Efficacy of electroacupuncture plus warm needling therapy for plantar heel pain: a randomised waitlist-controlled trial

Objective: To investigate the therapeutic effects of electroacupuncture plus warm needling (EAWN) therapy on pain and foot function in adults with plantar heel pain (PHP). Methods: This prospective, randomised, parallel-group, waitlist-controlled trial was conducted at a Chinese medicine centre in Hong Kong between May 2018 and February 2019. Eighty eligible community-dwelling subjects with PHP (mean age 59.7 years; 85% female) were equally randomised to receive EAWN therapy or remain on a waitlist. The treatment group received six 30-min sessions of standardised EAWN therapy over 4 weeks; the control group received no treatment. The outcome measures were the visual analogue scale (VAS) score for first-step pain, foot function index (FFI) scores and global rating of change (GRC) scale scores. Assessments were made at baseline, week 2 and week 4 (primary endpoint). The treatment group underwent additional assessments at week 8. Outcomes were evaluated by intention-to-treat analysis. Results: Patients who received EAWN therapy exhibited greater improvements in the mean first-step pain VAS and all FFI scores than did those in the control group at weeks 2 and 4, with significant between-group differences (all P < 0.001). Compared with baseline, there were significant decreases in mean first-step pain VAS scores at weeks 2 and 4, and FFI scores at week 4, in the treatment group but not in the control group. The improvements in the treatment group continued until week 8. GRC scores at week 4 indicated improvement in all treated patients and only 22.5% of the control group patients ( P < 0.001). There were no study-related adverse events. Conclusion: EAWN therapy could be an effective treatment for PHP in middle-aged and older adults. Trial registration number: ChiCTR1800014906 (Chinese Clinical Trials Registry)

Effect of Warm-Needling Acupuncture in Overweight and Obese Adults: Protocol for a Systematic Review and Meta-Analysis

Background: Overweight and obesity are chronic metabolic diseases characterized by abnormal or excessive fat accumulation that presents a risk to health. Warm-needling acupuncture (WNA), which combines the characteristics of acupuncture and moxibustion, has been commonly used to manage obesity with reasonable weight control in recent years. Therefore, our objective is to systematically appraise the efficacy and safety of WNA for overweight and obesity.Methods: Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (via PubMed), Excerpt Medica Database (EMBASE), ALT HealthWatch, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Allied and Complementary Medicine Database (AMED), the Chinese Biomedical Literature Database (CBM), Wanfang Data, and grey literature (trial registries, conference proceedings and academic degree dissertations) will be searched for the identification of articles. All randomized controlled trials (RCTs) involving WNA independently or as an adjunct to other active therapies, compared with the same therapies alone, will be included. The principal outcome will be the difference in BMI from baseline to the end of studies. Secondary outcomes include the change of weight, waist circumference, percentage of body fat, serum lipid before and after treatment. The severity and incidence of adverse events will be measured as the safety assessment. Study selection, data extraction, and assessment of risk of bias will be performed independently by two reviewers. A third reviewer will resolve and determine disagreements. The Review Manager software (V.5.3.5) and Stata software (V.14.0) will be used for data synthesis. Furthermore, the quality of the evidence for the results will be described according to the Grading of Recommendations Assessment, Development and Evaluation system (GRADE) with GRADEprofiler software (V.3.6.1).Discussion: This is the first systematic review to evaluate the effect of WNA in the management of obesity. This program will provide a high-quality synthesis of the current evidence to identify whether WNA is an effective therapeutic approach for overweight and obesity.Systematic review registration: PROSPERO CRD42019146380.