White Rose University Consortium logo
University of Leeds logo University of Sheffield logo York University logo

Investigating Acupuncture and Manual Therapy for Low Back Pain

Dascanio, Vivienne Claire (2018) Investigating Acupuncture and Manual Therapy for Low Back Pain. PhD thesis, University of York.

This is the latest version of this item.

[img]
Preview
Text (Investigating Acupuncture and Manual Therapy for Low Back Pain)
Dascanio_105032862_PhDThesis_VCD.pdf - Examined Thesis (PDF)
Available under License Creative Commons Attribution-Noncommercial-No Derivative Works 2.0 UK: England & Wales.

Download (8Mb) | Preview
[img]
Preview
Text (Appendices to Investigating Acupuncture and Manual Therapy for Low Back Pain)
Dascanio_105032862_PhDappendices_VCD.pdf - Examined Thesis (PDF)
Available under License Creative Commons Attribution-Noncommercial-No Derivative Works 2.0 UK: England & Wales.

Download (35Mb) | Preview

Abstract

Abstract Background Low Back Pain (LBP) is the principal cause of disability globally (Buchbinder et al. 2018; Hartvigsen et al. 2018). Research and packages of care have strived to reduce levels of LBP, but globally it continues to rise (Foster et al. 2018). There is debate as to the role of acupuncture in LBP care pathways and research on acupuncture is of varying quality and not conclusive (SAR, 2018). Previous research of acupuncture has not effectively used trial design to produce high quality, robust and convincing evidence. Aims To investigate if acupuncture and manual therapy are indicated as appropriate treatments for the treatment of LBP and consider if their combination may be viable and effective. To determine the international LBP recommendations for acupuncture and manual therapy. To establish which RCT design could best evaluate acupuncture and manual therapy for the treatment of LBP and to trial this in a pilot study. To ascertain if high-quality research compares and combines acupuncture with manual therapy for LBP. Methods To review the international clinical practice guidelines and their approach to acupuncture and manual therapy for LBP. To consider a range of clinical trial designs and establish a preferred design. To conduct a trial investigating acupuncture and manual therapy alone and in combination for LBP, using a cohort study with nested factorial RCT. To conduct a systematic review, comparing acupuncture with manual therapy for LBP. Results Further evidence is indicated in the study of acupuncture and manual therapy for LBP. Clinical practice guidelines are inconsistent in their interpretation of evidence and the recommendation of acupuncture. A cohort study with nested factorial RCT is an effective design for recruitment, retention and to evaluate acupuncture and manual therapy for LBP. 97% of participants accepted the interventions offered and 100% of individuals completed the RCT interventions and 100% returned (97% completion of primary outcomes measures) of follow-up questionnaires. Zero attrition was achieved with this pilot study (95% CI 0.0, 6.3). Manual therapy may be superior (-1.4, 95% CI -3.8, 1.0, P=0.24) to usual care, but the results are not statistically significant. Manual therapy appears favourable in an SR and meta-analysis of manual therapy versus acupuncture; the results were limited by the methodological quality of the studies included. Conclusions A full-scale definitive trial of acupuncture and manual therapy using a cohort design, with nested factorial RCT is needed.

Item Type: Thesis (PhD)
Related URLs:
Academic Units: The University of York > Health Sciences (York)
Identification Number/EthosID: uk.bl.ethos.792077
Depositing User: Mrs Vivienne Claire Dascanio
Date Deposited: 09 Dec 2019 12:21
Last Modified: 19 Feb 2020 13:08
URI: http://etheses.whiterose.ac.uk/id/eprint/25409

Available Versions of this Item

You do not need to contact us to get a copy of this thesis. Please use the 'Download' link(s) above to get a copy.
You can contact us about this thesis. If you need to make a general enquiry, please see the Contact us page.

Actions (repository staff only: login required)