Abstract
To the Editor:
We appreciate the opportunity to respond to the Letter to the Editor and thank the authors for their insightful comments regarding our study.
This was a small-scale pilot study supported by the Minnesota Office of Higher Education’s Spinal Cord Injury and Traumatic Brain Injury (TBI) Grant Program awarded in 2019. Due to delays associated with the COVID-19 pandemic, we were granted two no-cost extensions. Supplemental departmental funding was also secured to ensure completion of the study. Given the constraints of a limited budget, a methodological trade-off was necessary—either to maximize the number of acupuncture treatment sessions or the number of participants. We opted for the latter to ensure the ability to examine feasibility and safety, and to detect clinically meaningful effects.
We agree with the authors’ observation that the “high dose” group in our study (two treatments per week for five weeks) received a lower treatment intensity than prior studies, many of which report improved outcomes with at least three sessions or more per week. The descriptors “low-dose” and “high-dose” were used only to distinguish the two arms within the context of the study design and were not intended to represent standard or maximal dosing levels typically used in clinical settings. We agree that a more conventional high-dose regimen (e.g., three sessions per week), along with an appropriate control arm, would be more suitable for future investigations in a mild TBI population.