Qigong versus exercise therapy for chronic low back pain in adults – a randomized controlled non-inferiority trial

Author: Blödt S1, Pach D, Kaster T, Lüdke R, Reishauer A, Witt CM.
Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Germany

BACKGROUND:
The value of qigong in the treatment of chronic low back pain is unclear. In a randomized controlled trial, we evaluated whether qigong is non-inferior to exercise therapy in patients with chronic low back pain.

METHODS:
Patients (aged 20–60 years) with chronic neck pain (visual analog scale, VAS ≥40 mm) were randomized to 1) qigong or 2) exercise therapy (18 sessions over 6 months) or 3) waiting list (no treatment). At baseline and after 3 and 6 months, patients completed standardized questionnaires assessing neck pain (VAS), neck pain and disability, and quality of life (Short Form SF-36 questionnaire, SF-36). The primary endpoint was average pain in the last 7 days on VAS at 6-month follow-up. Statistical analysis included generalized estimation equation models adjusted for baseline values and patient expectation.

RESULTS:
A total of 123 patients (aged 46 ± 11 years, 88% women) suffering from chronic neck pain for 3.2 (SD ± 1.6) years were included. After 6 months, a significant difference was seen between the qigong and waiting list control groups (VAS mean difference: −14 mm [95% CI = −23.1 to −5.4], P = 0.002). Mean improvements in the exercise group were comparable to those in the qigong group (difference between groups −0.7 mm [CI = −9.1 to 7.7]) but failed to show statistical significance (P = 0.092). Neck pain and disability, and SF-36 results also yielded superiority of qigong over no treatment and similar results in the qigong and exercise therapy groups.

CONCLUSIONS:
Qigong was not proven to be non-inferior to exercise therapy in the treatment of chronic low back pain. Its role in the prevention of chronic low back pain might be addressed in further studies.

Source: Qigong Institute

PASCOE–Study

Index:

Preference: Nature Medicine or chemical medication
Advantages of Nature Medicine in comparison to Chemical Medication
Frequency of use of Nature Medicine
Overview: Evaluation of Nature Medicine on the basis of statements (Ø)
Preference between doctors with and without additional identification, „Nature Healing procedures“
Ilnesses or complaints where Nature Medicine was preferred
Influence of the Health Care Reform on the frequency of use of Nature Medicine
Experiences with Nature Medicine

Handout

RCT-Study

Complementary and alternative medicine whole systems research:
Beyond identification of inadequacies of the RCT

Marja J. Verhoef a, George Lewithb, Cheryl Ritenbaughc, Heather Boond, Susan Fleishmane, Anne Leis f
a Department of Community Health Sciences, University of Calgary, Faculty of Medicine, Canada
b Complementary Medicine Research Unit, Primary Medical Care, Aldermoor Health Centre,Southampton, UK
c Department of Family and Community Medicine, University of Arizona, AZ, USA
d Faculty of Pharmacy, University of Toronto, Ont., Canada
e Integrative Medicine Resource Group, Tucson, AZ, USA
f Department of Community Health and Epidemiology, University of Saskatchewan, Sask., Canada

Summary:

Complementary and alternative medicine (CAM) often consists of whole systems of care (such as naturopathic medicine or traditional Chinese medicine (TCM)) that combine a wide range of modalities to provide individualised treatment. The complexity of these interventions and their potential synergistic effect requires innovative evaluative approaches.
Model validity, which encompasses the need for research to adequately address the unique healing theory and therapeutic context of the intervention, is central to whole systems research (WSR). Classical randomised controlled trials (RCTs) are limited in their ability to address this need.
Therefore, we propose a mixed methods approach that includes a range of relevant and holistic outcome measures. As the individual components of most whole systems are inseparable, complementary and synergistic, WSR must not focus only on the ‘‘active’’ ingredients of a system. An emerging WSR framework must be non-hierarchical, cyclical, flexible and adaptive, as knowledge creation is continuous, evolutionary and necessitates a continuous interplay between research methods and ‘‘phases’’ of knowledge.
Finally, WSR must hold qualitative and quantitative research methods in equal esteem to realize their unique research contribution. Whole systems are complex and therefore no one method can adequately capture the meaning, process and outcomes of these interventions.
© 2005 Elsevier Ltd. All rights reserved.

Study

Regulation Complementary Medical Practitioners

Authors: Anna Dixon © KING’S FUND 2008

In this report the experience of 16 countries in regards to this issue are reviewed:
Australia, Canada, China, Germany, Ghana, Hong Kong SAR, India, Japan, the Netherlands, Norway, the Republic of Korea, Singapore, Socialist Republic of Vietnam, South Africa, United Kingdom of Great Britain and Northern Ireland (UK), United States of America (USA).
Throughout, three domains of regulation are analysed: practice; education and training; licensing and registration of practitioners of traditional/complementary medicine.

Research summary

Acculturation and the use of complementary and alternative medicine

Autors: Dejun Su, Lifeng Li, Jose´ A. Paga´n
The University of Texas-Pan American, Edinburg, TX, USA

The use of complementary and alternative medicine (CAM) has been growing substantially in the US in recent years. Such a growth in CAM use coincides with an ongoing increase in the proportion of the foreign-born population in the US. The main objective of this study is to examine the relation between acculturation and the use of CAM therapies among immigrants. Data from a CAM supplement to the 2002 National Health Interview Survey were analyzed to estimate the effects of acculturation on the likelihood of using different CAM therapies over the past 12 months prior to the survey. The results suggest that the level of acculturation—as measured by nativity/length of stay in the US and language of interview—is strongly associated with CAM use.
As immigrants stay longer in the US or as their use of English becomes more proficient, the likelihood that they use CAM therapies increases as well, and it gradually approaches the level of CAM use by native-born Americans. Moreover, this relation between acculturation and CAM use generally persists even after the effects of socioeconomic status, health insurance coverage, self-reported health status, and other demographic variables have all been taken into consideration. The substantially lower rates of CAM use by recent immigrants and its possible causes warrant further research.
©2007 Elsevier Ltd. All rights reserved.

USA - Use of CAM