Effects of acupuncture on shoulder impingement syndrome: A systematic review and meta-analysis.

BACKGROUND: Shoulder impingement syndrome (SIS) is a common condition that causes chronic shoulder pain. The effectiveness of acupuncture in treating chronic shoulder pain has been documented in previous studies; however, existing systematic reviews and meta-analyses have often excluded Chinese databases and combined different types of acupuncture interventions, such as electroacupuncture, warm acupuncture, pharmacopuncture, and acupotomy. Thus, this study specifically examines the exclusive impact of manual acupuncture on SIS. METHODS: Several databases, including PubMed, Cochrane Central, Embase, 1 Chinese database (China National Knowledge Infrastructure), and 5 Korean databases (ScienceON, Oriental Medicine Advanced Searching Integrated System, KoreaMed, Korean Studies Information Service System, and KMBASE), were systematically searched for relevant studies. The quality of the included studies was evaluated using the Cochrane Assessment Tool for Risk of Bias Version 2. Data collected from the selected studies were synthesized for meta-analysis. The primary outcome was a pain scale score, and the secondary outcomes were shoulder function and disability. RESULTS: This study included 5 randomized controlled trials. The primary outcome assessment revealed significantly reduced pain (standardized mean difference [SMD] = -0.50, 95% confidence interval [CI] = -0.74 to -0.27) and improvements in shoulder function and disability (SMD = -0.57, 95% CI = -0.96 to -0.19). A subgroup analysis based on treatment duration indicated that short-term acupuncture treatment (≤4 weeks) exhibited a high level of confidence with low heterogeneity (SMD = -0.37, 95% CI = -0.73 to -0.02). CONCLUSION: Manual acupuncture is effective for relieving pain and improving shoulder function and disability in patients with SIS. However, further research is necessary to validate these findings owing to the limited number of patients and heterogeneity among the studies reviewed.

Effectiveness and Safety of Progressive Loading-Motion Style Acupuncture Treatment for Acute Low Back Pain after Traffic Accidents: A Randomized Controlled Trial.

BACKGROUND: Traffic injuries include acute low back pain (LBP) needing active treatment to prevent chronicity. This two-armed, parallel, assessor-blinded, randomized controlled trial evaluated the effectiveness and safety of progressive loading-motion style acupuncture treatment (PL-MSAT) for acute LBP following traffic accidents. METHODS: Based on an effect size of 1.03, 104 participants were recruited and divided in a 1:1 ratio into PL-MAST and control groups using block randomization. Both groups underwent integrative Korean medicine treatment (IKMT) daily; only the PL-MSAT group underwent three PL-MSAT sessions. The outcomes were assessed before and after the treatment sessions and at 1 and 3 months post-discharge. The primary outcome was the difference in the numeric rating scale (NRS) for LBP. The secondary outcomes included a visual analog scale for LBP, leg pain status, the Oswestry disability index, lumbar active range of motion (ROM), quality of life, Patient Global Impression of Change, and Post-Traumatic Stress Disorder Checklist adverse events. RESULTS: In the modified intention-to-treat analysis, 50 and 51 participants were included in the PL-MSAT and control groups. On Day 4, the mean LBP NRS score was 3.67 (3.44-3.90) in the PL-MSAT group, indicating a significantly lower NRS 0.77 (0.44-1.11) compared to 4.44 (4.20-4.68) for the control group (p < 0.001). The PL-MSAT group exhibited greater ROM flexion (-5.31; -8.15 to -2.48) and extension (-2.09; -3.39 to -0.80). No significant differences were found for the secondary outcomes and follow-ups. CONCLUSIONS: Compared with IKMT alone, PL-MSAT plus IKMT showed significantly better outcomes for reducing pain and increasing the ROM in acute LBP.

The effect of Monkey Chair and Band exercise system on shoulder range of motion and pain in post-stroke patients with hemiplegia.

[Purpose] A simple rehabilitation device system for strengthening upper limb muscles in hemiplegic patients was developed. This system, which stimulates active exercise while accounting for intensity, time, and frequency, was examined in the present pilot study. [Subjects and Methods] Patients had shoulder pain and limited shoulder movement. Changes in range of motion (ROM) and scores of a visual analog scale (VAS) for pain were evaluated in the experimental and control groups every four weeks for twelve weeks. The modified motor assessment scale (MMAS) was used before and after experiments. [Results] Significant differences between experimental times in ROM for shoulder flexion, abduction, and adduction on the paralyzed side were observed in the experimental group at every time point. Pain VAS scores in the experimental group improved progressively and significantly with time, indicating a consistently increasing effect of exercise. There were significant differences between the MMAS scores before and after completion of the program in the experimental group. [Conclusion] Muscle strengthening is important in hemiplegic patients, and active exercise was more efficient than passive exercise in this regard. Rehabilitation with the Monkey Chair and Band system may represent an efficient and important tool in upper limb training and comprehensive modern rehabilitation therapy.