Author: MacPherson H1, Elliot B2, Hopton A1, Lansdown H1, Birch S3, Hewitt C1
Affiliation: <sup>1</sup>1 Department of Health Sciences, University of York , York, United Kingdom .
<sup>2</sup>2 Northern College of Acupuncture , York, United Kingdom .
<sup>3</sup>3 Department of Health Sciences, Kristiania University College , Oslo, Norway .
Conference/Journal: J Altern Complement Med.
Date published: 2017 Mar 2
Other:
Special Notes: doi: 10.1089/acm.2016.0303. [Epub ahead of print] , Word Count: 306
BACKGROUND: Lifestyle advice is widely considered as an integral component of acupuncture treatment. However, it is unclear whether lifestyle advice and related self-care are important for sustaining benefit over the longer term. In a novel secondary analysis of trial data, this paper explores the nature and impact of acupuncture-related diagnosis, and associated lifestyle advice and self-care, in patients with chronic neck pain.
DESIGN: In a three-arm, randomized, controlled multicenter trial with 12 months of follow-up, a total of 517 patients with chronic neck pain were randomized in equal proportions to acupuncture, Alexander technique, or usual care alone.
METHODS: For each acupuncture patient, practitioners reported treatment components that included an acupuncture-related diagnosis and provision of associated lifestyle advice. Patients reported at baseline, 3, 6, and 12 months on variables related to treatment, which included aspects of self-care, self-efficacy, and lifestyle advice acted upon, as well as pain and disability scores. Congruence between practitioner advice and patient take-up was assessed using chi-squared test. Impact of lifestyle advice and self-efficacy on outcome was evaluated using regression models.
RESULTS: Among patients randomized to acupuncture, the most common diagnostic framework involved the Zang-Fu syndromes for 139/160 (87%) patients. Lifestyle advice was provided by practitioners to 134/160 (84%) of patients, most commonly related to exercise, relaxation, diet, rest, and work. Significant congruence with patient take-up was found for diet, rest, and work. Moreover, patients in the acupuncture group improved their ability to use what they had learnt and increased their self-efficacy. In turn, these characteristics were associated with significant reductions in pain and disability scores at 12 months.
CONCLUSION: Acupuncture-related lifestyle advice helped patients improve the way they live and care for themselves and enhanced self-efficacy and ability to use what they had learnt. These changes were associated with reductions in pain and disability at 12 months.
KEYWORDS: acupuncture therapy; chronic neck pain; lifestyle advice; self-care; traditional East Asian medicine
PMID: 28253033 DOI: 10.1089/acm.2016.0303