ABSTRACT
BACKGROUND: Currently, there is a need for scientific evidence on the efficacy of classical massage therapy for chronic, unspecific back pain, especially for the improvement in functional impairment and long-term pain reduction. According to the National Health Care Guidelines, classical massage for nonspecific low back pain may only be prescribed in combination with exercise therapy and a share of the remuneration. Acupuncture, on the other hand, is recognised in the guidelines as an independent treatment for chronic back pain and is remunerated by health insurance companies. This raises the question of whether classical massage therapy is not inferior compared to acupuncture, based on the therapy of the GERAC study. The Clinic of Naturopathy in Blankenstein, Hattingen uses classical massage therapy subjectively successfully in patients with back pain. To objectify the success of the treatment, a randomised controlled, non-inferiority study was conducted. METHODS: The efficacy of classical massage (KMT, n = 66) was compared with acupuncture therapy (AKU, n = 66) in patients with chronic back pain. The primary endpoint was the non-inferiority of classical massage compared with the acupuncture treatment in respect of the impairment in everyday life, with the help of the Hannover function questionnaire (HFAQ) and the reduction in pain ("Von Korff"-Questionnaire) at the follow-up after one month. RESULTS: In the per-protocol analysis during the period between enrollment in the study and follow-up, the responder rate of the KMT was 56.5% and thus tended to be inferior to the responder rate of the AKU with 62.5% (Δ = - 6%; KIΔ: - 23.5 to + 11.4%). CONCLUSIONS: The results show that classical massage therapy is not significantly inferior to acupuncture therapy in the period from admission to follow-up. Thus, the non-inferiority of the KMT to the AKU cannot be proven in the context of the defined irrelevance area.
Subject(s)
Acupuncture Therapy , Chronic Pain , Back Pain/therapy , Exercise Therapy , Humans , Massage , Treatment OutcomeABSTRACT
OBJECTIVES: Evidence for complementary therapies as important strategies to relieve cancer treatment-associated symptoms is increasing. Mostly, these complementary therapies start at the end of adjuvant treatments, resulting in a long delay until the well-being of patients is addressed. Further, long distances between the rehabilitation center and the patients' residence hinder patients' compliance. METHODS: The multimodal outpatient LOTUS Care Cure Project (LCCP) was tested in a randomized controlled trial including patients of various cancer entities and stages while on adjuvant chemotherapy and/or radiotherapy or outpatient aftercare. The intervention group received the LCCP additionally to the conventional treatment (LCCP group, n = 50). The control group (CG) was split into 2 groups, with (CG1, n = 33) and without (CG2, n = 17) weekly talks. The primary endpoint was quality of life (QoL) after 3 months. RESULTS: In the LCCP group, QoL significantly improved after 3 months compared to CG2 (p = 0.022) but not compared to CG1. Other parameters showing a significant improvement were cognitive (p < 0.05, vs. CG1 and CG2) and social function (p < 0.05, vs. CG2). CONCLUSIONS: This pilot study describes a multimodal outpatient complementary therapy program conducted in parallel with conventional therapies and its potential to significantly improve QoL and reduce treatment-associated side effects. To substantiate these data, multicenter trials are needed.
Subject(s)
Aftercare , Chemotherapy, Adjuvant/adverse effects , Complementary Therapies , Neoplasms/psychology , Neoplasms/therapy , Quality of Life , Radiotherapy, Adjuvant/adverse effects , Adult , Aftercare/methods , Aftercare/psychology , Aged , Aged, 80 and over , Chemotherapy, Adjuvant/psychology , Complementary Therapies/methods , Female , Germany , Humans , Male , Middle Aged , Neoplasms/drug therapy , Neoplasms/radiotherapy , Outpatients , Pilot Projects , Program Evaluation , Prospective Studies , Radiotherapy, Adjuvant/psychology , Treatment OutcomeABSTRACT
In order to better understand the global approach and country differences in physicians' usage, knowledge, and attitudes towards natural remedies and homeopathy in pediatric practice, an online survey involving 582 general pediatricians and general practitioners treating pediatric diseases was conducted in 6 countries. Overall, 17% of the pediatric prescriptions refer to phytotherapy and 15% refer to homeopathic preparations. Natural remedies and homeopathic preparations are more frequently used in upper respiratory tract infections, infant colic, sleep disturbances, and recurrent infections. In the majority of cases, they are used together with chemical drugs. Both treatment options are typically used if parents are concerned about side effects of conventional drugs or prefer natural remedies for themselves. Physicians express high interest in natural remedies and homeopathy; however, their knowledge is variable. Lack of proven efficacy, knowledge on mechanism of action, and information on indications are main factors that limit their usage.