Assessment of Acupuncture to Improve Function, Exercise Capacity, and Pain - NCT00502619-21201(Clinical Trial 177694)
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| City: |
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Baltimore |
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State:
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MD |
| Zip Code: |
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21201 |
| Conditions: |
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Chronic Low Back Pain |
| Purpose: |
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The purpose of this research proposal is to conduct a feasibility study to determine the
viability a larger efficacy study of combined acupuncture treatments plus treadmill exercise
to decrease pain, facilitate exercise, and improve function in Veterans with chronic low
back pain (CLBP). To test this novel approach, subjects enrolled from a Veteran population
at the Veteran Affairs Maryland Health Care System (VAMHCS) will undergo acupuncture plus
low intensity treadmill walking exercise. Preliminary data regarding subject compliance,
self-report of function, pain control, ambulatory activity, and exercise capacity will be
collected to assess the response to this combined acupuncture/treadmill exercise protocol.
Additionally, this study will determine the viability of this combined treatment paradigm
for a larger study that will examine efficacy.
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| Study summary: |
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Chronic non-malignant low back pain (CLBP) is very common. It is treated with diverse
pharmacological and non-pharmacological therapies, including complementary and alternative
pain treatments. Acupuncture has gained increasing acceptance among patients in the United
States; however, the efficacy and duration of benefit of acupuncture treatments is often
unknown, and prolonged utilization of these treatments is expensive. Successful acupuncture
may provide an alternative to pain medications. Randomized studies have shown that exercise
can produce long term benefits for individuals experiencing CLBP. Studies have also shown
that acupuncture may be useful for the treatment of CLBP.
The purpose of the proposed research is to conduct a study to determine the feasibility of a
larger efficacy study of acupuncture to decrease pain and facilitate exercise and function
in Veterans with chronic low back pain (CLBP), in a Veteran population at the Veteran
Affairs Maryland Health Care System (VAMHCS). To test this novel approach, subjects will
undergo 16 weeks of treatment, consisting of acupuncture for 4 weeks followed by an
overlapping period of 12 weeks of acupuncture plus low intensity treadmill walking exercise.
Preliminary data will be collected to assess the improvement, if any, of: a) self-report of
function, b) pain control, c) ambulatory activity, and d) exercise capacity. Additionally,
this study will determine the viability of this combined treatment paradigm for a larger
study that will examine efficacy.
Major objectives are to determine the rates of compliance for participation in this therapy
of acupuncture plus low-intensity treadmill walking program, the completion rate of all
treatment sessions and associated health assessment forms, as well as the challenges of
recruitment. In addition, preliminary data to support the application for the larger pilot
study will be obtained. The investigators' long-term research goal is to study this novel
paradigm and its ability to reduce chronic low back pain.
The specific aims of the study are as follows:
Specific Objective 1. To determine whether individuals with CLBP receiving acupuncture plus
treadmill exercise will exhibit superior improvement in function measured by Oswestry
Disability Index II.
Specific Objective 2. To determine whether CLBP patients receiving acupuncture plus
treadmill exercise will exhibit reduced pain scores measured by the Numeric Pain Intensity
Rating Scale.
Specific Objective 3. To determine whether CLBP patients receiving acupuncture plus
treadmill exercise will have improved home and community based ambulatory activity levels
quantified by Step Activity Monitors (SAM).
Specific Objective 4. CLBP patients receiving acupuncture plus exercise will have greater
gains in cardiovascular fitness levels measured by exercise testing with open circuit
spirometry (V02 Max). |
| Criteria: |
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Inclusion Criteria:
- Veterans eligible for this study are men or women between 25 and 65 years old with
non-malignant low back pain greater than 6 months duration and pain scores greater
than 4 (on a Numeric Pain Scale of 0 = No Pain and 10 = Worst Imaginable Pain) on
most days out of the preceding month.
- Eligible subjects will also need to be able to tolerate 3 minutes walking at a rate
of 0.5 miles per hour on a horizontal surface.
Exclusion Criteria:
- Inability to provide informed consent
- Diagnosis of dementia
- Severe depression (Beck Depression Inventory score > 30), suicidality, or untreated
mental illness
- Severe anxiety (Beck Anxiety Inventory score > 30)
- Evidence of current substance abuse or alcoholism on the TICS
- Ongoing litigation related to the low back pain complaint
- Pregnancy or intent to become pregnant during time of study
- Ambulation requiring an assistive device
- Neurological, orthopedic, or other conditions impairing ambulation that would affect
exercise safety
- Progressive neurological changes, altered sensation, or a history of cauda equina
syndrome
- Pain below the knee that limits ambulation
- Lower extremity amputation proximal to the toes
- Low back pain problem requiring surgical intervention or impending surgery
- A history of lumbar vertebral fracture; and
- A history of prior lumbar surgery. Additional exclusion criteria include medical
conditions that would affect an exercise program, such as rheumatologic, infectious,
cardiac, peripheral vascular and pulmonary conditions, or ongoing cancer treatment. |
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| Study is available at: |
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Baltimore VAMC Baltimore, MD 21201 United States
Primary Contact: Robert A. Lavin, M.D. Email: robert.lavin@va.gov Phone: 410-605-7448 |
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If you are interested in this clinical trial please use the contact information above. If you would like to get additional information about this clinical trial please visit ClinicalTrials.gov.
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| Data Source: |
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ClinicalTrials.gov |
| Date Processed: |
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March 22, 2011 |
Modifications to
this listing: |
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above to view all information about this clinical trial. |
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