David 1998.
| Methods | Type of trial: RCT Number analysed/randomly assigned: 51/70 Intention‐to‐treat analysis: NR | |
| Participants | Subacute, chronic neck pain with degenerative changes (i.e. cervical spondylosis), whiplash‐associated disorder (WAD) | |
| Interventions | INDEX TREATMENT
Physiotherapy (A): technique: standard localised mobilisation described by Maitland, rotation, posterior‐anterior oscillations, longitudinal traction; frequency: 1 session/wk; route: cervical spine COMPARISON TREATMENT Acupuncture (B): technique: local needling of trigger point, regional needling (GB21‐supraspinatus tender area), distal needling (LI4‐web space between thumb and first finger); frequency: 1 session/wk; dose: needle left in situ for 15 minutes; route: as described under technique CO‐INTERVENTION: NR Duration of treatment: 6 weeks, 6 sessions maximum Duration of follow‐up: 24 weeks |
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| Outcomes | PAIN (VAS, 0 to 100) Baseline mean: A 51, B 51 End of study mean: A 22, B 28 Absolute benefit: A 29, B 23 Reported results: not significant SMD (A vs B): ‐0.33 (95% CI ‐0.89 to 0.23) (power 24%) FUNCTION (NPQ, 0 to 36) Baseline mean: A 36, B 36 End of study mean: A 22, B 25 Absolute benefit: A 14, B 11 Reported results: not significant SMD (A vs B): ‐0.16 (95% CI ‐0.72 to 0.39) (power 15%) PARTICIPANT SATISFACTION: NR GPE: NR QoL (GHQ 28, 0 to 28) Reported results: not significant RR (A vs B): 1.07 (95% CI 0.48 to 2.35) SIDE EFFECTS: no side effects with acupuncture COST OF CARE: NR |
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| Notes | ||
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Unclear risk | Randomisation technique not specified |
| Allocation concealment (selection bias) | Unclear risk | Not described |
| Blinding of Participants (performance bias) | High risk | Not possible owing to study design |
| Blinding of Personal (performance bias) | High risk | Not possible owing to study design |
| Blinding of the Outcome assessor (detection bias) | High risk | Not possible owing to study design |
| Incomplete outcome data (attrition bias) | High risk | Page 1119, right column 2, dropout not described and exceeds 30% long term |
| Randomized Participants analysed were allocated (attrition bias) | High risk | Table 1: Numbers do not add up |
| Selective outcome (reporting bias) | Unclear risk | No published protocol |
| Similar groups at baseline? | Low risk | Figures 1, 2 and 3 |
| co‐interventions avoided or similar? | Unclear risk | Not described |
| Compliance acceptable? | Unclear risk | Not described |
| Similar timing of outcome assessment? | Low risk | Baseline, 6 weeks, 6 months |