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Biomedical subjects

Nadine Graham

Publications and source records attributed to Nadine Graham.

2 recordsLinked to original sources

Acupuncture for neck disorders.

STUDY DESIGN: Systematic review. OBJECTIVE: To determine the effects of acupuncture for individuals with neck pain. SUMMARY OF BACKGROUND DATA: Neck pain is one of the 3 most frequently reported complaints of the musculoskeletal system. Treatments for neck pain are varied, as are the perceptions of benefits. METHODS.: We searched CENTRAL (2006, issue 1) and MEDLINE, EMBASE, MANTIS, Cumulative Index to Nursing and Allied Health Literature from their beginning to February 2006. We searched reference lists and the acupuncture database TCMLARS in China. Any published trials using randomized (RCT) or quasi-randomized (quasi-RCT) assignment to the intervention groups, either in full text or abstract form, were included. RESULTS: We found 10 trials that examined acupuncture treatments for chronic neck pain. Overall, methodologic quality had a mean of 2.3 of 5 on the Jadad scale. For chronic mechanical neck disorders, there was moderate evidence that acupuncture was more effective for pain relief than some types of sham controls, measured immediately posttreatment. There was moderate evidence that acupuncture was more effective than inactive, sham treatments measured immediately posttreatment, and at short-term follow-up (pooled standardized mean difference, -0.37; 95% confidence interval, -0.61 to -0.12). There was limited evidence that acupuncture was more effective than massage at short-term follow-up. For chronic neck disorders with radicular symptoms, there was moderate evidence that acupuncture was more effective than a wait-list control at short-term follow-up. CONCLUSIONS: There is moderate evidence that acupuncture relieves pain better than some sham treatments, measured at the end of the treatment. There is moderate evidence that those who received acupuncture reported less pain at short-term follow-up than those on a waiting list. There is also moderate evidence that acupuncture is more effective than inactive treatments for relieving pain posttreatment, and this is maintained at short-term follow-up.

Acupuncture Therapy↗

Mechanical traction for mechanical neck disorders: a systematic review.

OBJECTIVE: To assess whether mechanical traction, either alone or in combination with other treatments, improves pain, function/disability, patient satisfaction and global perceived effect in adults with mechanical neck disorders. METHODS: We conducted a systematic review up to September 2004 of randomized controlled trials and used pre-defined levels of evidence for qualitative analysis. Two independent reviewers conducted study selection, data abstraction and methodological quality assessment. Using a random effects model, relative risk and standardized mean differences were calculated. The reasonableness of combining studies was assessed on clinical and statistical grounds. In the absence of heterogeneity, pooled effect measures were calculated. RESULTS: Of the 10 selected trials, one study was of high quality. Our review revealed low-quality trials for mechanical neck disorders, showing evidence of benefit favouring intermittent traction for pain reduction. Continuous traction showed no significant difference for defined outcomes. CONCLUSION: Inconclusive evidence for continuous and intermittent traction exists due to trial methodological quality. Two clinical conclusions may be drawn, one favouring the use of intermittent traction and the other not supporting the use of continuous traction. Attention to research design flaws and description of traction characteristics is needed.

Adult↗