Différences
Ci-dessous, les différences entre deux révisions de la page.
| Les deux révisions précédentes Révision précédente Prochaine révision | Révision précédente | ||
|
acupuncture:evaluation:rhumatologie - orthopedie:03. douleurs musculo-squelettiques [07 Apr 2025 16:39] Nguyen Johan |
acupuncture:evaluation:rhumatologie - orthopedie:03. douleurs musculo-squelettiques [24 Oct 2025 11:38] (Version actuelle) Nguyen Johan [1.2.1.1. Yu 2023] |
||
|---|---|---|---|
| Ligne 113: | Ligne 113: | ||
| ^Conclusions| Compared with SA, TA was effective in treating MPS. The effects produced by different SA procedures were different, and the order of effects from greatest to least was as follows: SANA, NPA, and NPANA.| | ^Conclusions| Compared with SA, TA was effective in treating MPS. The effects produced by different SA procedures were different, and the order of effects from greatest to least was as follows: SANA, NPA, and NPANA.| | ||
| + | === Comparison of Acupuncture techniques === | ||
| + | == Liu 2025 == | ||
| + | Liu Z, Cheng Z, Zhang K, Lin X, Fu Y, Wang L, Zhang Q, Zhang F, Wu X, Dong B. Comparison of the efficacy of acupoint stimulation therapy in the treatment of pain in musculoskeletal diseases: A network meta-analysis based on randomized controlled trials. J Back Musculoskelet Rehabil. 2025 Jul 15:10538127251358729. https://doi.org/10.1177/10538127251358729 | ||
| + | ^Background|Orthopedic patients often present with significant pain symptoms, which can impact both the physical and mental well-being of patients, emerging as a significant concern. Given its safety, effectiveness, and absence of side effects, acupoint therapy is being increasingly utilized in the pain management of orthopedic patients. This study conducted a network meta-analysis to compare analgesic efficacy, safety, and effectiveness of acupuncture (AP), electroacupuncture (EA), moxibustion, and acupressure, so as to provide a reference for the clinical application of acupoint therapies in managing orthopedic pain.| | ||
| + | ^Methods|Eight databases, including PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang Data, and VIP, were searched for clinical randomized controlled trials (RCTs) investigating the effects of AP, EA, moxibustion, and acupressure on orthopedic pain. The quality of the included documents was evaluated using the Cochrane Risk of Bias Tool, and graphs regarding the risk of bias and network meta-analysis were drawn by Revman 5.2, Stata 18.0 and R software (v4.3.2). Intervention ranking probabilities were quantified using SUCRA values derived from a Bayesian random-effects model.| | ||
| + | ^Results|1) For decreasing Visual Analogue Scale (VAS) scores in patients with orthopedic pain, moxibustion therapy was identified as the optimal intervention (SUCRA=94.84%); 2) For decreasing VAS scores in patients with orthopedic pain undergoing surgical intervention, AP therapy was identified as the optimal intervention (SUCRA=76.99%); 3) For decreasing VAS scores in patients with orthopedic pain not undergoing surgical intervention, moxibustion therapy was identified as the optimal intervention (SUCRA=90.26%); 4) AP therapy (SUCRA=83.73%) demonstrated the most favorable safety profile; 5) Acupressure therapy (SUCRA=77.93%) was identified as the most effective therapeutic method.| | ||
| + | ^Conclusion|It is recommended to select differentiated acupoint therapies tailored to the type of orthopedic pain. Specifically, post-operative patients with orthopedic pain should prioritize AP, while moxibustion is advised for non-surgical patients.| | ||
| === Acupotomy === | === Acupotomy === | ||
| Ligne 447: | Ligne 454: | ||
| | The evidence for the effectiveness of acupuncture is most convincing for the treatment of chronic neck and shoulder pain. In terms of other injuries, the evidence is either inconclusive or insufficient. The state of the evidence on the effectiveness of acupuncture is not dissimilar to other physical therapies such as physiotherapy, chiropractic and osteopathy. \\ // General // \\ - There is insufficient evidence to make a recommendation for the use of acupuncture in the management of acute neck, back or shoulder pain \\ - There is emerging evidence that acupuncture may enhance/facilitate other conventional therapies (including physiotherapy & exercise-based therapies) \\ - There is a paucity of research for the optimal dosage of acupuncture treatment for treating shoulder, knee, neck and lower back pain \\ - Studies comparing effective conservative treatments (including simple analgesics, physical therapy, exercise, heat & cold therapy) for (sub) acute and chronic non-specific low back pain (LBP) have been largely inconclusive. \\ //Lower back// \\ - The evidence for the use of acupuncture in (sub)acute LBP is inconclusive \\ - There is limited evidence to support the use of acupuncture for pain relief in chronic LBP in the short term (up to 3 months) \\ - The evidence is inconclusive for the use of acupuncture for long term (beyond 3 months) pain relief in chronic LBP \\ - There is no evidence to recommend the use of acupuncture for lumbar disc herniation related radiculopathy (LDHR) \\ //Neck// \\ - There is good evidence that acupuncture is effective for short term pain relief in the treatment of chronic neck pain \\ - There is moderate evidence that real acupuncture is more effective than sham acupuncture for the treatment of chronic neck pain \\ - There is limited evidence that acupuncture has a long term effect on chronic neck pain \\ Shoulder \\ - There is good evidence from one pragmatic trial that acupuncture improves pain and mobility in chronic shoulder pain \\ - There is limited evidence for the efficacy of acupuncture for frozen shoulder \\ - There is contradictory evidence for the efficacy of acupuncture for subacromial impingement syndrome \\ //Knee// \\ - There is no evidence to recommend the use of acupuncture for injury-related knee pain. \\ //Ankle:// \\ - There is no evidence to recommend the use of acupuncture for ankle pain | | | The evidence for the effectiveness of acupuncture is most convincing for the treatment of chronic neck and shoulder pain. In terms of other injuries, the evidence is either inconclusive or insufficient. The state of the evidence on the effectiveness of acupuncture is not dissimilar to other physical therapies such as physiotherapy, chiropractic and osteopathy. \\ // General // \\ - There is insufficient evidence to make a recommendation for the use of acupuncture in the management of acute neck, back or shoulder pain \\ - There is emerging evidence that acupuncture may enhance/facilitate other conventional therapies (including physiotherapy & exercise-based therapies) \\ - There is a paucity of research for the optimal dosage of acupuncture treatment for treating shoulder, knee, neck and lower back pain \\ - Studies comparing effective conservative treatments (including simple analgesics, physical therapy, exercise, heat & cold therapy) for (sub) acute and chronic non-specific low back pain (LBP) have been largely inconclusive. \\ //Lower back// \\ - The evidence for the use of acupuncture in (sub)acute LBP is inconclusive \\ - There is limited evidence to support the use of acupuncture for pain relief in chronic LBP in the short term (up to 3 months) \\ - The evidence is inconclusive for the use of acupuncture for long term (beyond 3 months) pain relief in chronic LBP \\ - There is no evidence to recommend the use of acupuncture for lumbar disc herniation related radiculopathy (LDHR) \\ //Neck// \\ - There is good evidence that acupuncture is effective for short term pain relief in the treatment of chronic neck pain \\ - There is moderate evidence that real acupuncture is more effective than sham acupuncture for the treatment of chronic neck pain \\ - There is limited evidence that acupuncture has a long term effect on chronic neck pain \\ Shoulder \\ - There is good evidence from one pragmatic trial that acupuncture improves pain and mobility in chronic shoulder pain \\ - There is limited evidence for the efficacy of acupuncture for frozen shoulder \\ - There is contradictory evidence for the efficacy of acupuncture for subacromial impingement syndrome \\ //Knee// \\ - There is no evidence to recommend the use of acupuncture for injury-related knee pain. \\ //Ankle:// \\ - There is no evidence to recommend the use of acupuncture for ankle pain | | ||
| + | ===== Overviews of Clinical Practice Guidelines ===== | ||
| + | ==== Ho 2025 ==== | ||
| + | |||
| + | Ho L, Lai CNT, Chen H, Law SW, Yu ECL, Lam FPY, Cheung YC, Wu IX, Wong SYS, Sit RWS. Systematic review of clinical practice guidelines on acupuncture for chronic musculoskeletal pain. BMC Complement Med Ther. 2025 Sep 1;25(1):322. https://doi.org/10.1186/s12906-025-05070-y | ||
| + | |||
| + | ^Background|Acupuncture is increasingly utilised in primary care to manage chronic musculoskeletal pain, supported by a growing body of evidence. This rising adoption has driven demand for clinical practice guidelines (CPGs). We summarised the characteristics of recent acupuncture CPGs for osteoarthritis, low back pain, neck pain, and shoulder pain, and critically appraised their methodological quality.| | ||
| + | ^Methods|We searched nine databases to identify acupuncture CPGs published from January 2014 to November 2024. Eligible CPGs were required to be developed by guideline committees and to include evidence-informed recommendations linked to clearly defined levels of evidence. Two independent reviewers extracted CPG characteristics and assessed methodological quality using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument.| | ||
| + | ^Results|Of the 1,999 records screened, **17 CPGs were included, encompassing 35 recommendations**. Shoulder pain was the most addressed condition (n = 14), followed by low back pain (n = 11), osteoarthritis (n = 8), and neck pain (n = 2). Various types of acupuncture were considered, with manual acupuncture featuring in most (n = 26) recommendations. Overall, 60% of the recommendations supported the use of acupuncture, comprising 5.7% strong recommendations and 54.3% weak or conditional recommendations. In contrast, 22.9% of recommendations offered no explicit guidance, while 17.1% advised against its use. Methodological assessment classified 10 CPGs as high quality, while seven were of moderate quality.| | ||
| + | ^Conclusion|Contradictions exist among the included CPGs regarding whether acupuncture should be recommended for routine practice, potentially reflecting differences in clinical and cultural contexts. Local CPGs should be developed using rigorous methodology, ensuring the involvement of local stakeholders. An AGREE II extension should be developed for the methodological quality assessment of acupuncture CPGs.| | ||
