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Lifestyle Advice and Self-Care Integral to Acupuncture Treatment for Patients with Chronic Neck Pain: Secondary Analysis of Outcomes Within a Randomized Controlled Trial
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 n...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Mary Ann Liebert, Inc., publishers
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6266543/ https://www.ncbi.nlm.nih.gov/pubmed/28253033 http://dx.doi.org/10.1089/acm.2016.0303 |
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author | MacPherson, Hugh Elliot, Ben Hopton, Ann Lansdown, Harriet Birch, Stephen Hewitt, Catherine |
author_facet | MacPherson, Hugh Elliot, Ben Hopton, Ann Lansdown, Harriet Birch, Stephen Hewitt, Catherine |
author_sort | MacPherson, Hugh |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-6266543 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Mary Ann Liebert, Inc., publishers |
record_format | MEDLINE/PubMed |
spelling | pubmed-62665432018-11-30 Lifestyle Advice and Self-Care Integral to Acupuncture Treatment for Patients with Chronic Neck Pain: Secondary Analysis of Outcomes Within a Randomized Controlled Trial MacPherson, Hugh Elliot, Ben Hopton, Ann Lansdown, Harriet Birch, Stephen Hewitt, Catherine J Altern Complement Med Original Articles 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. Mary Ann Liebert, Inc., publishers 2017-03-01 2018-03-27 /pmc/articles/PMC6266543/ /pubmed/28253033 http://dx.doi.org/10.1089/acm.2016.0303 Text en © Hugh MacPherson et al., 2018; Published by Mary Ann Liebert, Inc. This Open Access article is distributed under the terms of the Creative Commons License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Articles MacPherson, Hugh Elliot, Ben Hopton, Ann Lansdown, Harriet Birch, Stephen Hewitt, Catherine Lifestyle Advice and Self-Care Integral to Acupuncture Treatment for Patients with Chronic Neck Pain: Secondary Analysis of Outcomes Within a Randomized Controlled Trial |
title | Lifestyle Advice and Self-Care Integral to Acupuncture Treatment for Patients with Chronic Neck Pain: Secondary Analysis of Outcomes Within a Randomized Controlled Trial |
title_full | Lifestyle Advice and Self-Care Integral to Acupuncture Treatment for Patients with Chronic Neck Pain: Secondary Analysis of Outcomes Within a Randomized Controlled Trial |
title_fullStr | Lifestyle Advice and Self-Care Integral to Acupuncture Treatment for Patients with Chronic Neck Pain: Secondary Analysis of Outcomes Within a Randomized Controlled Trial |
title_full_unstemmed | Lifestyle Advice and Self-Care Integral to Acupuncture Treatment for Patients with Chronic Neck Pain: Secondary Analysis of Outcomes Within a Randomized Controlled Trial |
title_short | Lifestyle Advice and Self-Care Integral to Acupuncture Treatment for Patients with Chronic Neck Pain: Secondary Analysis of Outcomes Within a Randomized Controlled Trial |
title_sort | lifestyle advice and self-care integral to acupuncture treatment for patients with chronic neck pain: secondary analysis of outcomes within a randomized controlled trial |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6266543/ https://www.ncbi.nlm.nih.gov/pubmed/28253033 http://dx.doi.org/10.1089/acm.2016.0303 |
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