Acupuncture improved dyspnea on exertion in COPD

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Acupuncture improved dyspnea on exertion in COPD
Acupuncture improved dyspnea on exertion in COPD

HealthDay News -- Acupuncture appears to improve dyspnea during exertion in patients with chronic obstructive pulmonary disease (COPD), study findings show.

Patients treated with acupuncture in a small randomized trial experienced less shortness of breath during exercise compared with placebo, Masao Suzuki, PhD, from Kyoto University in Japan and colleagues reported online in Archives of Internal Medicine.

They randomly assigned 68 patients with COPD, who were already receiving standard medication, to traditional acupuncture or placebo needling (in which needles did not penetrate the skin) in a 1:1 ratio. Patients in both groups received needling at the same acupoints once weekly for 12 weeks.

The main outcome measure was change on the 10-point Borg dyspnea scale (higher scores indicated more severe impairment) measured after a 6-minute walk test. Average baseline Borg scale scores were 5.5 in the acupuncture group and 4.2 in the placebo group.

After the 12-week treatment program, the average Borg score decreased to 1.9 in the acupuncture group, but was slightly worse in the placebo group at 4.6. The mean difference in Borg score from baseline was significant at -3.6 in the acupuncture group vs. 0.4 in the placebo group.

Patients assigned to traditional acupuncture also experienced improvements in walk distance during exercise compared with placebo, the researchers found. At baseline, the average distance walked for patients in the acupuncture group was 405.2 meters compared with 373.2 meters in the placebo group. After 12 weeks, those in the acupuncture group had gained 19.4 meters on average, whereas those in the placebo group had lost 63.5 meters.

"This study clearly demonstrates that acupuncture is a useful adjunctive therapy in reducing dyspnea on exertion in patients with COPD," the researchers wrote.

However, the underlying mechanisms by which acupuncture may improve pulmonary function are not clear. "[R]elaxation of hyperactivated respiratory muscles and the correction of the autonomic tone might cause the beneficial effect on pulmonary function," the researchers suggested.

In an accompanying editorial, George Lewith, MD, and Mike Thomas, PhD, both of the University of Southampton in Southampton, U.K., called the study "thoughtful and methodologically rigorous," but said that the findings still need to be replicated in larger studies. 

They suggested that future studies focus on designing appropriate placebo and control interventions, as well as analyzing cost, deciding what is a reasonable dose and what is best practice.

Suzuki M et al. Arch Intern Med. 2012; doi:10.1001/archinternmed.2012.1233.

Lewith GT, Thomas M. Arch Intern Med. 2012; doi:10.1001/archinternmed.2012.1674.

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