Authors (including presenting author) :
WONG KK(1), WONG MF (1), WONG NM(2), CHENG SK(3)
Affiliation :
(1) Occupational Therapy Department, United Christian Hospital (2) Department of Orthopaedics & Traumatology, United Christian Hospital (3)Department of Rehabilitation Sciences, The Hong Kong Polytechnic University
Introduction :
Low back pain (LBP) is one of the most common conditions resulting in socioeconomic burden on health care systems. There is emerging evidence that Bowen Therapy may improve musculoskeletal pain. While it can be an effective treatment strategy to enhance pain modulation; studies on the clinical effect are scarce.
Objectives :
To conduct a RCT to assess the effectiveness of Bowen Therapy on pain, function & disability, self-efficacy and health-related Quality of Life in terms of pain intensity and pain relief using Numeric Pain Rating Scales (NPRS), Owestry Disability Index (ODI), Chinese version of Pain Self-efficacy Questionnaire (PSEQ-HK) and SF-12 – version 2 (HK).
Methodology :
Parallel-group randomized controlled trial (RCT) study was employed. The trial was registered with ClinicalTrial.gov (Identifier: NCT04861129). 46 participants with informed consent who meet the eligibility criteria of study were recruited and randomly assigned to one of two groups i.e. Bowen Therapy group and Sham Bowen Therapy group. Permuted block randomization was applied to control the key confounding variable of catastrophizing which was significantly associated with pain and disability in chronic LBP. Sequentially numbered, opaque, sealed envelopes (SNOSE) was used to ensure the allocation sequence before the group allocation. Double blinding of participants and outcome assessor was adopted. Measurements were collected at the baseline, post-intervention and at a 4-week follow-up.
Result & Outcome :
Data screening was performed to exam data accuracy, detect outliers, handle missing data and conduct assumption testing. The results of two-way mixed ANOVA showed there was a significant group x time interaction effect on pain intensity, F(2, 88) = 9.06, p < 0.001, ηp2 = 0.17 (large). Multiple comparison with Fisher's least significant difference (LSD) showed significant pain score difference in BT group across baseline to post-intervention, t(88) = 4.83, p < 0.01, d = 1.03 (large), and baseline to 4-week post intervention, t(88) = 7.29, p < 0.01, d = 1.55 (large). The mean difference of pain intensity in BT group was -1.35 95% CI: 0.98 - 1.72. No statistically significant difference was found in pain intensity at follow-up time points in Sham-BT group. Other secondary outcomes were also found significant interaction effect between group x time (p < 0.05). The results of the present study supported 6-session Bowen Therapy can be effective and viable treatment option for patient with chronic LBP. It provides a solid evidence on the clinical application of Bowen Therapy alongside conventional treatment.
