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    Evaluation of Randomized Controlled Trial Research

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    Critical evaluation of a research paper "Treatment of low back pain by acupressure and physical therapy: randomised controlled trial"

    Link to paper: http://www.bmj.com/content/332/7543/696.pdf%2Bhtml

    Evaluation questions for sections below are "attached" as word document:

    Evaluation of the Introduction:
    - Literature review:
    - Aim/objective

    Evaluation of the Methods Section:
    - Sample size and Subjects selection
    - Apparatus/instrumentation
    - Control group/s
    - Subject assignment
    - Treatment parameters
    - Rosenthal & Hawthorn effects?
    - Tables and graphs
    - Selection of statistics
    - Interpretation of the findings

    Discussing quality of paper:
    - Internal validity
    - External validity
    - Overall quality of paper

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    Solution Preview

    Setting: Orthopaedic clinic in Kaohsiung, Taiwan.
    Participants: 129 patients with chronic low back pain.
    Intervention: Acupressure or physical therapy for one month.

    Main Outcome Measures: Self-administered Chinese versions of standard outcome measures for low back pain (primary outcome: Roland and Morris disability questionnaire) at baseline, after treatment, and at six month follow-up. Results: The mean total Roland and Morris disability questionnaire score after treatment was significantly lower in the acupressure group than in the physical therapy group regardless of the difference in absolute score (- 3.8, 95% confidence interval - 5.7 to - 1.9) or mean change from the baseline (- 4.64, - 6.39 to - 2.89). Acupressure conferred an 89% (95% confidence interval 61% to 97%) reduction in significant disability compared with physical therapy. The improvement in disability score in the acupressure group compared with the physical group remained at six month follow-up. Statistically significant differences also occurred between the two groups for all six domains of the core outcome, pain visual scale, and modified Oswestry disability questionnaire after treatment and at six month follow-up. Conclusions: Acupressure was effective in reducing low back pain in terms of disability, pain scores, and functional status. The benefit was sustained for six months.

    Evaluation of the Introduction:

    - Literature review:

    The literature review shows that acupressure is effective in relieving pain associated with back pain as several randomized controlled trials have been conducted proving this statement. The outcomes in those studies assessed the patients' description of their pain while failing to take into account functional status and disability as recommended by most low back pain researchers. Literature shows that outcome measurement in regard to ...

    Solution Summary

    Evaluation of a Randomized controlled trial Research