Acupuncture treatment: multidimensional assessment of low back pain in pregnant women

Martins, Eveliny Silva; Tavares, Tainan Maria Cruz Lopes; Lessa, Paula Renata Amorim; Aquino, Priscila de Souza; Castro, Régia Christina Moura Barbosa; Pinheiro, Ana Karina Bezerra

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ORIGINAL ARTICLE • Rev. esc. enferm. USP 52 • 2018 • https://doi.org/10.1590/S1980-220X2017040303323 copy

Acupuncture treatment: multidimensional assessment of low back pain in pregnant women^* * Excerpt from the thesis “Efeitos da Acupuntura no tratamento de dor lombar em gestantes”, Universidade Federal do Ceará, 2017.

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective

To evaluate the effects of acupuncture in the treatment of low back pain in pregnant women in the second and third trimesters of pregnancy.

Method

A quasi-experimental pre-post design was applied to pregnant women at a gestational age between 14 and 37 weeks, who had complaints of low back pain. Acupuncture sessions were performed, working systemic and auricular points. The McGill questionnaire was used to assess pain, as well as the instrument for identifying the sociodemographic, clinical and obstetric profile.

Results

The acupuncture technique performed in up to six sessions in 56 pregnant women with low back pain had positive effects on the participants’ health. According to the pain assessment, there was a statistically significant reduction in the low back pain among the pregnant women as early as in the second session, with a gradual improvement with the advancement of the number of sessions. There were no serious adverse events related to acupuncture.

Conclusion

Acupuncture offered significant effects for reducing or relieving pain in pregnant women. The participants expressed satisfaction and well-being as they left each session.

Acupuncture; Pregnant Women; Low Back Pain; Obstetric Nursing; Complementary Therapies

MCGILL	Opening session	2^nd session	4^th session	6^th session	Reduction
Number of sensory descriptors	7.38 ± 2.71	6.54 ± 3.10	4.87 ± 3.71	2.41 ± 2.91
Number of affective descriptors	3.14 ± 1.62	2.35 ± 1.92	1.66 ± 1.70	0.62 ± 1.05
Number of evaluative descriptors	1 ± 0	0.83 ± 0.38	0.74 ± 0.45	0.48 ± 0.51
Number of miscellaneous descriptors	2.59 ± 1.52	2.28 ± 1.47	1.58 ± 1.54	0.59 ± 1.18

Total number of descriptors	14.05 ± 5.42	11.74 ± 6.51	8.84 ± 6.91	4.10 ± 5.18	Total 9.95

Sensory Pain Index	17.45 ± 8.56	13.02 ± 7.66	9.00 ± 7.46	3.66 ± 4.97
Affective Pain Index	4.71 ± 3.12	3.11 ± 2.91	1.97 ± 2.14	0.83 ± 1.95
Evaluative Pain Index	2.43 ± 1.44	1.63 ± 0.97	1.14 ± 0.79	0.69 ± 0.81
Miscellaneous pain index	5.64 ± 4.22	3.98 ± 3.31	2.57 ± 2.66	0.66 ± 1.32

Total Pain Index	30.23 ± 15.55	21.65 ± 13.19	14.08 ± 11.21	5.83 ± 7.95	Total 24.4

Initial moment	Final moment	Initial assessment	Final assessment	p-value
Number of sensory descriptors
Start	2^nd session	7.32 ± 2.73	6.54 ± 3.10	0.033
Start	4^th session	7.54 ± 2.67	4.87 ± 3.71	<0.001
Start	6^th session	7.34 ± 2.68	2.41 ± 2.91	<0.001
2^nd session	4^th session	6.92 ± 2.77	4.87 ± 3.71	<0.001
2^nd session	6^th session	6.86 ± 2.76	2.41 ± 2.91	<0.001
4^th session	6^th session	5.55 ± 3.54	2.41 ± 2.91	<0.001

Number of affective descriptors
Start	2^nd session	3.11 ± 1.55	2.35 ± 1.92	<0.001
Start	4^th session	3.30 ± 1.37	1.66 ± 1.70	<0.001
Start	6^th session	3.21 ± 1.37	0.62 ± 1.05	<0.001
2^nd session	4^th session	2.49 ± 1.91	1.66 ± 1.70	0.015
2^nd session	6^th session	2.28 ± 1.79	0.62 ± 1.05	<0.001
4^th session	6^th session	1.93 ± 1.62	0.62 ± 1.05	0.001

Number of evaluative descriptors
Start	2^nd session	1	0.83 ± 0.38	0.005
Start	4^th session	1	0.74 ± 0.45	0.002
Start	6^th session	1	0.48 ± 0.51	<0.001
2^nd session	4^th session	0.89 ± 0.32	0.74 ± 0.45	0.059
2^nd session	6^th session	0.93 ± 0.26	0.48 ± 0.51	<0.001
4^th session	6^th session	0.86 ± 0.35	0.48 ± 0.51	<0.001

Number of miscellaneous descriptors
Start	2^nd session	2.57 ± 1.57	2.28 ± 1.47	<0.001
Start	4^th session	2.70 ± 1.61	1.58 ± 1.54	<0.001
Start	6^th session	2.66 ± 1.59	0.59 ± 1.18	<0.001
2^nd session	4^th session	2.43 ± 1.46	1.58 ± 1.54	<0.001
2^nd session	6^th session	2.45 ± 1.40	0.59 ± 1.18	<0.001
4^th session	6^th session	1.79 ± 1.50	0.59 ± 1.18	<0.001

Number of total descriptors					Reduction

Start	2^nd session	13.94 ± 5.38	11.74 ± 6.51	<0.001	2.2
Start	4^th session	14.46 ± 5.16	8.84 ± 6.91	<0.001	5.62
Start	6^th session	14.10 ± 5.01	4.10 ± 5.18	<0.001	10
2^nd session	4^th session	12.41 ± 6.13	8.84 ± 6.91	<0.001	3.57
2^nd session	6^th session	12.10 ± 5.86	4.10 ± 5.18	<0.001	8
4^th session	6^th session	10.14 ± 6.44	4.10 ± 5.18	<0.001	6.04

Initial moment	Final moment	Initial assessment	Final assessment	Total reduction	p-value
Sensory Pain Index
Start	2^nd session	17.47 ± 8.94	13.02 ± 7.66		<0.001
Start	4^th session	18.76 ± 8.86	9.00 ± 7.46		<0.001
Start	6^th session	18.00 ± 8.52	3.66 ± 4.97		<0.001
2^nd session	4^th session	13.95 ± 7.57	9.00 ± 7.46		<0.001
2^nd session	6^th session	13.62 ± 7.60	3.66 ± 4.97		<0.001
4^th session	6^th session	10.00 ± 7.42	3.66 ± 4.97		<0.001

Affective Pain Index
Start	2^nd session	4.77 ± 3.21	3.11 ± 2.91		<0.001
Start	4^th session	5.03 ± 2.98	1.97 ± 2.14		<0.001
Start	6^th session	4.72 ± 2.81	0.83 ± 1.95		<0.001
2^nd session	4^th session	3.22 ± 2.84	1.97 ± 2.14		0.005
2^nd session	6^th session	2.86 ± 2.72	0.83 ± 1.95		<0.001
4^th session	6^th session	2.24 ± 2.10	0.83 ± 1.95		0.002

Evaluative Pain Index
Start	2^nd session	2.55 ± 1.52	1.63 ± 0.97		<0.001
Start	4^th session	2.65 ± 1.57	1.14 ± 0.79		<0.001
Start	6^th session	2.66 ± 1.72	0.69 ± 0.81		<0.001
2^nd session	4^th session	1.76 ± 0.90	1.14 ± 0.79		0.002
2^nd session	6^th session	1.69 ± 0.76	0.69 ± 0.81		<0.001
4^th session	6^th session	1.31 ± 0.71	0.69 ± 0.81		0.001

Miscellaneous pain index
Start	2^nd session	5.64 ± 4.34	3.98 ± 3.31		0.004
Start	4^th session	5.73 ± 4.13	2.57 ± 2.66		<0.001
Start	6^th session	5.55 ± 4.11	0.66 ± 1.32		<0.001
2^nd session	4^th session	4.19 ± 3.27	2.57 ± 2.66		<0.001
2^nd session	6^th session	4.31 ± 3.42	0.66 ± 1.32		<0.001
4^th session	6^th session	2.90 ± 2.65	0.66 ± 1.32		<0.001

Total Pain Index				Index Reduction

Start	2^nd session	30.43 ± 16.23	21.65 ± 13.19	8.78	<0.001
Start	4^th session	32.16 ± 15.61	14.08 ± 11.21	18.08	<0.001
Start	6^th session	30.93 ± 15.04	5.83 ± 7.95	25.01	<0.001
2^nd session	4^th session	23.08 ± 12.77	14.08 ± 11.21	9	<0.001
2^nd session	6^th session	22.45 ± 12.48	5.83 ± 7.95	16.62	<0.001
4^th session	6^th session	15.69 ± 10.79	5.83 ± 7.95	9.86	<0.001

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

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[1] Corresponding author: Eveliny Silva Martins. Rua Alexandre Baraúna, 1115 – Rodolfo Teófilo CEP 60416-000 – Fortaleza – CE, Brazil evelinymartins@yahoo.com.br

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Acupuncture treatment: multidimensional assessment of low back pain in pregnant women* * Excerpt from the thesis “Efeitos da Acupuntura no tratamento de dor lombar em gestantes”, Universidade Federal do Ceará, 2017.

ABSTRACT

Objective

Method

Results

Conclusion

Acupuncture treatment: multidimensional assessment of low back pain in pregnant women^* * Excerpt from the thesis “Efeitos da Acupuntura no tratamento de dor lombar em gestantes”, Universidade Federal do Ceará, 2017.