Korean medicine clinical practice guideline on acupuncture for acute ankle sprains in adults: Evidence-based approach

Introduction: Based on a structured, rigorous methodology developed for creating evidence-based clinical practice guidelines (CPGs), the Korean Institute of Oriental Medicine and Korean Acupuncture and Moxibustion Medicine Society developed a guideline for treating acute ankle sprain using acupuncture which is part of Korean medicine (KM). Methods: Using a revised Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach, the committee based these recommendations on a systematic review of randomized controlled trials on any form of acupuncture used for ankle sprains published up to July 2015. Accessible sources relating to ankle sprain were collected, and a systematic review and meta-analysis were applied to the collected data. The quality of evidence was graded, and the recommendations were drafted and then finalized after official approval. Results: For this CPG, six clinical questions and recommendations that were primarily related to manual acupuncture methods were addressed. Four were related to manual acupuncture alone, of which one focused on electroacupuncture and another on pharmacopuncture. Clinical outcomes evaluated were pain reduction using a visual analogue scale (VAS) or the numeric rating scale and improved cure rates, joint position sense, kinesthesia, and range of motion. Manual acupuncture was thus recommended as grade A treatment for alleviating VAS-graded pain. Conclusions: The guideline for treating ankle sprain establishes a standard procedure to ensure high-quality medical care for ankle sprain that could be applied globally to patients seeking KM. It also supports international traditional medicine research methodology. When further clinical research is conducted, this CPG can be updated, adding value to its content.