The Experts below are selected from a list of 675 Experts worldwide ranked by ideXlab platform
Wonsuk Chung - One of the best experts on this subject based on the ideXlab platform.
-
acupuncture for chronic low back pain a multicenter randomized patient assessor blind sham controlled clinical trial
Spine, 2013Co-Authors: Yujeong Cho, Yunkyung Song, Yunyeop Cha, Byungcheul Shin, Imhee Shin, Hijoon Park, Hyangsook Lee, Kohwoon Kim, Jaeheung Cho, Wonsuk ChungAbstract:STUDY DESIGN Multicenter, randomized, patient-assessor blind, sham-controlled clinical trial. OBJECTIVE To investigate the efficacy of acupuncture treatment with individualized setting for reduction of Bothersomeness in participants with chronic low back pain (cLBP). SUMMARY OF BACKGROUND DATA Low back pain is one of the main reasons of disability among adults of working age. Acupuncture is known as an effective treatment of cLBP, but it remains unclear whether acupuncture is superior to placebo. METHODS One hundred thirty adults aged 18 to 65 years with nonspecific LBP lasting for at least last 3 months prior to the trial participated in the study from 3 Korean medical hospitals. Participants received individualized real acupuncture treatments or sham acupuncture treatments for more than 6 weeks (twice a week) from Korean Medicine doctors. Primary outcome was change of visual analogue scale (VAS) score for Bothersomeness of cLBP. Secondary outcomes included VAS score for pain intensity and questionnaires including Oswestry Disability Index, general health status (Short Form-36), and Beck Depression Inventory (BDI). RESULTS There were no baseline differences observed between the 2 groups, except in the Oswestry Disability Index. One hundred sixteen participants finished the treatments and 3- and 6-month follow-ups, with 14 subjects dropping out. Significant difference in VAS score for Bothersomeness and pain intensity score of cLBP has been found between the 2 groups (P < 0.05) at the primary end point (8 wk). In addition, those 2 scores improved continuously until 3-month follow-up (P = 0.011, P = 0.005, respectively). Oswestry Disability Index, the Beck Depression Inventory, and Short Form-36 scores were also improved in both groups without group difference. CONCLUSION This randomized sham-controlled trial suggests that acupuncture treatment shows better effect on the reduction of the Bothersomeness and pain intensity than sham control in participants with cLBP.
James Neil Weinstein - One of the best experts on this subject based on the ideXlab platform.
-
recurrence of pain after usual nonoperative care for symptomatic lumbar disk herniation analysis of data from the spine patient outcomes research trial
Pm&r, 2016Co-Authors: Pradeep Suri, Jon D Lurie, Wenyan Zhao, Adam M Pearson, Emily A Scherer, Tamara S Morgan, James Neil WeinsteinAbstract:Abstract Objective To determine risks and predictors of recurrent leg and low back pain (LBP) after unstructured, usual nonoperative care for subacute/chronic symptomatic lumbar disk herniation (LDH). Design Secondary analysis of data from a concurrent randomized trial and observational cohort study. Setting Thirteen outpatient spine practices. Participants A total of 199 participants with resolution of leg pain and 142 participants with resolution of LBP from among 478 participants receiving usual nonoperative care for symptomatic LDH. Assessment of Risk Factors Potential predictors of recurrence included time to initial symptom resolution, sociodemographics, clinical characteristics, work-related factors, imaging-detected herniation characteristics, and baseline pain Bothersomeness. Main Outcome Measurements Leg pain and LBP Bothersomeness were assessed by the use of a 0-6 numerical scale at up to 4 years of follow-up. For individuals with initial resolution of leg pain, we defined recurrent leg pain as having leg pain, receiving lumbar epidural steroid injections, or undergoing lumbar surgery subsequent to initial leg pain resolution. We calculated cumulative risks of recurrence by using Kaplan-Meier survival plots and examined predictors of recurrence using Cox proportional hazards models. We used similar definitions for LBP recurrence. Results One- and 3-year cumulative recurrence risks were 23% and 51% for leg pain, and 28% and 70% for LBP, respectively. Early leg pain resolution did not predict future leg pain recurrence. Complete leg pain resolution (adjusted hazard ratio [aHR] 0.47, 95% confidence interval [CI] 0.31-0.72) and posterolateral herniation location (aHR 0.61; 95% CI 0.39-0.97) predicted a lower risk of leg pain recurrence, and joint problems (aHR 1.89; 95% CI 1.16-3.05) and smoking (aHR 1.81; 95% CI 1.07-3.05) predicted a greater risk of leg pain recurrence. For participants with complete initial resolution of pain, recurrence risks at 1 and 3 years were 16% and 41% for leg pain and 24% and 59% for LBP, respectively. Conclusions Recurrence of pain is common after unstructured, usual nonsurgical care for LDH. These risk estimates depend on the specific definitions applied, and the predictors identified require replication in future studies.
-
single versus multilevel fusion for single level degenerative spondylolisthesis and multilevel lumbar stenosis four year results of the spine patient outcomes research trial
Spine, 2013Co-Authors: Yossi Smorgick, Jon D Lurie, Wenyan Zhao, Daniel K Park, Kevin C Baker, Tor D Tosteson, Harry N Herkowitz, Jeffrey S Fischgrund, James Neil WeinsteinAbstract:Study design A subanalysis study. Objective To compare surgical outcomes and complications of multilevel decompression and single-level fusion with multilevel decompression and multilevel fusion for patients with multilevel lumbar stenosis and single-level degenerative spondylolisthesis (DS). Summary of background data In patients with DS who are treated surgically, decompression and fusion provide a better clinical outcome than decompression alone. Surgical treatment for multilevel lumbar stenosis and DS typically includes decompression and fusion of the spondylolisthesis segment and decompression with or without fusion for the other stenotic segments. To date, no study has compared the results of these 2 surgical options for single-level DS with multilevel stenosis. Methods The results from a multicenter randomized and observational study, the Spine Patient Outcomes Research Trial comparing multilevel decompression and single-level fusion and multilevel decompression and multilevel fusion for spinal stenosis with spondylolisthesis, were analyzed. The primary outcome measures were the bodily pain and physical function scales of the Medical Outcomes Study 36-item Short-Form General Health Survey (SF-36) and the modified Oswestry Disability Index at 1, 2, 3, and 4 years postoperatively. Secondary analysis consisted of stenosis Bothersomeness index, low back pain Bothersomeness, leg pain, patient satisfaction, and self-rated progress. Results Overall, 207 patients were enrolled for the study, 130 had multlilevel decompression with 1 level fusion and 77 patients had multilevel decompression and multilevel fusion. For all primary and secondary outcome measures, there were no statistically significant differences in surgical outcomes between the 2 surgical techniques. However, operative time and intraoperative blood loss were significantly higher in the multilevel fusion group. Conclusion Decompression and single-level fusion and decompression and multilevel fusion provide similar outcomes in patients with multilevel lumbar stenosis and single-level DS.
-
the influence of obesity on the outcome of treatment of lumbar disc herniation analysis of the spine patient outcomes research trial sport
Journal of Bone and Joint Surgery American Volume, 2013Co-Authors: Jeffrey A Rihn, Jon D Lurie, Wenyan Zhao, Alan S Hilibrand, Todd J Albert, Mark F Kurd, James Neil WeinsteinAbstract:Background: Questions remain as to the effect that obesity has on patients managed for symptomatic lumbar disc herniation. The purpose of this study was to determine if obesity affects outcomes following the treatment of symptomatic lumbar disc herniation. Methods: An as-treated analysis was performed on patients enrolled in the Spine Patient Outcomes Research Trial for the treatment of lumbar disc herniation. A comparison was made between patients with a body mass index of <30 kg/m2 (nonobese) (n = 854) and those with a body mass index of ≥30 kg/m2 (obese) (n = 336). Baseline patient demographic and clinical characteristics were documented. Primary and secondary outcomes were measured at baseline and at regular follow-up time intervals up to four years. The difference in improvement from baseline between operative and nonoperative treatment was determined at each follow-up period for both groups. Results: At the time of the four-year follow-up evaluation, improvements over baseline in primary outcome measures were significantly less for obese patients as compared with nonobese patients in both the operative treatment group (Short Form-36 physical function, 37.3 compared with 47.7 points [p < 0.001], Short Form-36 bodily pain, 44.2 compared with 50.0 points [p = 0.005], and Oswestry Disability Index, −33.7 compared with −40.1 points [p < 0.001]) and the nonoperative treatment group (Short Form-36 physical function, 23.1 compared with 32.0 points [p < 0.001] and Oswestry Disability Index, −21.4 compared with −26.1 points [p < 0.001]). The one exception was that the change from baseline in terms of the Short Form-36 bodily pain score was statistically similar for obese and nonobese patients in the nonoperative treatment group (30.9 compared with 33.4 points [p = 0.39]). At the time of the four-year follow-up evaluation, when compared with nonobese patients who had been managed operatively, obese patients who had been managed operatively had significantly less improvement in the Sciatica Bothersomeness Index and the Low Back Pain Bothersomeness Index, but had no significant difference in patient satisfaction or self-rated improvement. In the present study, 77.5% of obese patients and 86.9% of nonobese patients who had been managed operatively were working a full or part-time job. No significant differences were observed in the secondary outcome measures between obese and nonobese patients who had been managed nonoperatively. The benefit of surgery over nonoperative treatment was not affected by body mass index. Conclusions: Obese patients realized less clinical benefit from both operative and nonoperative treatment of lumbar disc herniation. Surgery provided similar benefit over nonoperative treatment in obese and nonobese patients. Level of Evidence: Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
-
the effect of iliac crest autograft on the outcome of fusion in the setting of degenerative spondylolisthesis a subgroup analysis of the spine patient outcomes research trial sport
Journal of Bone and Joint Surgery American Volume, 2012Co-Authors: Kristen E Radcliff, Jon D Lurie, Wenyan Zhao, Alan S Hilibrand, Raymond Hwang, Harvey E Smith, Jordan A Gruskay, Todd J Albert, James Neil WeinsteinAbstract:Background: There is considerable controversy about the long-term morbidity associated with the use of posterior autologous iliac crest bone graft for lumbar spine fusion procedures compared with the use of bone-graft substitutes. The hypothesis of this study was that there is no long-term difference in outcome for patients who had posterior lumbar fusion with or without iliac crest autograft. Methods: The study population includes patients enrolled in the degenerative spondylolisthesis cohort of the Spine Patient Outcomes Research Trial who underwent lumbar spinal fusion. Patients were divided according to whether they had or had not received posterior autologous iliac crest bone graft. Results: There were 108 patients who had fusion with iliac crest autograft and 246 who had fusion without iliac crest autograft. There were no baseline differences between groups in demographic characteristics, comorbidities, or baseline clinical scores. At baseline, the group that received iliac crest bone graft had an increased percentage of patients who had multilevel fusions (32% versus 21%; p = 0.033) and L5-S1 surgery (37% versus 26%; p = 0.031) compared with the group withoutiliaccrestautograft.Operativetimewashigherintheiliaccrestbone-graftgroup(233.4versus200.9minutes;p< 0.001), and there was a trend toward increased blood loss (686.9 versus 582.3; p = 0.057). There were no significant differences in postoperative complications, including infection or reoperation rates, between the groups. On the basis of the numbers available, no significant differences were detected between the groups treated with or without iliac crest bone graft with regard to the scores on Short Form-36, Oswestry Disability Index, Stenosis Bothersomeness Index, and Low Back Pain Bothersomeness Scale or the percent of patient satisfaction with symptoms averaged over the study period. Conclusions: The outcome scores associated with the use of posterior iliac crest bone graft for lumbar spinal fusion were not significantly lower than those after fusion without iliac crest autograft. Conversely, iliac crest bone-grafting was not associated with an increase in the complication rates or rates of reoperation. On the basis of these results, surgeons may choose to use iliac crest bone graft on a case-by-case basis for lumbar spinal fusion. Level of Evidence: Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.
Hijoon Park - One of the best experts on this subject based on the ideXlab platform.
-
Effect and neurophysiological mechanism of acupuncture in patients with chronic sciatica: protocol for a randomized, patient-assessor blind, sham-controlled clinical trial
Trials, 2019Co-Authors: Kohwoon Kim, Hijoon Park, Jaeheung Cho, Kyungmo Park, Geon-ho Jahng, Eun-mo Song, Woo-chul Shin, Ye-ji Yoon, Soo-jeon Kim, Seulgi EunAbstract:Background Sciatica is a relatively frequent illness that easily becomes a chronic and relapsing condition. Although numerous systematic reviews have analyzed various therapies for sciatica, the validity of their included studies is limited. Considering the limitations of conventional treatment options for sciatica, acupuncture is a possible option; however, evidence supporting its efficacy and mechanism in patients with sciatica is lacking. The aim of this proposed protocol is to investigate the effect and neurophysiological mechanism of acupuncture in patients with chronic sciatica. Methods/design This study is a randomized, patient-assessor blind, two-arm, parallel, non-penetrating, sham-controlled clinical trial. Eligible participants will include adults (aged 19–70 years old) with a clinical diagnosis of chronic sciatica (40 mm or more of a 100-mm visual analog scale (VAS) for Bothersomeness) blinded to the treatment received. Patients will be randomly allocated into the acupuncture treatment group (manual acupuncture plus electroacupuncture (EA), n = 34) or the sham acupuncture control group (sham acupuncture plus placebo EA without electrical stimulation, n = 34). Groups will receive treatment twice a week for a total of eight sessions over 4 weeks. Functional magnetic resonance imaging will be implemented at baseline and endpoint to investigate the mechanism of acupuncture. The primary outcome measure is the VAS for Bothersomeness and secondary outcomes include the VAS for pain intensity, Oswestry Disability Index, EuroQol 5-Dimension, Coping Strategy Questionnaire, Beck’s Depression Inventory, and State-Trait Anxiety Inventory. Adverse events will be assessed at every visit. Discussion The results of this trial (which will be available in 2020) should provide important clinical evidence for the effect of acupuncture and demonstrate how acupuncture can be helpful for the treatment of chronic sciatica. Trial registration ClinicalTrials.gov, ID: NCT03350789 . Registered on 15 November 2017.
-
acupuncture for chronic low back pain a multicenter randomized patient assessor blind sham controlled clinical trial
Spine, 2013Co-Authors: Yujeong Cho, Yunkyung Song, Yunyeop Cha, Byungcheul Shin, Imhee Shin, Hijoon Park, Hyangsook Lee, Kohwoon Kim, Jaeheung Cho, Wonsuk ChungAbstract:STUDY DESIGN Multicenter, randomized, patient-assessor blind, sham-controlled clinical trial. OBJECTIVE To investigate the efficacy of acupuncture treatment with individualized setting for reduction of Bothersomeness in participants with chronic low back pain (cLBP). SUMMARY OF BACKGROUND DATA Low back pain is one of the main reasons of disability among adults of working age. Acupuncture is known as an effective treatment of cLBP, but it remains unclear whether acupuncture is superior to placebo. METHODS One hundred thirty adults aged 18 to 65 years with nonspecific LBP lasting for at least last 3 months prior to the trial participated in the study from 3 Korean medical hospitals. Participants received individualized real acupuncture treatments or sham acupuncture treatments for more than 6 weeks (twice a week) from Korean Medicine doctors. Primary outcome was change of visual analogue scale (VAS) score for Bothersomeness of cLBP. Secondary outcomes included VAS score for pain intensity and questionnaires including Oswestry Disability Index, general health status (Short Form-36), and Beck Depression Inventory (BDI). RESULTS There were no baseline differences observed between the 2 groups, except in the Oswestry Disability Index. One hundred sixteen participants finished the treatments and 3- and 6-month follow-ups, with 14 subjects dropping out. Significant difference in VAS score for Bothersomeness and pain intensity score of cLBP has been found between the 2 groups (P < 0.05) at the primary end point (8 wk). In addition, those 2 scores improved continuously until 3-month follow-up (P = 0.011, P = 0.005, respectively). Oswestry Disability Index, the Beck Depression Inventory, and Short Form-36 scores were also improved in both groups without group difference. CONCLUSION This randomized sham-controlled trial suggests that acupuncture treatment shows better effect on the reduction of the Bothersomeness and pain intensity than sham control in participants with cLBP.
-
Acupuncture for chronic low back pain: protocol for a multicenter, randomized, sham-controlled trial
BMC Musculoskeletal Disorders, 2010Co-Authors: Hijoon Park, Imhee Shin, Mi-yeon SongAbstract:Background Use of acupuncture has widely increased in patients with chronic low back pain. However, the evidence supporting its efficacy remains unclear. In this article, we report the design and the protocol of a multi-center randomized sham-controlled trial to treat chronic low back pain. Our goal is to verify the effect of acupuncture on chronic low back pain. Methods/Design This study is a multi-center randomized sham-controlled trial with 2 parallel arms. Participants included in the study met the following criteria: 1) low back pain lasting for at least the last 3 months, 2) a documented ≥ 5 points on a 10 cm visual analog scale for Bothersomeness of low back pain at the time of screening and 3) between 18 and 65 years of age. Participants were blinded to the real and sham acupuncture treatments. The real acupuncture treatment group received real acupuncture 2 times a week, during a total of 12 sessions over 6 weeks. The control group received sham acupuncture during the same period. In order to assess the primary and secondary outcome measures, the participants were asked to fill out a questionnaire at the baseline and 6, 8, 12 and 24 weeks after starting the treatments. The primary outcome was measured using the visual analog scale for Bothersomeness of low back pain at 8 weeks after the initiation of treatments. Discussion The result of this trial (which will be available in 2010) will demonstrate the efficacy of using acupuncture to treat chronic low back pain. Trial registration This study is registered with the U.S. National Institutes of Health Clinical Trials registry: NCT00815529
Yujeong Cho - One of the best experts on this subject based on the ideXlab platform.
-
acupuncture for chronic low back pain a multicenter randomized patient assessor blind sham controlled clinical trial
Spine, 2013Co-Authors: Yujeong Cho, Yunkyung Song, Yunyeop Cha, Byungcheul Shin, Imhee Shin, Hijoon Park, Hyangsook Lee, Kohwoon Kim, Jaeheung Cho, Wonsuk ChungAbstract:STUDY DESIGN Multicenter, randomized, patient-assessor blind, sham-controlled clinical trial. OBJECTIVE To investigate the efficacy of acupuncture treatment with individualized setting for reduction of Bothersomeness in participants with chronic low back pain (cLBP). SUMMARY OF BACKGROUND DATA Low back pain is one of the main reasons of disability among adults of working age. Acupuncture is known as an effective treatment of cLBP, but it remains unclear whether acupuncture is superior to placebo. METHODS One hundred thirty adults aged 18 to 65 years with nonspecific LBP lasting for at least last 3 months prior to the trial participated in the study from 3 Korean medical hospitals. Participants received individualized real acupuncture treatments or sham acupuncture treatments for more than 6 weeks (twice a week) from Korean Medicine doctors. Primary outcome was change of visual analogue scale (VAS) score for Bothersomeness of cLBP. Secondary outcomes included VAS score for pain intensity and questionnaires including Oswestry Disability Index, general health status (Short Form-36), and Beck Depression Inventory (BDI). RESULTS There were no baseline differences observed between the 2 groups, except in the Oswestry Disability Index. One hundred sixteen participants finished the treatments and 3- and 6-month follow-ups, with 14 subjects dropping out. Significant difference in VAS score for Bothersomeness and pain intensity score of cLBP has been found between the 2 groups (P < 0.05) at the primary end point (8 wk). In addition, those 2 scores improved continuously until 3-month follow-up (P = 0.011, P = 0.005, respectively). Oswestry Disability Index, the Beck Depression Inventory, and Short Form-36 scores were also improved in both groups without group difference. CONCLUSION This randomized sham-controlled trial suggests that acupuncture treatment shows better effect on the reduction of the Bothersomeness and pain intensity than sham control in participants with cLBP.
Kohwoon Kim - One of the best experts on this subject based on the ideXlab platform.
-
Effect and neurophysiological mechanism of acupuncture in patients with chronic sciatica: protocol for a randomized, patient-assessor blind, sham-controlled clinical trial
Trials, 2019Co-Authors: Kohwoon Kim, Hijoon Park, Jaeheung Cho, Kyungmo Park, Geon-ho Jahng, Eun-mo Song, Woo-chul Shin, Ye-ji Yoon, Soo-jeon Kim, Seulgi EunAbstract:Background Sciatica is a relatively frequent illness that easily becomes a chronic and relapsing condition. Although numerous systematic reviews have analyzed various therapies for sciatica, the validity of their included studies is limited. Considering the limitations of conventional treatment options for sciatica, acupuncture is a possible option; however, evidence supporting its efficacy and mechanism in patients with sciatica is lacking. The aim of this proposed protocol is to investigate the effect and neurophysiological mechanism of acupuncture in patients with chronic sciatica. Methods/design This study is a randomized, patient-assessor blind, two-arm, parallel, non-penetrating, sham-controlled clinical trial. Eligible participants will include adults (aged 19–70 years old) with a clinical diagnosis of chronic sciatica (40 mm or more of a 100-mm visual analog scale (VAS) for Bothersomeness) blinded to the treatment received. Patients will be randomly allocated into the acupuncture treatment group (manual acupuncture plus electroacupuncture (EA), n = 34) or the sham acupuncture control group (sham acupuncture plus placebo EA without electrical stimulation, n = 34). Groups will receive treatment twice a week for a total of eight sessions over 4 weeks. Functional magnetic resonance imaging will be implemented at baseline and endpoint to investigate the mechanism of acupuncture. The primary outcome measure is the VAS for Bothersomeness and secondary outcomes include the VAS for pain intensity, Oswestry Disability Index, EuroQol 5-Dimension, Coping Strategy Questionnaire, Beck’s Depression Inventory, and State-Trait Anxiety Inventory. Adverse events will be assessed at every visit. Discussion The results of this trial (which will be available in 2020) should provide important clinical evidence for the effect of acupuncture and demonstrate how acupuncture can be helpful for the treatment of chronic sciatica. Trial registration ClinicalTrials.gov, ID: NCT03350789 . Registered on 15 November 2017.
-
acupuncture for chronic low back pain a multicenter randomized patient assessor blind sham controlled clinical trial
Spine, 2013Co-Authors: Yujeong Cho, Yunkyung Song, Yunyeop Cha, Byungcheul Shin, Imhee Shin, Hijoon Park, Hyangsook Lee, Kohwoon Kim, Jaeheung Cho, Wonsuk ChungAbstract:STUDY DESIGN Multicenter, randomized, patient-assessor blind, sham-controlled clinical trial. OBJECTIVE To investigate the efficacy of acupuncture treatment with individualized setting for reduction of Bothersomeness in participants with chronic low back pain (cLBP). SUMMARY OF BACKGROUND DATA Low back pain is one of the main reasons of disability among adults of working age. Acupuncture is known as an effective treatment of cLBP, but it remains unclear whether acupuncture is superior to placebo. METHODS One hundred thirty adults aged 18 to 65 years with nonspecific LBP lasting for at least last 3 months prior to the trial participated in the study from 3 Korean medical hospitals. Participants received individualized real acupuncture treatments or sham acupuncture treatments for more than 6 weeks (twice a week) from Korean Medicine doctors. Primary outcome was change of visual analogue scale (VAS) score for Bothersomeness of cLBP. Secondary outcomes included VAS score for pain intensity and questionnaires including Oswestry Disability Index, general health status (Short Form-36), and Beck Depression Inventory (BDI). RESULTS There were no baseline differences observed between the 2 groups, except in the Oswestry Disability Index. One hundred sixteen participants finished the treatments and 3- and 6-month follow-ups, with 14 subjects dropping out. Significant difference in VAS score for Bothersomeness and pain intensity score of cLBP has been found between the 2 groups (P < 0.05) at the primary end point (8 wk). In addition, those 2 scores improved continuously until 3-month follow-up (P = 0.011, P = 0.005, respectively). Oswestry Disability Index, the Beck Depression Inventory, and Short Form-36 scores were also improved in both groups without group difference. CONCLUSION This randomized sham-controlled trial suggests that acupuncture treatment shows better effect on the reduction of the Bothersomeness and pain intensity than sham control in participants with cLBP.