Trial of Acupuncture Pelvic and Low Back Pain in Pregnancy (Medical and Economical Assessment) (GAME)
Pelvic girdle and low back pain are common in pregnancy, and cause severe impairment in 10% of women. Our hypothesis is that offering acupuncture in addition to standard care would reduce pain and impairment throughout pregnancy. 300 pregnant women from 5 maternity units will be randomized over a 3 year period to receive standard care or standard care plus acupuncture. Main outcome will be the number of days during pregnancy with maximum pain ≤ 4/10. Secondary outcomes will compare groups for an impairment score and for direct and indirect costs.
|Study Design:||Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
|Official Title:||Trial of Acupuncture Pelvic and Low Back Pain in Pregnancy (TAPPP)|
- Number and % of days during pregnancy with maximum pain ≤ 4/10. [ Time Frame: at 4 weeks ] [ Designated as safety issue: No ]daily recording on logbook (self assessment)
- Mean Oswestry disability score [ Time Frame: during pregnancy ] [ Designated as safety issue: No ]
- Number and % of days with maximum pain ≤ 4/10. [ Time Frame: during pregnancy ] [ Designated as safety issue: No ]
- direct and indirect costs [ Time Frame: during pregnancy ] [ Designated as safety issue: No ]direct costs related to pregnancy care and pain management, indirect costs related to impairment throughout pregnancy and the immediate postpartum.
|Study Start Date:||September 2012|
|Estimated Study Completion Date:||April 2015|
|Estimated Primary Completion Date:||April 2015 (Final data collection date for primary outcome measure)|
5 acupuncture sessions over a 4 week period plus standard treatment
Active Comparator: usual care
standard treatment (pregnancy belt, behavioral recommendations, exercises, pain killers as prescribed by usual health care professional)
|Other: usual care|
Background. Pelvic and low back pain (PLBP) affects 30% of pregnant women for weeks or months, causing severe impairment in 10% of women. Standard treatment, based on pain killers, postural recommendations, exercises, is of limited value. Previous trials showed that adding acupuncture to standard treatment reduces pain and impairment in the short run.
Hypothesis Providing acupuncture to pregnant women with PLBP could reduce pain and impairment throughout pregnancy, thus reducing other direct and indirect cots related to PLBP.
Primary Outcome. Number and % of days during pregnancy with maximum pain ≤ 4/10.
Secondary Outcomes. Pain scale 4 weeks after inclusion, mean Oswestry disability score between inclusion and delivery, direct costs related to pregnancy care and pain management, indirect costs related to impairment throughout pregnancy and the immediate postpartum.
Method. Multicenter randomized trial with parallel groups. Intervention: 5 acupuncture sessions over 4 weeks, plus standard treatment. Controls: standard treatment.
Analysis per pregnancy Follow up: logbook kept by he patient plus analysis of obstetrical records. Number of patients: 300 Inclusion criteria: singleton uncomplicated 16-34 weeks pregnancy, with PLBP > 4/10 Exclusion criteria Obstetrical complication other than PLBP, contra indication to acupuncture, sciatica, maternal age < 18, no health insurance.
Duration. Overall duration: 3 years and 6 months, inclusions over 3 years. Duration of inclusion per patient: 2-26 weeks Number of participating centers 5
Please refer to this study by its ClinicalTrials.gov identifier: NCT01848587
|Centre d'Investigation Clinique Paris Est - Hôpital Pitié Salpêtrière|
|Paris, France, 75013|
|Principal Investigator:||Marc Dommergues, Md, PhD||APHP|