Monday, June 22, 2009
OA knee ESCAPE programme
Just found some interesting evidence for an OA knee exercise programme:
http://www.kcl.ac.uk/content/1/c6/04/79/67/escapeprogramm...
The guide is very good and it gives ideas for handouts for patients, here is an outline:
Objective
Chronic knee pain is a major cause of disability and healthcare expenditure, but there
are concerns about efficacy, cost and side-effects associated with usual management.
Conservative rehabilitation may offer a safe, effective, affordable alternative. We compared the
efficacy of a rehabilitation programme (Enabling Self-management and Coping with Arthritic
knee Pain through Exercise, ESCAPE-knee pain) of improving function in people with chronic
knee pain better than usual primary care, delivered to individuals or groups of people.
Methods
This was a single blind, pragmatic, cluster randomised controlled trial. Participants aged
50 years and over, complaining of knee pain for more than 6 months, were recruited from a
random sample of 54 inner city primary care practices. Usual primary care was compared with
participation on a rehabilitation programme (integrating exercise, self-management and active
coping strategies) delivered to participants individually or groups of 8 participants. Primary
outcome was self-reported function (WOMAC-func) 6 months after completing rehabilitation.
Results 418 participants were recruited; 76 (18%) withdrew, only 5 (1%) due to adverse events.
Rehabilitated participants had better function than participants continuing usual primary care (-
3.33 WOMAC-func points, CI -5.88 to -0.78; p=0.01). Improvements were similar whether
participants received individual (-3.53, CI -6.52 to -0.55) or group rehabilitation (-3.16, CI -6.55
to -0.12). The number needed to treat was 7 (CI 4 to 27).
Conclusions
ESCAPE-knee pain provides a safe, clinically practicable intervention for chronic
knee pain, and is equally effective whether delivered to individuals or groups of participants.
23:42 Posted in Knee, Pain, Research | Permalink | Comments (0) | Email this
Tuesday, May 05, 2009
Restless Leg Syndrome and acupuncture
22:07 Permalink | Comments (0) | Email this
acupuncture for migrane
acupuncture for migrane
From the iCSP website:
Posted: 22 April 2009 08:43
Thanks
Lynn Pearce:
I run a day on headache and acupuncture and the pathology of headache can be complex - the International Headache Society offer at least 10 sub-gorups when trying to classify headaches, and migraine is a group all on it's own.
A few pointers - face pain - where is this?? Likely to be a referral from the opthalmic branch of the trigeminal cranial nerve. Also, this nerve ( and you'll have got this from Dean Watson's course ) can be involved in a structure known as the TCN - the trigemino-cervical nucleus - it's anatomical location puts it in the brainstem and extending down into the cervical spine. Dean feels this structure is effected with mobilising C0 - C 3.
HOWEVER!!! - the neural supply to this region can come from the upper thoracic levels ( notably T 1 - 4, which in turn supplies the superior cervical ganglia and this in turn supplies the C0 - C 3 region.
REAL migraine ( and I say this, as a lot of people say they get migraine when they don;t - they can easily have upper cervical spine driven headache which appears as if it's 'migraine' in the public eye... ) can be treated from a number of points. GB 20 has always been considered THE headache point, but there are a number of ways to effect this area, and ALWAYS assume it's coming from the thoracic / cervical spines until they've been eliminated!!
Bl 10 ( and there are two different locations ) can be useful too, but each patient gets assessed on their own merit and a treatment tailored to them, there is no ' headache recipe'.
If you're looking at the Andrew Vickers study, you'll see that there was a point point suggested, but no 'exact formula'. The common points are GB 21, GB 20, but I would have many other suggestions, based on more clinical info regarding these headaches and how they present.
A word on the other presentation - it is possible that it is Cluster Headache' which is hard to diagnose, more common in men, and harder to treat.!!!
Food for thought for now....
Regards
Lynn P
AACP Tutor
22:03 Posted in Acupuncture | Permalink | Comments (0) | Email this