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KMID : 1147720180110060367
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Journal of Acupuncture and Meridian Studies
2018 Volume.11 No. 6 p.367 ~ p.374
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Pragmatic Combinations of Acupuncture Points for Lateral Epicondylalgia are Unreliable in the Physiotherapy Setting
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Alvim Danielle T.
Ferreira Arthur S.
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Abstract
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This study describes the reliability of pragmatic combinations of acupuncture points for lateral epicondylalgia (LE) as prescribed by physiotherapists who were experts in acupuncture. Raters (n = 14; 33?59 years) independently prescribed acupuncture points for 30 simulated human patients with LE who were surveyed via a printed questionnaire. The frequency and cooccurrence of acupuncture points prescribed for patients with lateral epicondylitis were assessed. Absolute agreement and Light's kappa (κLight) with 95% confidence interval (CI) were used to quantify the interrater agreement. Raters prescribed 103 unique acupuncture points in different combinations with a median (min?max) of 5 (0?11) acupuncture points. The most prescribed acupuncture point was LI-11 (297 of 420; 71%), and the most common cooccurring acupuncture points were LI-11 and LI-4 (160 of 420; 38%). The absolute agreement for prescribing the acupuncture points ranged from 70% (point GB-20) to 0% (points LI-10, SP-6, LI-11, GB-34, LI-12, and LI-4). Point LR-3 showed the highest interrater reliability for prescribing the acupuncture points [κLight = 0.112, 95% CI = (0.055?0.194)], whereas point LI-4 showed the lowest reliability [κLight = ?0.003, 95% CI = (?0.024 to 0.024)]. These findings suggest that pragmatic prescriptions of acupuncture points for LE are unreliable among physiotherapists who are experts in acupuncture. Explicit, high-level evidence-based rules for prescribing and teaching combinations of acupuncture points for LE are warranted.
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KEYWORD
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acupuncture therapy, expert opinion, lateral epicondylitis, rehabilitation, reproducibility of results
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