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Alternative
Therapy
Expectations Affect Results
NEW
YORK (Reuters Health) - Patients who expect acupuncture or massage
to work wonders for their back pain seem to improve more than
patients who have lower expectations, according to a report.
Dr. Donna
Kalauokalani, of Washington University in St. Louis, Missouri,
and her colleagues performed a 10-week study of 135 patients who
complained about chronic low back pain. At the start of the study,
patients were asked to rate how helpful they expected either acupuncture
or massage therapy to be on a scale of 0 to 10. Afterwards, they
were randomly assigned to receive one of the treatments for up
to 10 sessions.
About half
of the patients reported high hopes for the treatment, rating
their expectations as 8 or above, the researchers report in the
July issue of Spine. These individuals tended to be more functionally
disabled at the start of the study than others who reported lower
expectations, the authors note.
Patients with
higher expectations were five times more likely to report a substantial
improvement in their symptoms than those with average expectations,
the report indicates. This difference remained true even after
the investigators took into consideration the patients' sociodemographics,
health status, and physical factors.
Patients with
high expectations for massage tended to do better if they were
assigned to the massage group and those with high expectations
for acupuncture tended to do better if they received acupuncture,
Kalauokalani's team points out. On the other hand, ``general optimism
about treatment, divorced from a specific treatment, is not strongly
associated with outcome,'' they note.
``Patient
expectation thus may account for some of the variability in the
results of clinical trials of low back pain treatment,'' Kalauokalani
and colleagues write.
The findings
``also may be important for therapy choices made in the clinical
setting,'' the researchers conclude.
SOURCE:
Spine 2001;26.
Reference
Source 89
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