Introducing a novel sham acupuncture method for double-blind trials: A validation study

Introduction: Various clinical studies have been conducted worldwide to evaluate the effectiveness of acupuncture; however, designing an adequate control group is challenging. Sham acupuncture tools, designed to mimic real acupuncture without skin penetration, aim to address this challenge, but thei...

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Main Authors: Sung Min Lim, Eunji Go, Jungsup Lee, Go Eun Lee, Chihyoung Son
Format: Article
Language:English
Published: Elsevier 2025-09-01
Series:Complementary Therapies in Medicine
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Online Access:http://www.sciencedirect.com/science/article/pii/S0965229925000731
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author Sung Min Lim
Eunji Go
Jungsup Lee
Go Eun Lee
Chihyoung Son
author_facet Sung Min Lim
Eunji Go
Jungsup Lee
Go Eun Lee
Chihyoung Son
author_sort Sung Min Lim
collection DOAJ
description Introduction: Various clinical studies have been conducted worldwide to evaluate the effectiveness of acupuncture; however, designing an adequate control group is challenging. Sham acupuncture tools, designed to mimic real acupuncture without skin penetration, aim to address this challenge, but their efficacy and blinding success are debated. Methods: In this study, we conducted a randomized, double-blind, parallel-group clinical trial to validate a newly developed sham acupuncture method for future double-blind trials. Sixty-six healthy participants were randomly assigned to verum or sham acupuncture groups. Verum acupuncture targeted LI4 and ST36, common acupuncture points, while sham acupuncture aimed to mimic verum without skin penetration to ensure participant blinding. Blinding (Bang’s Blinding Index), penetration, pain, and deqi sensations were evaluated using a standardized questionnaire and an 11-point Numeric Rating Scale. Results: Participant blinding was successfully maintained at ST36, whereas “more correct guesses” were observed for verum acupuncture than expected by chance for sham acupuncture at LI4. Furthermore, the practitioners randomly guessed the verum and sham acupuncture that they had administered to both points. Penetration and pain were higher in the verum group for both points, while deqi sensations had mixed responses. There were no adverse events in the verum acupuncture and sham acupuncture groups. Conclusions: The newly developed sham acupuncture demonstrated potential in blinding participants and practitioners, particularly at ST36. However, challenges were observed, especially at LI4, indicating limitations in blinding efficacy. This study underscores the importance of additional validation studies with larger sample sizes, diverse acupuncture points, and specific patient populations. Trial registration: Clinical Research Information Service of the Republic of Korea (registration number: KCT0008335, https://cris.nih.go.kr).
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spelling doaj-art-bde939ef390e46378609dc39d65084e52025-08-20T03:34:05ZengElsevierComplementary Therapies in Medicine0965-22992025-09-019210319810.1016/j.ctim.2025.103198Introducing a novel sham acupuncture method for double-blind trials: A validation studySung Min Lim0Eunji Go1Jungsup Lee2Go Eun Lee3Chihyoung Son4Department of Clinical Rehabilitation Research, National Rehabilitation Research Institute, Seoul, Republic of KoreaDepartment of Clinical Rehabilitation Research, National Rehabilitation Research Institute, Seoul, Republic of KoreaDepartment of Korean Traditional Internal Medicine, National Rehabilitation Center, Seoul, Republic of KoreaDepartment of Korean Traditional Rehabilitation Medicine, National Rehabilitation Center, Seoul, Republic of KoreaDepartment of Korean Traditional Rehabilitation Medicine, National Rehabilitation Center, Seoul, Republic of Korea; Correspondence to: Department of Korean Traditional Rehabilitation Medicine, National Rehabilitation Center, 58 Samgaksan-ro, Gangbuk-gu, Seoul 01022, Republic of Korea.Introduction: Various clinical studies have been conducted worldwide to evaluate the effectiveness of acupuncture; however, designing an adequate control group is challenging. Sham acupuncture tools, designed to mimic real acupuncture without skin penetration, aim to address this challenge, but their efficacy and blinding success are debated. Methods: In this study, we conducted a randomized, double-blind, parallel-group clinical trial to validate a newly developed sham acupuncture method for future double-blind trials. Sixty-six healthy participants were randomly assigned to verum or sham acupuncture groups. Verum acupuncture targeted LI4 and ST36, common acupuncture points, while sham acupuncture aimed to mimic verum without skin penetration to ensure participant blinding. Blinding (Bang’s Blinding Index), penetration, pain, and deqi sensations were evaluated using a standardized questionnaire and an 11-point Numeric Rating Scale. Results: Participant blinding was successfully maintained at ST36, whereas “more correct guesses” were observed for verum acupuncture than expected by chance for sham acupuncture at LI4. Furthermore, the practitioners randomly guessed the verum and sham acupuncture that they had administered to both points. Penetration and pain were higher in the verum group for both points, while deqi sensations had mixed responses. There were no adverse events in the verum acupuncture and sham acupuncture groups. Conclusions: The newly developed sham acupuncture demonstrated potential in blinding participants and practitioners, particularly at ST36. However, challenges were observed, especially at LI4, indicating limitations in blinding efficacy. This study underscores the importance of additional validation studies with larger sample sizes, diverse acupuncture points, and specific patient populations. Trial registration: Clinical Research Information Service of the Republic of Korea (registration number: KCT0008335, https://cris.nih.go.kr).http://www.sciencedirect.com/science/article/pii/S0965229925000731AcupunctureDouble blind studyClinical trialSham treatment
spellingShingle Sung Min Lim
Eunji Go
Jungsup Lee
Go Eun Lee
Chihyoung Son
Introducing a novel sham acupuncture method for double-blind trials: A validation study
Complementary Therapies in Medicine
Acupuncture
Double blind study
Clinical trial
Sham treatment
title Introducing a novel sham acupuncture method for double-blind trials: A validation study
title_full Introducing a novel sham acupuncture method for double-blind trials: A validation study
title_fullStr Introducing a novel sham acupuncture method for double-blind trials: A validation study
title_full_unstemmed Introducing a novel sham acupuncture method for double-blind trials: A validation study
title_short Introducing a novel sham acupuncture method for double-blind trials: A validation study
title_sort introducing a novel sham acupuncture method for double blind trials a validation study
topic Acupuncture
Double blind study
Clinical trial
Sham treatment
url http://www.sciencedirect.com/science/article/pii/S0965229925000731
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