the following. technique has already been tested for the control of chronic groups sham waiting list standard medical treatment active. pain 6 however due to heterogeneity and methodological treatment or no treatment comparison and chronic pain 3. failures in randomized clinical trials RCT the evidence on months or more 12 in at least one of the spine segments cer. AA for its management is incipient 6 In addition despite vical thoracic and or lumbar outcomes The studies excluded. having a synthesis of the evidence in the literature on the were those that did not provide the full abstract online those. effects of acupuncture in specific segments of the spine mainly that were not located by any means and studies with pregnant. in the lumbar region 8 9 up to the present moment systematic women It should be noted that there were no restrictions on. analyses designed specifically for investigating AA effects for the year of publication and the language of the analyzed studies. chronic pain in all segments of the spine cervical thoracic The data of the studies included in the review were extracted. and or lumbar have not been identified by two independent researchers using a standardized data. Therefore the objective of this study was to investigate collection form 13 and adapted by the study researchers The. and analyze RCT found in the literature on the action of following data were extracted article identification title. AA for chronic back pain in adults and to identify the most author s area of study journal year of publication country. commonly used outcomes for assessing this condition the study language objectives methodological characteristics. protocol used for applying the intervention and the effect design sample size loss to follow up inclusion and exclusion. of the therapy on pain intensity in these studies criteria clinical data number of patients by gender age diag. nosis duration of symptoms description of interventions in the. METHOD follow up groups treatment line number of sessions treatment. A systematic literature review and a metanalysis were duration application device time the device was kept on appli. developed according to the Preferred Reporting Items cation points unilateral or bilateral application location of the. for Systematic Reviews and Meta Analyses PRISMA points type of protocol professional who performed the inter. Statement criteria 10 vention years of experience in the field outcomes and assess. The PICO P population I intervention C com ment methods number of evaluations intervals among them. parison O outcomes 11 strategy was used to formulate measuring tools data analysis main results and conclusions. the guiding question What are the effects of auricular acu A third researcher cross checked the information collected to. puncture for chronic pain in adults reach a final consensus on the extracted data. The search for articles conducted by two independent The methodological quality of the eligible studies was. reviewers with the help of a librarian in the field of health assessed using the Jadad scale 14 which focuses on internal. 2 Rev Esc Enferm USP 2019 53 e03461 www ee usp br reeusp. Moura CC Chaves ECL Cardoso ACLR Nogueira DA Azevedo C Chianca TCM. validity The questions have yes or no answer options with a tests Because the heterogeneity results in the test were sta. total score of five points three questions are given one point tistically significant p 0 05 and the calculated value of. each for affirmative answers and two additional points are I2 suggested high heterogeneity 86 8 16 the model of. given to appropriate methods of randomization and alloca random effects was adopted for the analysis. tion confidentiality 10 Two independent reviewers carried. out the evaluation and a third researcher was consulted to RESULTS. solve possible differences A total of 427 studies were found in the electronic and. Data analyses were carried out using the Stata SE 12 0 manual searches Because they were duplicated 161 studies. statistical software The absolute difference among the were removed from the list After reviewing their titles and. means with a 95 confidence interval was selected to abstracts 225 articles were excluded whereas 41 remained for. describe the mean differences among the treated groups full text analysis Out of these the texts of four studies were. and the assessment control carried out at the end of the not located online through bibliographic commutation or. treatment A p 005 value was considered statistically sig direct contact with the authors and 22 articles were excluded. nificant The potential heterogeneity among the studies was Thus 15 articles were included in the synthesis of the qualita. checked using the Cochran s Q 15 and the I2 16 statistical tive analysis and seven in the quantitative analysis Figure 1. Studies indentified,through database search,Web of Science 74. Indentification,MEDLINE via PubMed 43,Additional articles indentified. through other sources Lists of,LILACS via BVS 07,systematic reviews metanalyses. BDENF via BVS 01,CUMED via BVS 01,Duplicated articles removed.
Selected articles Excluded articles,n 266 n 225,Full text articles. Eligibility,Full text articles assessed excluded n 26. for eligibility,They were not RCT 13,They did not report acute or. chronic pain temporality 2,Auricular diagnosis 2,They involve other body parts. besides the back 5,Studies included in the They were not accessed 4.
qualitative analysis n 15,MEDLINE via PubMed 02,LILACS via BVS 01. List of systematic review,or metanalvis 01,Studies included in the quantitative. analysis metanalysis n 07,MEDLINE via PubMed 01,Lists of systematic. review metanalvis 01, Figure 1 Flowchart of article selection for the systematic review Belo Horizonte MG Brasil 2018. www ee usp br reeusp Rev Esc Enferm USP 2019 53 e03461 3. Auricular acupuncture for chronic back pain in adults a systematic review and metanalysis. A total of 930 individuals participated in the selected most affected region n 10 17 26 followed by the cervical. studies with age varying from 18 to 90 years of age whereas region n 3 27 29 and the dorsal region as a whole n 2 30 31. 462 were in the groups that received auricular acupuncture Chart 1 shows the characterization of the studies regard. and 468 were in the control groups All participants presented ing the interventions applied in the experimental and control. chronic pain conditions 8 whereas the lumbar spine was the groups and their main findings. Chart 1 Characterization of the studies regarding the applied intervention Belo Horizonte MG Brazil 2018. Intervention in the Intervention in the,Authors Year Country Main findings.
experimental group control group,Auricular acupuncture was effective. Ushinohama et al Auricular acupuncture Ultrasound turned off in reducing temporarily the intensity of. 2016 17 n 40 n 40 the pain but not sufficiently to improve. body balance,Among the participants in the intervention. group real AAP a 30 reduction,in the worst pain was showed after the. Auricular acupressure on, Auricular acupressure first day of treatment and the steady. points not related to the, Yeh et al 2015 18 United States AAP reduction of the pain 44 was reported.
focus of the treatment,n 30 after concluding four weeks The use of. painkillers by the intervention,group participants was also reduced. compared to the sham group,Auricular acupuncture and Zen Shiatsu are. effective in reducing the levels of chronic,Auricular acupuncture Zen Shiatsu. Eberhardt et al 2015 30 Brazil lower back pain in nursing professionals This. effect lasted for 7 days One treatment is not,better than the other.
The intervention effect on pain symptoms in, Auricular acupuncture in patients with non specific cervical pain was. Auricular acupuncture points not related to the inconclusive since the observed reductions. Silva et al 2015 27 Brazil, n 12 focus of the treatment through protocols of simulated and real. n 12 auricular acupuncture treatment were,practically the same. The reduction of the worst pain from,the baseline up to the end of the intervention. was 41 for the intervention group,Auricular acupressure in.
real AAP and 5 for the sham group,Auricular acupressure points not related to the. Yeh et al 2014 19 United States The disability scores in the Roland Morris. n 19 focus of the treatment,Disability Questionnaire showed a. reduction of 29 in the real group,and remained unchanged in the. simulated group,Auriculopressure reduced the pain in. Patches with an inactive, Auricular acupressure the short and medium term and improved.
Vas et al 2014 31 Spain black plastic disc, n 130 quality of life of the patients with unspecific. chronic rachialgia,Auricular acupuncture, Auricular acupuncture with electric stimulus The effects on the pain and on lumbar. Marignan 2014 20, France with electric stimulus on points that do not flexibility were significant especially for the. n 6 correspond to the affected group that received real treatment. The participants of the real group,showed a 70 reduction in the worst. Auricular acupressure on pain intensity a 75 reduction in the. Auricular acupressure points not related to the overall pain intensity and a 42. Yeh et al 2013 21,United States, n 11 focus of the treatment improvement in disability due to.
n 10 back pain These findings were,statistically higher than those found in the. simulated group,Auricular acupuncture,There is an increase in clinical outcome. Northern associated to an exercise Exercise program. Hunter et al 2012 22 benefits when auricular acupuncture is. Ireland program n 28,associated with an exercise program. The combination of auricular points and the, Auricular acupressure external application of medicated patch led. with medicated patch Medicated patch to a better result After a 3 day treatment. associated with the application on the the combined therapy showed a statistically. cognitive behavior therapy acupuncture among others 3 Auricular acupuncture AA is an adjuvant therapy to the regular acupuncture treatment It has been used as a therapeutic approach in China since the Han dynasty and a modern version of the technique was developed at the end of the 1950s 6 which consists of a method for diagnosis and

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