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Complementary and Alternative Therapies (CAM)  Deborah Rothman, Ph.D. , M.D. Shriners Hospital for Children Springfield, MA JA  2011 National Conference Arlington, VA
 
Why is there so much interest in CAM? ,[object Object],[object Object],[object Object],[object Object]
How does this apply to children with arthritis? ,[object Object],[object Object],[object Object]
Goals ,[object Object],[object Object],[object Object],[object Object],[object Object]
How do we know something helps? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Reliable Sources: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Not so Reliable Sources ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Warning ,[object Object],[object Object],[object Object],[object Object],[object Object]
Suggestions ,[object Object],[object Object]
What is the evidence that this  is  effective? ,[object Object],[object Object],[object Object]
How do we know a therapy is effective  ? ,[object Object],[object Object],[object Object]
What is a RCT? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Diet  I ,[object Object],[object Object],[object Object],[object Object]
Vegetarian Diet ,[object Object],[object Object],[object Object]
Types of Vegetarian Diets ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Vegetarian Diet ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
FASTING ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Fish Oil ,[object Object],[object Object],[object Object],[object Object]
Fish Oil Caveats ,[object Object],[object Object],[object Object],[object Object],[object Object]
Fish Recommendations ,[object Object],[object Object],[object Object]
Botanical (Plant) Oils ,[object Object],[object Object],[object Object],[object Object],[object Object]
Borage Oil ,[object Object],[object Object],[object Object],[object Object],[object Object]
GLA suppresses acute and chronic inflammation in  animal models of arthritis. It has also been shown in  placebo-controlled double-blind trials to reduce  synovitis in adults with rheumatoid arthritis   These promising results were the basis for this clinical  trial to study borage oil for the treatment  of  JIA.
What does this mean? ,[object Object],[object Object],[object Object],[object Object],[object Object]
Study Design I ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
What does this mean? ,[object Object],[object Object]
Study Design II ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Results
Outcome Variable Borage Oil Placebo  P value Physician ’ s global assessment  (0-4) 0.38 (1.02)  0.92  ( 1.20) 0.002 Parent ’ s global assessment  (0-100) 10.82 (13.78)  17.46 (22.40) 0.069 Functional ability scale  (0-3) 0.34  (.40 ) 0.42  (.47) 0.113 Number of joints with active arthritis 4.39 ( 9.75) 5.68  ( 9.85) 0.045 Number of joints with limited range of motion 2.75  (5.37) 3.54 (4.80) 0.117 Number of swollen joints 4.25  ( 9.72) 5.46  (9.91) 0.371 Number of tender joints 0.57  (2.10) 0.25  (.84) 0.825
Changing Gears
Diet II ,[object Object],[object Object],[object Object],[object Object]
Elimination: Nightshade Vegetables ,[object Object],[object Object],[object Object],[object Object],[object Object]
Elimination: Wheat ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Elimination: Milk ,[object Object],[object Object]
Recommendations  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Safe Nutrition Interventions ,[object Object],[object Object],[object Object],[object Object]
 

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Dancing: Alternative Therapies

  • 1.  
  • 2. Complementary and Alternative Therapies (CAM) Deborah Rothman, Ph.D. , M.D. Shriners Hospital for Children Springfield, MA JA 2011 National Conference Arlington, VA
  • 3.  
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  • 25. GLA suppresses acute and chronic inflammation in animal models of arthritis. It has also been shown in placebo-controlled double-blind trials to reduce synovitis in adults with rheumatoid arthritis These promising results were the basis for this clinical trial to study borage oil for the treatment of JIA.
  • 26.
  • 27.
  • 28.
  • 29.
  • 31. Outcome Variable Borage Oil Placebo P value Physician ’ s global assessment (0-4) 0.38 (1.02) 0.92 ( 1.20) 0.002 Parent ’ s global assessment (0-100) 10.82 (13.78) 17.46 (22.40) 0.069 Functional ability scale (0-3) 0.34 (.40 ) 0.42 (.47) 0.113 Number of joints with active arthritis 4.39 ( 9.75) 5.68 ( 9.85) 0.045 Number of joints with limited range of motion 2.75 (5.37) 3.54 (4.80) 0.117 Number of swollen joints 4.25 ( 9.72) 5.46 (9.91) 0.371 Number of tender joints 0.57 (2.10) 0.25 (.84) 0.825
  • 33.
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