CLINICAL RESEARCH POSTER PRESENTATION ABSTRACTS
Please note: All posters will be displayed in
Salons 10-12.
THURSDAY, 10:15-11:00 AM
Levine RA, Mandel SS, Nunez R, Pocock JR, Ball RM,
Seidman MD, Rodriguez AI.
Randomized controlled clinical trial testing complementary
and alternative medicine therapies to alleviate chronic low back pain.
Henry Ford Health System bob-levine@earthlink.net
Chronic low back pain (LBP), one of the most
difficult and costly conditions to treat, affects over 100 million Americans,
and many experience little or no relief from conventional medicine.
While Americans are increasingly using CAM therapies, integrative medicine
that incorporates CAM modalities remains largely outside of mainstream
healthcare because of lack of insurance coverage, and proof of efficacy
and cost savings. Thus, there is a need for controlled clinical trials
testing innovative approaches to minimize or eliminate pain and disability
in a cost-effective manner. This ongoing randomized, controlled trial
is testing the hypothesis that integrative care approaches involving
CAM therapies are more effective than conventional care at reducing
pain and disability.
The trial compares in 180 patients (60 in each
of 3 groups) the following interventions (delivered over 3 mo) combined
with physician supervision and medications as needed: 1) Conventional
care involving physical therapy and other care as determined by physician;
2) Comprehensive Integrative Care involving 5 CAM modalities (acupuncture,
chiropractic, Feldenkrais movement reeducation, St. John Neuromuscular
therapy, and hypnosis) delivered to each patient by five different practitioners;
and 3) Streamlined Integrative Care involving a non-invasive, less costly
treatment incorporating ryodoraku (non-needling stimulation of acupuncture
points), somatic functional therapy (a type of movement reeducation),
and hypnosis, delivered to each patient by a single practitioner. Measured
health outcomes include general health (SF-12), back-specific health
(Revised Oswestry Low Back Pain Disability Questionnaire), pain (numeric
rating scale), depression (Beck Depression Inventory-II) and functional
movement (Functional Movement Index). Patients are evaluated prior,
during, and immediately following treatment. Follow-up evaluations are
conducted at 3, 6 and 12 months following treatment.
Preliminary results indicate that these integrative
approaches significantly reduce pain scores and disability, and increase
functional movement, all of which are sustained at 3 months after the
end of treatment. In certain cases, patients' chronic pain was completely
eliminated. In this clinical trial, we are continuing to collect data
on health outcomes and costs, as well as long-term follow-up to ascertain
the extent to which health benefits are sustained and whether costs
are lowered in the long-term by these treatments
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