Using auriculotherapy for osteoarthritic knee among elders: a double-blinded randomised feasibility study

Lorna K P Suen, Chao Hsing Yeh, Simon K W Yeung, Lorna K P Suen, Chao Hsing Yeh, Simon K W Yeung

Abstract

Background: Osteoarthritic knee (OA knee) is a common condition in the elderly. Exploration of non-invasive complementary therapies for OA knee is warranted given the limitations of pharmacologic therapies. Auriculotherapy (AT) is a therapeutic method in which specific points on the auricle are stimulated to treat various disorders of the body, and the therapeutic value and synergistic effect of laser auriculotherapy (LAT) when combined with magneto-auriculotherapy (MAT) merits further investigation.

Methods: This study adopted a double-blinded four-arm randomized placebo design. The aims of study are (1) to assess the feasibility of AT among elders with OA knee in a future large-scale study, including the use of blinding in subjects and evaluators, acceptance of treatment protocol, and estimating the effect size and attrition rate; and (2) to evaluate the preliminary effect of AT in elders with OA knee. Subjects were randomly divided into four groups with different modes of AT with/without placebo objects. A total of 43 subjects completed the 6-week intervention and post-assessment. Assessments included a numerical rating scale of pain (NRS), the timed-up-and-go test (TUGT), and standard goniometer measurements during knee flexion and extension, Kruskal-Wallis test was used to evaluate differences among groups, and Wilcoxon sign-ranked test for examining within-group comparison.

Results: Preliminary results indicated the absence of differences in the NRS, TUGT, and active/passive knee flexion and extension at baseline, as well as post-therapy, between the four groups. Even though the differences of these parameters between groups were not significant, the relative differences of NRS and TUGT in subjects who received combined MAT plus LAT were higher than those treated with MAT or LAT alone, or the placebo group. Four of the six parameters demonstrated significant within group differences in subjects who received MAT and/or LAT, whereas no significant differences were found in the placebo group.

Conclusion: This study demonstrates that the AT protocol adopted in this study for elders with OA knee is feasible and could be applied in future larger-scale study. Larger sample size should be considered in a future trial to determine the causal relationship between treatment and effect.

Trial registration: ClinicalTrials.gov: NCT02352636 . Registered on 23 January 2015.

Keywords: Auriculotherapy; Elderly; Laser; Magnetotherapy; Osteoarthritic knee.

Figures

Fig. 1
Fig. 1
Selected ear acupoints for elders with osteoarthritic knee
Fig. 2
Fig. 2
Flow diagram of study. MAT: Placebo LAT and magnetotherapy, LAT: Laser auriculotherapy & placebo MAT, Combined: LAT plus MAT, Placebo: Placebo LAT & placebo MATᅟ

References

    1. Yip YB, Sit WH, Fung KKY, Wong DYS, Chong SYC, Chun LH, Ng TP. Effects of a self-management arthritis programme with an added exercise component for osteoarthritic knee: randomized controlled trial. JAN. 2007;59:20–28. doi: 10.1111/j.1365-2648.2007.04292.x.
    1. Yip YB, Sit JW, Wong DYS, Chong SYC, Chung LH. A 1-year follow-up of an experimental study of a self-management arthritis programme with an added exercise component of clients with osteoarthritis of the knee. Psychol, Health & Med. 2008;13:402–414. doi: 10.1080/13548500701584030.
    1. Shen CL, James CR, Chyu MC, Bixby WR, Brismee JM, Zumwalt MA, Poklikuha G. Effects of tai chi on gait kinematics, physical function, and pain in elderly with knee osteoarthritis – A pilot study. Am J Chin Med. 2008;36:219–232. doi: 10.1142/S0192415X08005734.
    1. Woo PCY, Lin AWC, Lau SKP. Acupuncture transmitted infections. In: Saad M, editor. Acupuncture – clinical practice, particular techniques and special issues. Croatia: Europe InTech; 2011. pp. 123–138.
    1. Suen LKP, Wong TKS, Leung AWN. Is there a place for auricular therapy in the realm of nursing? Compl Ther Nurs Midwifery. 2001;7:132–139. doi: 10.1054/ctnm.2001.0565.
    1. Oleson T 4th, editor. Auriculotherapy Manual. Edinburgh: Churchill Livingstone Elsevier; 2014.
    1. Ramey DW. Magnetic and electromagnetic therapy. Sci Rev Alt Med. 1998;2:13–19.
    1. Tian DZ. Laser acupuncture and TCM (Part I) Int J Clin Acupuncture. 1996;7:397–399.
    1. Kneebone WJ. Laser acupuncture as a pain relief modality. Pract Pain Manage 2008 (May). pp. 64–68.
    1. Suen LKP, Wong EMC. Longitudinal changes in disability level of elderly with low back pain after auriculotherapy. Comple Ther Med. 2008;16:28–35. doi: 10.1016/j.ctim.2007.09.002.
    1. Suen LKP, Wong TKS, Leung AWN. Effectiveness of auricular therapy using magnetic pearls on sleep promotion in the elderly. Am J Chin Med. 2002;30:429–449. doi: 10.1142/S0192415X0200051X.
    1. Yao SY. 46 cases of insomnia treated by semiconductor laser irradiation on auricular points. J Tradit Chin Med. 1999;19:298–299.
    1. Altman RD, Asch E, Bloch D, Bole G, Borenstein D, Brandr K, et al. Development criteria for the classification and reporting of osteoarthritis – classification of osteoarthritis of the knee. Arthritis Rheum. 1986;29:1039–1049. doi: 10.1002/art.1780290816.
    1. Feng CX, Bai XH, Du Y. Chinese auricular therapy [中國耳穴療法] Beijing: Scientific and Technical Documents Publishing House; 1994.
    1. Nomenclature and location of auricular points (GB/T 13734-2008) China Standardization Organizing Committee. Beijing: China Zhijian Publishing House and Standards Press of China; 2008.
    1. Round R, Litscher G, Bahr F. Auricular acupuncture with laser. Evidence-based Complementary and Alternative Medicine. 2013;Article ID 984763:22.
    1. Ng MML, Leung MCP, Poon DMY. The effects of electro-acupuncture and transcutaneous electrical nerve stimulation on patients with painful osteoarthritic knees: A randomized controlled trial with follow-up evaluation. J Altern Comple Med. 2003;9:641–649. doi: 10.1089/107555303322524490.
    1. Podsiadlo D, Richardson S. The timed “up and go”. A test of basic functional mobility for frail elderly persons. J Am Geri Soc. 1991;39:142–148. doi: 10.1111/j.1532-5415.1991.tb01616.x.
    1. Yeh CH, Morone NE, Chien LC, Cao Y, Lu H, Shen J, Margolis L, Bhatnagar S, Hoffman S, Liang Z, Glick RM, Suen LKP. Auricular point acupressure to manage chronic low back pain in older adults: A randomized controlled pilot study. EB-CAM, Article ID 375173. . Accessed 20 July 2016.
    1. Kalauokalani D, Cherkin DC, Sherman KJ, Koepsell TD, Deyo RA. Lessons from a trial of acupuncture and massage for low back pain: patient expectations and treatment effects. Spine. 2001;26:1418–1424. doi: 10.1097/00007632-200107010-00005.
    1. Lenhard W, Lenhard A. Calculation of Effect Sizes, available: . Psychometrica: Bibergau (Germany); 2014.
    1. WHO. Handbook for good clinical research practice (GCP): Guidance for implementation. World Health Organisation; 2002. . Accessed 20 July 2016.
    1. Suen LKP, Chair SY, Thompson DR, Yu CM, Lin ZX, Lee PW, Chu TSK. Traditional Auriculotherapy for Hypertension: A Pilot Randomized Trial. J Cardiovasc Dis 2014; 2:19–24. ISSN:2330-4596 (Print)/2330-460X (Online) Accessed 20 July 2016.
    1. Fung DTC, Ng GYF, Leung MCP. Combined treatment of therapeutic laser and herbal application improves the strength of repairing ligament. Connect Tissue Res. 2005;46:125–130. doi: 10.1080/03008200591008473.
    1. Marovino TA. Laser auriculotherapy as part of the nicotine detoxification process: evaluation of 1280 subjects and theoretical considerations of a developing model. Am J Acupuncture. 1994;22:69–71.
    1. Sprouse-Blum AS, Smith G, Sugai D, Parsa FD. Understanding endorphins and their importance in pain management. Hawaii Med J. 2010;69:70–71.

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