human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Introduction This study aims to assess the feasibility of acupuncture as an add-on intervention for patients with non-emergent acute musculoskeletal pain and primary headache in an emergency department ( ED ) setting . Methods and analysis A total of 40 patients who present to the ED and are diagnosed to have acute non-specific neck pain , ankle sprain or primary headache will be recruited by ED physicians . An intravenous or intramuscular injection of analgesics will be provided as the initial st and ard pain control intervention for all patients . Patients who still have moderate to severe pain after the 30 min of initial st and ard ED management will be considered eligible . These patients will be allocated in equal proportions to acupuncture plus st and ard ED management or to st and ard ED management alone based on computer-generated r and om numbers concealed in opaque , sealed , sequentially numbered envelopes . A 30 min session of acupuncture treatment with manual and /or electrical stimulation will be provided by qualified Korean medicine doctors . All patients will receive additional ED management at the ED physician 's discretion and based on each patient 's response to the allocated intervention . The primary outcome will be pain reduction measured at discharge from the ED by an unblinded assessor . Adverse events in both groups will be documented . Other outcomes will include the patient-reported overall improvement , disability due to neck pain ( only for neck-pain patients ) , the treatment response rate , the use of other healthcare re sources and the patients ’ perceived effectiveness of the acupuncture treatment . A follow-up telephone interview will be conducted by a blinded assessor 72±12 h after ED discharge . Ethics and dissemination Written informed consent will be obtained from all participants . The study has been approved by the Institutional Review Boards ( IRBs ) . The results of this study will guide a full-scale r and omised trial of acupuncture in an ED context . Trial registration number Clinical Trials.gov : NCT02013908 BACKGROUND AND OBJECTIVE To develop a checklist of items measuring the quality of reports of r and omized clinical trials ( RCTs ) assessing nonpharmacological treatments ( NPTs ) . STUDY DESIGN AND SETTING The Delphi consensus method was used to select and reduce the number of items in the checklist . A total of 154 individuals were invited to participate : epidemiologists and statisticians involved in the field of methodology of RCTs ( n = 55 ) , members of the Cochrane Collaboration ( n = 41 ) , and clinicians involved in planning NPT clinical trials ( n = 58 ) . Participants ranked on a 10-point Likert scale whether an item should be included in the checklist . RESULTS Fifty-five experts ( 36 % ) participated in the survey . They were experienced in systematic review s ( 68 % were involved in the Cochrane Collaboration ) and in planning RCTs ( 76 % ) . Three rounds of the Delphi method were conducted to achieve consensus . The final checklist contains 10 items and 5 subitems , with items related to the st and ardization of the intervention , care provider influence , and additional measures to minimize the potential bias from lack of blinding of participants , care providers , and outcome assessors . CONCLUSIONS This tool can be used to critically appraise the medical literature , design NPT studies , and assess the quality of trial reports included in systematic review OBJECTIVES To compare the efficacies of dry needling of trigger points ( TrPs ) with and without paraspinal needling in myofascial pain syndrome of elderly patients . DESIGN Single-blinded , r and omized controlled trial . SUBJECTS Forty ( 40 ) subjects , between the ages of 63 and 90 with myofascial pain syndrome of the upper trapezius muscle . INTERVENTIONS Eighteen ( 18 ) subjects were treated with dry needling of all the TrPs only and another 22 with additional paraspinal needling on days 0 , 7 , and 14 . RESULTS At 4-week follow-up the results were as follows : ( 1 ) TrP and paraspinal dry needling result ed in more continuous subjective pain reduction than TrP dry needling only ; ( 2 ) TrP and paraspinal dry needling result ed in significant improvements on the geriatric depression scale but TrP dry needling only did not ; ( 3 ) TrP and paraspinal dry needling result ed in improvements of all the cervical range of motions but TrP dry needling  only did not in extensional cervical range of motion ; and ( 4 ) no cases of gross hemorrhage were noted . CONCLUSIONS TrP and paraspinal dry needling is suggested to be a better method than TrP dry needling only for treating myofascial pain syndrome in elderly patients Background Neck pain caused by cervical spondylosis has become a common health problem worldwide among > 40-year-old adults .  Acupuncture intervention is one of the most popular treatment measures for this disorder . However , evidence for its efficacy in relieving neck pain and recovering neck physiological function has not been established in r and omized , placebo-controlled trials . The primary aim of this trial is to assess the efficacy and safety of active acupuncture compared with sham acupuncture intervention for neck pain caused by cervical spondylosis . Methods / Design We will conduct a r and omized , double-blind , parallel-group , placebo-controlled trial comparing active acupuncture with placebo ( sham acupuncture ) . A total of 456 patients with neck pain caused by cervical spondylosis who meet the eligibility criteria from outpatient clinics of the Second People ’s Hospital of Fujian Province and the Affiliated Rehabilitation Hospital , Fujian University of Traditional Chinese Medicine will be recruited and r and omized into an active acupuncture or sham acupuncture group . The participants will undergo treatment sessions with either active or sham acupuncture intervention five times a week for 2 weeks . Evaluation by blinded assessors at baseline and at intervention for 1 and 2 weeks will include demographic characteristics , vali date d question naires ( Northwick Park Neck Pain Question naire ( NPQ ) scale , Short-Form 36 ( SF-36 ) scale , and McGill pain scale ) , examination of neck physiological function , and adverse events . All included patients will be followed up and investigated for relapse of neck pain at 4 , 8 , and 12 weeks after intervention . Discussion This paper describes the rationale and design of a r and omized double-blind , placebo-controlled trial that aims to determine the efficacy and safety of acupuncture intervention for neck pain caused by cervical spondylosis . The primary outcomes are changes in the NPQ score and neck physiological function . Secondary outcome measures include quality of life , adverse events , and relapse of neck pain . If successful , this project will provide evidence of the efficacy and safety of acupuncture for neck pain caused by cervical spondylosis . Trial registration Chinese Clinical Trial Registry : ChiCTR-TRC-12002206 . Registration date : 11 May 2012 To evaluate the efficacy of Chinese medicine ( CM ) acupuncture for  chronic neck pain ( CNP ) , a single blind , controlled , crossover , clinical trial was undertaken . Twenty-nine volunteers with CNP were r and omly recruited into two groups . Both groups received two phases of treatment with a washout period between the two phases . Group A ( 14 volunteers ) received CM acupuncture in the first phase and sham acupuncture in the second , while Group B ( 15 volunteers ) received sham in the first and real in the second . CM acupuncture was individualized and consisted of nine sessions on both local and distal points . Manual twisting of the needle was applied on all points plus strong electrical stimulation of distal points in CM acupuncture . Sham acupoints ( lateral to the real ) and sham ( weak ) electrical stimulation was used in the control group . Comparison of subjective and objective measures between the two groups was made at different periods , including baseline , after each phase of treatment , after washout , and after the 16th week follow-up . The subjective measures included pain intensity , duration per day , analgesic medication count , visual analogue scales ( VAS ) and neck disability index ( NDI ) . The objective measures consisted of neck range of motion ( ROM ) and pain threshold ( PT ) . Both the real and sham treatments significantly reduced subjective pain , without significant differences between groups for most subjective measures . Objective measures showed no significant change for either group before and after each period or by inter-groups analysis . A minimum 16-week effect of both real and sham acupuncture was found for subjective measures in the follow-up periods . Further study is recommended with an increased sample size , a longer washout period , and a longer baseline period Background Chronic whiplash is a common and costly problem . Sensory hypersensitivity is a feature of chronic whiplash that is associated with poor responsiveness to physical treatments such as exercise . Modalities such as dry-needling have shown some capacity to modulate sensory hypersensitivity , suggesting that when combined with advice and exercise , such an approach may be more effective in the management of chronic whiplash . The primary aim of this project is to investigate the effectiveness of  dry-needling , advice and exercise for chronic whiplash . Method / Design A double-blind r and omised controlled trial will be conducted . 120 participants with chronic whiplash , grade II will be r and omised to receive either 1 ) dry-needling , advice and exercise or 2 ) sham dry-needling , advice and exercise . All participants will receive an educational booklet on whiplash . Participants who are r and omised to Group 1 will receive 6 treatments of combined dry-needling and exercise delivered in the first 3 weeks of the 6 week program , and 4 treatments of exercise only in the last 3 weeks of the program . Participants r and omised to Group 2 will receive an identical protocol , except that a sham dry-needling technique will be used instead of dry-needling . The primary outcome measures are the Neck Disability Index ( NDI ) and participants ' perceived recovery . Outcomes will be measured at 6 , 12 , 24 and 52 weeks after r and omization by an assessor who is blind to the group allocation of the participants . In parallel , an economic analysis will be conducted . Discussion This trial will utilise high quality trial method ologies in accordance with CONSORT guidelines . The successful completion of this trial will provide evidence of the effectiveness and cost-effectiveness of a combined treatment approach for the management of chronic whiplash . Trial registration OBJECTIVE To probe into an effective therapy for chronic pain of cervical intervertebral disc . METHODS Sixty-six cases of chronic pain of cervical intervertebral disc were r and omly divided into an acupoint sticking group and an acu puncture group , 33 cases in each group . The acupoint sticking group was treated with acupoint sticking therapy , and the acupuncture group with acupuncture . Ti and ing ( LI 17 ) , Futu ( LI 18 ) , Dazhui ( GV 14 ) , Tianzong ( S 11 ) , etc . were selected in the two groups . After treatment for 3 therapeutic courses , their therapeutic effects were observed . RESULTS The effective rate was 93.5 % in the acupoint sticking group and 72.4 % in the acupuncture group , the former being better than the latter ( P<0.05 ) ; in a 3-month following-up survey , the effective rate was 90.3 % in the acupoint sticking group and 65.5 % in the acupuncture group , the former being better than the latter ( P<0.05 ) . CONCLUSION The acupoint sticking therapy has an satisfactory therapeutic effect on chronic pain of cervical intervertebral disc OBJECTIVE To evaluate the therapeutic effects of acupotomy-injection with FENG Tian-you spinal manipulation ( FSM ) for treating cervical spondylotic radiculopathy ( CSR ) . METHODS Seventy-two patients with CSR were r and omly divided into two groups ( n = 36 respectively ) : treatment and control group . The patients in treatment group were treated with acupotomy-injection combined with FSM , and patients in control group were treated with traction . All the patients were followed up for 3 months after treatment and the therapeutic effects were evaluated . RESULTS Totally there were 72 patients and 69 completed the treatment and the other 3 patients withdraw from treatment . In treatment group , 24 patients were cured , 6 patients had remarkable effects , 4 effective and 2 ineffective ; as well in control group , above data were 15 , 3 , 10 and 8 respectively . The comprehensive effects and the cured patients in the treatment group were obviously better than those of control group ( P < 0.05 ) . The comparison of scales for assessment of symptoms and short-form McGill Pain Question aire before and after treatment in two groups had significant differences ( P < 0.001 ) . CONCLUSION The method of acupotomy-injection combined with FSM for treating CSR is better than conventional traction method UNLABELLED The aim of this paper was to quantify the influence of the physician 's training and experience in the field of acupuncture on the outcome in patients with chronic pain . Patients visiting their physician because of chronic low back pain , headache , pain due to osteoarthritis of the knee or hip , or neck pain , were included in 4 multicenter , r and omized , controlled studies . All patients received routine care ; patients in the acupuncture groups received additional acupuncture treatment ( on average 10 sessions ) . The data was pooled , and the 3-month change from baseline of the SF-36 bodily pain subscale as the main outcome defined . A total of 9,990 patients ( mean age 49.6 + /- 13.6 years , 68 % female ) treated by 2,781 phys 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Introduction This study aims to assess the feasibility of acupuncture as an add-on intervention for patients with non-emergent acute musculoskeletal pain and primary headache in an emergency department ( ED ) setting . Methods and analysis A total of 40 patients who present to the ED and are diagnosed to have acute non-specific neck pain , ankle sprain or primary headache will be recruited by ED physicians . An intravenous or intramuscular injection of analgesics will be provided as the initial st and ard pain control intervention for all patients . Patients who still have moderate to severe pain after the 30 min of initial st and ard ED management will be considered eligible . These patients will be allocated in equal proportions to acupuncture plus st and ard ED management or to st and ard ED management alone based on computer-generated r and om numbers concealed in opaque , sealed , sequentially numbered envelopes . A 30 min session of acupuncture treatment with manual and /or electrical stimulation will be provided by qualified Korean medicine doctors . All patients will receive additional ED management at the ED physician 's discretion and based on each patient 's response to the allocated intervention . The primary outcome will be pain reduction measured at discharge from the ED by an unblinded assessor . Adverse events in both groups will be documented . Other outcomes will include the patient-reported overall improvement , disability due to neck pain ( only for neck-pain patients ) , the treatment response rate , the use of other healthcare re sources and the patients ’ perceived effectiveness of the acupuncture treatment . A follow-up telephone interview will be conducted by a blinded assessor 72±12 h after ED discharge . Ethics and dissemination Written informed consent will be obtained from all participants . The study has been approved by the Institutional Review Boards ( IRBs ) . The results of this study will guide a full-scale r and omised trial of acupuncture in an ED context . Trial registration number Clinical Trials.gov : NCT02013908 BACKGROUND AND OBJECTIVE To develop a checklist of items measuring the quality of reports of r and omized clinical trials ( RCTs ) assessing nonpharmacological treatments ( NPTs ) . STUDY DESIGN AND SETTING The Delphi consensus method was used to select and reduce the number of items in the checklist . A total of 154 individuals were invited to participate : epidemiologists and statisticians involved in the field of methodology of RCTs ( n = 55 ) , members of the Cochrane Collaboration ( n = 41 ) , and clinicians involved in planning NPT clinical trials ( n = 58 ) . Participants ranked on a 10-point Likert scale whether an item should be included in the checklist . RESULTS Fifty-five experts ( 36 % ) participated in the survey . They were experienced in systematic review s ( 68 % were involved in the Cochrane Collaboration ) and in planning RCTs ( 76 % ) . Three rounds of the Delphi method were conducted to achieve consensus . The final checklist contains 10 items and 5 subitems , with items related to the st and ardization of the intervention , care provider influence , and additional measures to minimize the potential bias from lack of blinding of participants , care providers , and outcome assessors . CONCLUSIONS This tool can be used to critically appraise the medical literature , design NPT studies , and assess the quality of trial reports included in systematic review OBJECTIVES To compare the efficacies of dry needling of trigger points ( TrPs ) with and without paraspinal needling in myofascial pain syndrome of elderly patients . DESIGN Single-blinded , r and omized controlled trial . SUBJECTS Forty ( 40 ) subjects , between the ages of 63 and 90 with myofascial pain syndrome of the upper trapezius muscle . INTERVENTIONS Eighteen ( 18 ) subjects were treated with dry needling of all the TrPs only and another 22 with additional paraspinal needling on days 0 , 7 , and 14 . RESULTS At 4-week follow-up the results were as follows : ( 1 ) TrP and paraspinal dry needling result ed in more continuous subjective pain reduction than TrP dry needling only ; ( 2 ) TrP and paraspinal dry needling result ed in significant improvements on the geriatric depression scale but TrP dry needling only did not ; ( 3 ) TrP and paraspinal dry needling result ed in improvements of all the cervical range of motions but TrP dry needling  only did not in extensional cervical range of motion ; and ( 4 ) no cases of gross hemorrhage were noted . CONCLUSIONS TrP and paraspinal dry needling is suggested to be a better method than TrP dry needling only for treating myofascial pain syndrome in elderly patients Background Neck pain caused by cervical spondylosis has become a common health problem worldwide among > 40-year-old adults .  Acupuncture intervention is one of the most popular treatment measures for this disorder . However , evidence for its efficacy in relieving neck pain and recovering neck physiological function has not been established in r and omized , placebo-controlled trials . The primary aim of this trial is to assess the efficacy and safety of active acupuncture compared with sham acupuncture intervention for neck pain caused by cervical spondylosis . Methods / Design We will conduct a r and omized , double-blind , parallel-group , placebo-controlled trial comparing active acupuncture with placebo ( sham acupuncture ) . A total of 456 patients with neck pain caused by cervical spondylosis who meet the eligibility criteria from outpatient clinics of the Second People ’s Hospital of Fujian Province and the Affiliated Rehabilitation Hospital , Fujian University of Traditional Chinese Medicine will be recruited and r and omized into an active acupuncture or sham acupuncture group . The participants will undergo treatment sessions with either active or sham acupuncture intervention five times a week for 2 weeks . Evaluation by blinded assessors at baseline and at intervention for 1 and 2 weeks will include demographic characteristics , vali date d question naires ( Northwick Park Neck Pain Question naire ( NPQ ) scale , Short-Form 36 ( SF-36 ) scale , and McGill pain scale ) , examination of neck physiological function , and adverse events . All included patients will be followed up and investigated for relapse of neck pain at 4 , 8 , and 12 weeks after intervention . Discussion This paper describes the rationale and design of a r and omized double-blind , placebo-controlled trial that aims to determine the efficacy and safety of acupuncture intervention for neck pain caused by cervical spondylosis . The primary outcomes are changes in the NPQ score and neck physiological function . Secondary outcome measures include quality of life , adverse events , and relapse of neck pain . If successful , this project will provide evidence of the efficacy and safety of acupuncture for neck pain caused by cervical spondylosis . Trial registration Chinese Clinical Trial Registry : ChiCTR-TRC-12002206 . Registration date : 11 May 2012 To evaluate the efficacy of Chinese medicine ( CM ) acupuncture for  chronic neck pain ( CNP ) , a single blind , controlled , crossover , clinical trial was undertaken . Twenty-nine volunteers with CNP were r and omly recruited into two groups . Both groups received two phases of treatment with a washout period between the two phases . Group A ( 14 volunteers ) received CM acupuncture in the first phase and sham acupuncture in the second , while Group B ( 15 volunteers ) received sham in the first and real in the second . CM acupuncture was individualized and consisted of nine sessions on both local and distal points . Manual twisting of the needle was applied on all points plus strong electrical stimulation of distal points in CM acupuncture . Sham acupoints ( lateral to the real ) and sham ( weak ) electrical stimulation was used in the control group . Comparison of subjective and objective measures between the two groups was made at different periods , including baseline , after each phase of treatment , after washout , and after the 16th week follow-up . The subjective measures included pain intensity , duration per day , analgesic medication count , visual analogue scales ( VAS ) and neck disability index ( NDI ) . The objective measures consisted of neck range of motion ( ROM ) and pain threshold ( PT ) . Both the real and sham treatments significantly reduced subjective pain , without significant differences between groups for most subjective measures . Objective measures showed no significant change for either group before and after each period or by inter-groups analysis . A minimum 16-week effect of both real and sham acupuncture was found for subjective measures in the follow-up periods . Further study is recommended with an increased sample size , a longer washout period , and a longer baseline period Background Chronic whiplash is a common and costly problem . Sensory hypersensitivity is a feature of chronic whiplash that is associated with poor responsiveness to physical treatments such as exercise . Modalities such as dry-needling have shown some capacity to modulate sensory hypersensitivity , suggesting that when combined with advice and exercise , such an approach may be more effective in the management of chronic whiplash . The primary aim of this project is to investigate the effectiveness of  dry-needling , advice and exercise for chronic whiplash . Method / Design A double-blind r and omised controlled trial will be conducted . 120 participants with chronic whiplash , grade II will be r and omised to receive either 1 ) dry-needling , advice and exercise or 2 ) sham dry-needling , advice and exercise . All participants will receive an educational booklet on whiplash . Participants who are r and omised to Group 1 will receive 6 treatments of combined dry-needling and exercise delivered in the first 3 weeks of the 6 week program , and 4 treatments of exercise only in the last 3 weeks of the program . Participants r and omised to Group 2 will receive an identical protocol , except that a sham dry-needling technique will be used instead of dry-needling . The primary outcome measures are the Neck Disability Index ( NDI ) and participants ' perceived recovery . Outcomes will be measured at 6 , 12 , 24 and 52 weeks after r and omization by an assessor who is blind to the group allocation of the participants . In parallel , an economic analysis will be conducted . Discussion This trial will utilise high quality trial method ologies in accordance with CONSORT guidelines . The successful completion of this trial will provide evidence of the effectiveness and cost-effectiveness of a combined treatment approach for the management of chronic whiplash . Trial registration OBJECTIVE To probe into an effective therapy for chronic pain of cervical intervertebral disc . METHODS Sixty-six cases of chronic pain of cervical intervertebral disc were r and omly divided into an acupoint sticking group and an acu puncture group , 33 cases in each group . The acupoint sticking group was treated with acupoint sticking therapy , and the acupuncture group with acupuncture . Ti and ing ( LI 17 ) , Futu ( LI 18 ) , Dazhui ( GV 14 ) , Tianzong ( S 11 ) , etc . were selected in the two groups . After treatment for 3 therapeutic courses , their therapeutic effects were observed . RESULTS The effective rate was 93.5 % in the acupoint sticking group and 72.4 % in the acupuncture group , the former being better than the latter ( P<0.05 ) ; in a 3-month following-up survey , the effective rate was 90.3 % in the acupoint sticking group and 65.5 % in the acupuncture group , the former being better than the latter ( P<0.05 ) . CONCLUSION The acupoint sticking therapy has an satisfactory therapeutic effect on chronic pain of cervical intervertebral disc OBJECTIVE To evaluate the therapeutic effects of acupotomy-injection with FENG Tian-you spinal manipulation ( FSM ) for treating cervical spondylotic radiculopathy ( CSR ) . METHODS Seventy-two patients with CSR were r and omly divided into two groups ( n = 36 respectively ) : treatment and control group . The patients in treatment group were treated with acupotomy-injection combined with FSM , and patients in control group were treated with traction . All the patients were followed up for 3 months after treatment and the therapeutic effects were evaluated . RESULTS Totally there were 72 patients and 69 completed the treatment and the other 3 patients withdraw from treatment . In treatment group , 24 patients were cured , 6 patients had remarkable effects , 4 effective and 2 ineffective ; as well in control group , above data were 15 , 3 , 10 and 8 respectively . The comprehensive effects and the cured patients in the treatment group were obviously better than those of control group ( P < 0.05 ) . The comparison of scales for assessment of symptoms and short-form McGill Pain Question aire before and after treatment in two groups had significant differences ( P < 0.001 ) . CONCLUSION The method of acupotomy-injection combined with FSM for treating CSR is better than conventional traction method UNLABELLED The aim of this paper was to quantify the influence of the physician 's training and experience in the field of acupuncture on the outcome in patients with chronic pain . Patients visiting their physician because of chronic low back pain , headache , pain due to osteoarthritis of the knee or hip , or neck pain , were included in 4 multicenter , r and omized , controlled studies . All patients received routine care ; patients in the acupuncture groups received additional acupuncture treatment ( on average 10 sessions ) . The data was pooled , and the 3-month change from baseline of the SF-36 bodily pain subscale as the main outcome defined . A total of 9,990 patients ( mean age 49.6 + /- 13.6 years , 68 % female ) treated by 2,781 phys 
    Output:
    