The Effectiveness of Doin (Conduction Exercise) of the Pelvic Joint for HLD With Radiating Leg Pain
Condition: Intervertebral Disc Displacement; Sciatica; Sciatic Radiculopathy
MeSH terms: Intervertebral Disc Displacement; Radiculopathy; Sciatica
Study type: Observational [Patient Registry]

Summary: 
      A prospective pilot study will be conducted to investigate the effectiveness and safety in
      herniated lumbar disc (HLD) patients receiving integrative Korean medicine treatment
      including Doin (conduction exercise) at a Korean medicine hospital through assessment of
      pain, functional disability, and quality of life.
    

Detailed description: 
      A prospective single-center observational pilot study will be conducted to investigate the
      effectiveness and safety in herniated lumbar disc (HLD) patients with radiating leg pain
      receiving integrative Korean medicine treatment including Doin (conduction exercise) of the
      pelvic joint at Daejeon Jaseng Hospital of Korean Medicine through assessment of pain,
      functional disability, quality of life, satisfaction, and safety.

      The study is expected to be performed over a period of 6 months, during the former 3 months
      of the study period of which the Integrative Korean medicine treatment group will be
      recruited, and after a wash-out period of 2 weeks, during the latter 3 months of the study
      period of which the Doin with integrative Korean medicine will be recruited separately.
    

Intervention name(s): Doin (conduction exercise); Herbal medicine; Chuna manual therapy; Bee venom pharmacopuncture; Pharmacopuncture; Acupuncture; Electroacupuncture; Cupping; Other intervention(s)
Intervention type(s): Procedure; Drug; Procedure; Procedure; Procedure; Procedure; Procedure; Procedure; Other
Intervention description(s): An acupuncture physician will administer acupuncture at 4-8 acupoints in the low back and gluteal area (mandatory points: BL54, and GB30 ipsilateral to the dysfunctional site; and selective points: BL23, BL24, BL25, BL26, BL31, BL32, Ah-shi points, local acupuncture points and/or trigger points. Doin (conduction exercise) will be performed as active and passive movement with the needles in situ to the aim of effective treatment of pain and functional disability by increasing the hip joint range of motion (flexion and extension) with physician guidance and isometric resistance exercise (flexion and extension) as needed. Doin (conduction exercise) sessions will be performed 1 session/day for the duration of hospitalized treatment while the patient presents radiating leg pain (NRS≥1).; Herbal medicine will be mainly administered in water-based decoction (120ml) and dried powder (2g) form (the ingredients are mainly, but not restricted to: Ostericum koreanum, Eucommia ulmoides, Acanthopanax sessiliflorus, Achyranthes japonica, Psoralea corylifolia, Saposhnikovia divaricata, Cibotium barometz, Lycium chinense, Boschniakia rossica, Cuscuta chinensis, Glycine max, Atractylodes japonica).; Chuna is a Korean spinal manipulation that incorporates spinal manipulation techniques for joint mobilization involving high-velocity, low amplitude thrusts to joints slightly beyond the passive range of motion and gentle force to joints within the passive range of movement. Chuna manipulation will be administered at the physician's discretion.; Bee venom pharmacopuncture will be administered only after confirming a negative response to hypersensitivity skin test. Diluted bee venom (saline:bee venom ratio, 10,000:1) filtered for allergens will be injected at 4-5 acupoints proximal to the dysfunctional site at the physician's discretion. Each acupuncture point will be injected to a total of 0.5-1 cc using disposable injection needles (CPL, 1 cc, 26G x 1.5 syringe, Shinchang medical co., Korea).; Pharmacopuncture consisting of select herbal ingredients will be administered at Ah-shi points and local acupuncture points using disposable injection needles (CPL, 1 cc, 26G x 1.5 syringe, Shinchang medical co., Korea).; Acupuncture treatment will be administered using mainly proximal acupuncture points and Ah-shi points.; Electroacupuncture treatment will be administered using mainly proximal acupuncture points and Ah-shi points.; Cupping treatment will be administered at 1-2 points using mainly proximal acupuncture points and Ah-shi points.; Patients will be allowed any other additional intervention(s) as deemed necessary by the attending physician regardless of type or dose, and patterns of use will be investigated and recorded as an pragmatic clinical study.
Other intervention name(s): Doin Exercise; Do-in Exercise; Conduction Exercise; Traditional herbal medicine; Chuna manipulation; Chuna spinal manipulation; Bee venom acupuncture
Observational model: Case-Only
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Herniated lumbar disc (HLD) patients with radiating leg pain
      
Keywords: Complementary Therapies; Exercise; Acupuncture