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Hackl, G.
Auricular Nerve Stimulation in Peripheral Arterial Disease Patients
Doktoratsstudium der Medizinischen Wissenschaft; Humanmedizin; [ Dissertation ] Graz Medical University; 2017. pp. [OPEN ACCESS]
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Authors Med Uni Graz:
Advisor:: Brodmann Marianne; Hafner Franz; Pilger Ernst
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Abstract:: Objectives: Auricular nerve stimulation has been proven effective in the treatment of pain in different diseases. We investigated if a conservative therapeutic alternative for claudication in peripheral arterial occlusive disease (PAOD) via electroacupuncture of the outer ear can be established. Methods: In this prospective, double blinded trial an ear acupuncture using an electroacupuncture device was carried out in 40 PAOD patients in Fontaine stage IIb. 20 patients were randomized to the verum group using a fully functional electroacupuncture device, the other 20 patients received a sham device (control group). Per patient, 8 cycles (1 cycle = 1 week) of electroacupuncture was administered. The primary endpoint was defined as a significantly increased maximal (absolute) walking distance (+100%) after 8 cycles of electroacupuncture in a standardized treadmill testing. Secondary endpoints were a significant improvement of the total score of the Walking impairment questionnaire (WIQ) as well es improvements in Quality of Life using the Short Form 36 health survey (SF-36). Results: There were no differences in baseline characteristics between the two groups. The initial walking distance significantly increased in both groups (verum group: 182 [95%CI 128-236] meters to 345 [95%CI 227-463] meters [+90%], p<0.01; control group: 159 [95%CI 109-210] meters to 268 [95%CI 182-366] meters [+69%], p=0.01). Twelve patients (60%) in the verum group and five patients (25%) in controls reached the primary endpoint of doubling walking distance (p=0.05). Total Score of WIQ significantly improved in the verum group (+22%, p=0.01) but not in controls (+8%, p=0.56). SF-36 showed significantly improvements in 6 of 8 categories in the verum group and only in 1 of 8 in controls. Conclusions: Electroacupuncture of the outer ear seems to be an easy-to-use therapeutic option in an age of increasingly invasive and mechanically complex treatments for PAOD patients.