ABSTRACT
[Objective] In the past, we reported results focusing on the immediate effect of psychosocial factors that influence the effects of acupuncture on patients with chronic low back pain. In the present study, we conducted a retrospective analysis of the data before and after four weeks of acupuncture therapy.[Materials and Methods] Fifty-three patients with an initial diagnosis of chronic low back pain who visited the Acupuncture Department of the Center for Integrative Medicine, Tsukuba University of Technology between August and December 2019 and showed baseline lumbar pain intensity by Visual Analogue Scale (VAS) > 30 mm, were subjects of this study. Psychosocial scales viz, Pain Catastrophizing Scale (PCS), Hospital Anxiety and Depression Scale (HADS), Pain Self-Efficacy Questionnaire (PSEQ), social factors (cohabitation family situation, final education, social participation status), Roland-Morris Disability Questionnaire (RDQ), and impression of acupuncture were recorded using a self-administered questionnaire at the first visit and at four weeks after the first acupuncture therapy. Based on VAS, RDQ, and anchor questions about low back pain before and four weeks after the acupuncture therapy, patients were classified into "effective group" and "non-effective group"; then, the logistic regression analysis was performed using this classification as a dependent variable. In addition, r repeated measures analysis of variance (rANOVA) was performed on the data before and after four weeks of acupuncture therapy.[Results and Discussion] The number of patients in the "effective group" and "non-effective group" were 24 and 29, respectively. Among items used as covariates in the logistic regression analysis, the PCS (OR: 0.924, P = 0.037) and age (OR: 0.418, P = 0.005) showed statistical significance. In the rANOVA, all the evaluated items showed statistically significant differences before and after four weeks; only VAS in motion showed a statistically significant difference (P = 0.046) regarding the presence or absence of an immediate effect. Therefore, it was suggested that it is important to focus on psychosocial factors from an early stage of therapy, and to make appropriate evaluations and judgments based on both physical and psychosocial aspects of patients to treat them effectively.
ABSTRACT
Objective: Various psychosocial factors were exploratively investigated in order to specify items that influence on immediate effect of acupuncture among patients with chronic low back pain. Method: Fifty-six outpatients with initial diagnosis of chronic low back pain, visiting the Acupuncture Department of Center for Integrative Medicine, Tsukuba University of Technology between August to December 2019 were included in the study. The baseline lumbar pain intensity of the patients evaluated using the Visual Analogue Scale (VAS) was >30 mm. Psychological scales viz., Pain Catastrophizing Scale (PCS), Hospital Anxiety and Depression Scale (HADS), Pain Self-Efficacy Questionnaire (PSEQ), social factors (cohabitation family situation, final education, social participation status), lumbar dysfunction, and impression on acupuncture were recorded using a self-administered questionnaire during the first visit. Patients showing decreased VAS scale (≦30 mm) after the first acupuncture treatment as well as self-recognition of improvement in pain were classified as “high responders” while the others were treated as “low responders”. Physical and psychosocial factors were exploratively compared between high and low responders and logistic regression analysis of the two groups was performed using a dichotomous dependent variable. Results and Discussion: The number of high and low responders were 22 and 34, respectively. On comparing these groups exploratively, positive (P＝0.001) and negative (P＝0.004) impression on acupuncture were the only items that showed statistical significance. Among items used as covariates in the logistic regression analysis, the PCS (OR: 0.886 (95% CI: 0.808 to 0.971); P＝0.010), positive impression on acupuncture (OR: 5.085 (95% CI: 1.724 to 15.002); P＝0.003), and number of people living together (OR: 0.355 (95% CI: 0.149 to 0.844); P＝0.019) showed statistical significance. Hence, it may be suggested that psychosocial factors influence the immediate effect of acupuncture among patients with chronic low back pain.
ABSTRACT
Objective: Various psychosocial factors were exploratively investigated in order to specify items that influence on immediate effect of acupuncture among patients with chronic low back pain. Method: Fifty-six outpatients with initial diagnosis of chronic low back pain, visiting the Acupuncture Department of Center for Integrative Medicine, Tsukuba University of Technology between August to December 2019 were included in the study. The baseline lumbar pain intensity of the patients evaluated using the Visual Analogue Scale (VAS) was >30 mm. Psychological scales viz., Pain Catastrophizing Scale (PCS), Hospital Anxiety and Depression Scale (HADS), Pain Self-Efficacy Questionnaire (PSEQ), social factors (cohabitation family situation, final education, social participation status), lumbar dysfunction, and impression on acupuncture were recorded using a self-administered questionnaire during the first visit. Patients showing decreased VAS scale (≦30 mm) after the first acupuncture treatment as well as self-recognition of improvement in pain were classified as “high responders” while the others were treated as “low responders”. Physical and psychosocial factors were exploratively compared between high and low responders and logistic regression analysis of the two groups was performed using a dichotomous dependent variable. Results and Discussion: The number of high and low responders were 22 and 34, respectively. On comparing these groups exploratively, positive (P＝0.001) and negative (P＝0.004) impression on acupuncture were the only items that showed statistical significance. Among items used as covariates in the logistic regression analysis, the PCS (OR: 0.886 (95% CI: 0.808 to 0.971); P＝0.010), positive impression on acupuncture (OR: 5.085 (95% CI: 1.724 to 15.002); P＝0.003), and number of people living together (OR: 0.355 (95% CI: 0.149 to 0.844); P＝0.019) showed statistical significance. Hence, it may be suggested that psychosocial factors influence the immediate effect of acupuncture among patients with chronic low back pain.