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Article

The Impact of Acupuncture on Health-Related Quality of Life in Veterans with Combat Post-Traumatic Stress Disorder: A Secondary Analysis of a Randomized Control Trial

by
Andrea Munoz
1,*,
Jennifer Lai-Trzebiatowski
1,
Tyler Smith
2,
Nikki N. Frousakis
1,
An-Fu Hsiao
1,3,
Seth D. Norrholm
4,
Chelsea Aden
1,
Teresa Calloway
1,
Megan Jung
1,
Kala Carrick
1,
Ruth Alpert
1,
Anastasia Krajec
1,
Tanja Jovanovic
4 and
Michael Hollifield
1,5
1
Tibor Rubin VA Medical Center, Long Beach, CA 90822, USA
2
Department of Health Services and Leadership, School of Health Professions, National University, San Diego, CA 92237, USA
3
Department of Medicine, Health Policy Research Institute and General Internal Medicine, University of California Irvine, Irvine, CA 92697, USA
4
Department of Psychiatry and Behavioral Neurosciences, School of Medicine, Wayne State University, Detroit, MI 48202, USA
5
Department of Psychiatry and Behavioral Sciences, George Washington School of Medicine & Health Sciences, Washington, DC 20037, USA
*
Author to whom correspondence should be addressed.
Trauma Care 2025, 5(4), 27; https://doi.org/10.3390/traumacare5040027
Submission received: 9 August 2025 / Revised: 13 November 2025 / Accepted: 19 November 2025 / Published: 23 November 2025
Browse Figure
Review Reports Versions Notes

Abstract

Background: Quality of life is a foundational component of overall health and is negatively impacted by post-traumatic stress disorder (PTSD). In the last decade, acupuncture treatment has become a popularized treatment option for PTSD, especially for Veterans. Research evidence is needed to provide support for acupuncture as a treatment for PTSD which leads to an enhanced quality of life. Objectives: This paper investigated the changes in health-related quality of life in Veterans with combat PTSD who enrolled in a 5-year randomized (two-arm, parallel-group, prospective, single-blinded) clinical trial, completing either a control (Sham) or acupuncture (Verum) treatment (N = 93). Methods: Health-related quality of life was measured by the Veterans RAND 12-item Health Survey (VR-12). Paired t tests between and among participants’ differences were calculated for the Verum acupuncture group, Sham acupuncture group, and Total group. Results: Veterans who completed acupuncture treatment in either randomized arm (Verum and Sham) had a self-perceived improvement in quality of life when assessing physical and mental health symptoms. Specifically, those who were randomized and completed Verum acupuncture treatment reported the greatest improvement in mental health quality of life. Conclusions: Study results support prior foundational findings that acupuncture has a positive effect on self-reported quality of life by reducing PTSD symptoms in Veterans with combat PTSD, with Verum acupuncture eliciting the greatest improvement on mental health symptoms.

1. Introduction

1.1. Origin of Acupuncture Treatment

Acupuncture treatment originated in China during the clan commune period, approximately 4000–6000 years ago [1]. Through trade and cultural exchanges, acupuncture spread to Japan, Korea, Southeast Asia, and, later, India. In the 16th century, France greatly contributed to acupuncture being spread throughout Europe [1]. With time, due to globalization, and through the advancement of technology, techniques of acupuncture have evolved to become a popularized treatment option for enhancing overall health and reducing the impact of often comorbid mental and physical symptoms.

1.2. Brief Overview of Acupuncture

There are numerous acupuncture points over the human body which serve both as pathways of “circulation of qi and blood” and “loci of responses to diseases” [1]. Proper techniques of needle insertion and manipulation are applied at acupuncture points to increase the body’s strength to treat and prevent disease. In addition, proper needle insertion assists in the regulation of the body’s functional activities. Over the ages, practitioners of acupuncture have created recordings “describing the locations and indications of acupuncture points” formulating a systematic theory [1].

1.3. Acupuncture Treatment in Veterans

Utilization of acupuncture as a treatment for Veterans at the Veterans Health Administration (VA) has been increasing in the last decade as part of the Whole Health Initiative [2]. In May 2017, VA included acupuncture as a “covered treatment” option in the Veterans’ medical benefits package, initiated by Directive 1137. Interest has grown so much that the VA restructured the program in December 2022 to add acupuncture as an option to “complement conventional health care” [3]. Moreover, acupuncture as a treatment for post-traumatic stress disorder (PTSD) in Veterans has emerged with promising results in the last decade [4,5].

1.4. PTSD and Quality of Life

A Veteran’s quality of life is negatively impacted by PTSD in several ways. Interpersonally, PTSD has been found to impair several life domains, including occupational, academic, marital, friendship, and family functioning [6,7,8,9]. At the individual level, PTSD causes emotional and cognitive challenges, such as intrusive thoughts, sleep disturbances, flashbacks, challenges with concentration, and irritability, that impact their psychological functioning [10]. A diagnosis of PTSD requires that symptoms cause distress and interfere with social functioning, and/or occupational/other important areas of functioning [10].
Though PTSD is largely recognized as a mental disorder, it also impacts physical health. Increased PTSD symptoms have been found to be associated with poorer mental and physical health in Veterans [11]. PTSD was also found to be independently associated with an increase in medical illnesses and more frequent use of health care. Over time, the relationship between PTSD and medical illnesses has been shown to have strengthened [12]. Other studies have indicated that rates of smoking, alcohol consumption, and other behavioral risks are higher in Veteran populations with PTSD, while they simultaneously have lower rates of engagement in preventative health behaviors and diminished health scores [13,14,15,16].

1.5. Current Paper and Main Study Overview

The current paper is an investigation into the changes in self-reported health-related quality of life in Veterans with combat PTSD that have completed acupuncture treatment. Health-related quality of life was measured by the Veterans RAND 12-item Health Survey (VR-12). See Section 2.3.2 (below) for psychometric properties of VR-12.
This current study is a secondary analysis of data from a published randomized controlled trial study of acupuncture for PTSD in Veterans [5]. That main study was a two-arm, parallel-group, prospective, single-blinded, randomized clinical trial (RCT) that hypothesized the superiority of Verum to Sham acupuncture in symptom reduction for Veterans with combat PTSD. It was designed to address previous limitations by comparing Verum (active) vs. Sham (placebo) procedures in an adequately powered sample assessing clinical and biological outcomes and monitoring protocol adherence. See Figure 1 for the study flow.

1.6. Current Study Hypotheses

We hypothesized that Verum acupuncture treatment will result in greater improvements from pre- to post-treatment in health-related quality of life than Sham acupuncture treatment in Veterans with combat PTSD.

2. Materials and Methods

2.1. Ethics and IRB

The original study received institutional review board approval by the Tibor Rubin VA Medical Center, and data were monitored by the Veterans Health Administration Office of Research and Development. This study was registered on 8 August 2016 at ClinicalTrials.gov under NCT02869646 (https://clinicaltrials.gov/study/NCT02869646, accessed on 9 August 2025).

2.2. Recruitment, Inclusion and Exclusion Criteria

Recruitment for the main RCT was carried out from April 2018 to May 2022 using flyers, email, and in-person recruitment at VA Hospital in Long Beach, California. Inclusion criteria were Veterans between the ages of 18 and 55 meeting diagnostic criteria per the Diagnostic and Statistical Manual (DSM-5) for PTSD, with a severity score of >26 on the Clinician-Administered PTSD Scale-5 (CAPS-5). The exclusion criteria included variables that are known PTSD treatment confounders, might affect biological assessment, indicate past non-adherence or treatment resistance, or indicate a risk of harm.

2.3. Intervention and Measures

2.3.1. Acupuncture

Individual treatment sessions for Verum and Sham acupuncture were one-hour-long, carried out twice per week for up to 15 weeks to complete 24 sessions, and structured to reflect clinical practice. Sessions were structured with an interview, pulse and tongue observation, standard needling, and needle retention. Participants were blinded to group assignment and received alternating front and back treatment. Fidelity to protocol was also established. Adverse events and serious adverse events were assessed upon each study visit. Although acupuncturists were not blind to the intervention, fidelity video assessment suggested that participants were. This design enhanced internal validity and better assessed the specific effect of Verum acupuncture compared with that of minimal needling [5]. Verum acupuncture was delivered vis a protocol that was empirically developed to use 11 front alternating and 13 back points, with up to three additional points selected to address current constitutional factors [17]. Sham acupuncture used the same number of alternating points using “non-points” near acupoints not expected to have an effect on PTSD.

2.3.2. Veterans RAND 12-Item Health Survey (VR-12)

The VR-12 is a 12-item self-report questionnaire for assessing health-related quality of life and disease burden [18]. The VR-12 is a valid and reliable measure and has been utilized on Veterans since 1997 [18,19]. The questionnaire queries several health domains, including “general health perceptions, physical functioning, role limitations due to physical and emotional problems, bodily pain, energy-fatigue, social functioning, and mental health” [18]. For all 12 questions, respondents can choose from a Likert scale to select their best response. Response items are then summarized into two scores—a Physical Component Summary (PCS) score and a Mental Component Summary (MCS) score. “Higher scores” are interpreted as better quality of life.
Outcomes for the current study were the pre- to post-intervention changes in the VR-12. Internal consistency reliability (Cronbach α) was estimated to be at 0.90 for PCS and MCS. PCS and MCS scores from VR-12 were also found to account for 92% of the reliable variance from previous VR assessment versions.

2.4. Data Analyses

All randomized participants were included in analysis. Paired t tests and effect sizes for between- and among-participant differences were calculated for the Verum acupuncture group, Sham acupuncture group, and Total group (which included both Verum and Sham acupuncture). Data were missing due to computer error and participant withdrawal from testing; individuals with missing data were not included in the analyses.

3. Results

Table 1 shows the demographic characteristics of participants and that there were no differences between the Verum and Sham groups.
The analyses only included two time points representing primary outcomes, pre- and post-treatment, for treatment completers. Differences and p values were calculated for pre- and post-treatment completers, as shown in Table 2 and Table 3. The figures and tables below also show mid-point data as a visual for the reader.

3.1. Primary Analysis of MCS Findings

Among the VR-12 MCS scores, there was a statistically significant change found (with a medium effect size) in the Verum treatment group from pre (31.1[10.1])- to post (36.7[11.1])-treatment (n = 39, Δ = 5.22, paired t = 2.83, p = 0.01, d = 0.53).
There was also a statistically significant change found (with a small effect size) in the Total treatment group from pre (31.3[9.2])- to post (34.4[11.4])-treatment (Δ = 2.55, paired t = 2.01, p = 0.049, d = 0.12).
Lastly, the degree of change in VR-12 MCS scores (from pre- to post-treatment) was larger in the Verum group than the change in scores in the Sham group (n = 39, Δ= −5.22 vs. n = 32, Δ = 0.71; t = 2.40, p = 0.002).

3.2. Primary Analysis of PCS Findings

Among the VR-12 PCS scores, there was a statistically significant change found (with a small effect size) in the Total group from pre (39.8[10.8])- to post (41.3[10.9])-treatment (Δ = 2.85, paired t = 2.56, p =0.01, d = 0.30) but no significant pre- to post-treatment change for the Verum group, the Sham group, or the between-group comparison.

3.3. Percentage of Clinically Relevant Change at the Individual Level

The percentage of participants who experienced a clinically relevant change in mental health (MCS) and physical health (PCS) symptoms for each treatment group from pre- to post-treatment at the individual level (versus the population level) was calculated. In other words, the percentage of participants in each treatment group (Verum and Sham) who experienced a clinically relevant change in their PCS and MCS scores was examined. A clinically relevant change (at the individual level) is defined as an increase in score of 6.5 for PCS and 7.9 for MCS [20].
Although the Verum group showed a greater percentage of individual participants who experienced a clinically relevant change than the Sham group for MCS (38.5% vs. 18.8%), the difference was not statistically significant.
Similarly, the Verum group showed a greater percentage of individual participants who experienced a clinically relevant change than the Sham group for PCS (35.9% vs. 28.1%), though this difference also did not achieve statistical significance.

4. Discussion

4.1. Discussion of Results

It was originally hypothesized that Verum acupuncture would result in a greater improvement in health-related quality of life (in terms of both physical and mental symptoms) than Sham acupuncture in Veterans with combat PTSD from pre- to post-treatment. The current findings generally support this hypothesis for mental health symptoms, but surprisingly not for physical health symptoms.
Overall, a statistically significant improvement (with a medium effect size) in quality of life, as measured by mental health symptoms from pre- to post-treatment, was found for participants who completed Verum acupuncture, consistent with the original hypothesis.
A statistically significant improvement (with a small effect size) in quality of life, as measured by mental health symptoms, was also found in both the Verum and Total group, but not the Sham group. The Total group included both types of acupuncture treatment (Verum and Sham). The lack of significance in the Sham group may suggest that while receiving some acupuncture treatment (Verum or Sham) may have some positive impact on mental health-related quality of life, the impact is much stronger when Verum acupuncture is provided.
When examining physical health symptoms, a statistically significant improvement (with a small effect size) was found in the Total group, but not for the individual Verum or Sham groups. It is important to re-emphasize that the Total group involved a combination of data from both the Verum and Sham acupuncture types. This finding indicates that both types of acupuncture, and not specifically one type over the other, resulted in some improvement in quality of life. This is somewhat inconsistent with the original hypothesis, which posits greater improvement from Verum treatment. With further investigation and a larger sample size, it should be determined if this is extant data.
Importantly, no statistically significant improvements were noted in either mental health or physical health symptoms for those specifically receiving Sham acupuncture; only a numeric improvement in scores was observed.
Additional intragroup analyses of each of the acupuncture treatment modalities (Verum and Sham) yielded more insights. Within the Verum acupuncture group, statistical significance for improvements in mental health symptoms was reached, but not for physical health symptoms, though the values for the latter approached significance (p = 0.06). In other words, physical health symptoms appear to have improved for those who received Verum acupuncture, but mental health symptoms improved to a greater extent. This result was not fully expected because acupuncture is commonly known as a somatic or physical intervention for physical ailments such as chronic pain, gastrointestinal diseases, and osteoarthritis [21,22,23,24,25,26,27]. On the other hand, the acupuncture protocol was developed specifically for PTSD, suggesting that the specificity of the current protocol likely plays an important and meaningful role in targeting intended symptoms, and further supporting acupuncture as a treatment for mental health disorders such as depression, insomnia, and anxiety [21,22,23,24,25]. This study shows support for acupuncture resulting in improvements in both mental health- and physical health-related quality of life, with Verum treatment demonstrating better outcomes.

4.2. Population-Level Changes in PCS and MCS

Though minimal, small changes of 1–2 points in the PCS and MCS scores at the population level have been shown to have implications on the social, clinical, and policy levels [20,26,27,28,29]. At the population level, a one-point increase in PCS scores has been associated with lower rates of total health care and pharmacy expenditures and lower rates of hospital inpatient, outpatient, and medical provider visits [20]. A one-point increase at the population level in MCS scores has also been associated with lower rates of total health care and pharmacy expenditures and lower rates of hospital inpatient visits and medical provider visits [20]. These “small” changes were found in this study and reflect the positive potential impact of acupuncture for PTSD.

4.3. Individual-Level Changes in PCS and MCS

At the individual level, an improvement in score of 7.9 units in MCS and 6.5 units in PCS are considered clinically important [20,27,28,29]. Though a secondary analysis, the importance of how many individuals benefitted from acupuncture is crucial, especially for clinicians and patients looking for “non-traditional” treatment options for PTSD.
Of the participants who completed Verum acupuncture, 38.5% of participants experienced a meaningful improvement in mental health symptoms, compared to 18.8% participants in the Sham acupuncture group. In total, 35.9% of participants in the Verum acupuncture group experienced a meaningful improvement in physical health symptoms, compared to 28.1% participants in the Sham acupuncture group.
While both treatment groups (Verum and Sham) reported clinically meaningful changes for both physical and mental health symptoms (yet not at the statistically significant level), it is worth highlighting that over a third of participants in the Verum treatment group reported meaningful improvements in their quality of life subsequent to study participation for both mental and physical health symptoms. Additionally, it is worth noting that even participants in the Sham acupuncture group, despite this intervention being purposely designed as a placebo comparator, experienced an improvement in both physical and mental health symptoms.

4.4. Clinical Implications

This study’s results have important clinical implications for the treatment of PTSD and the range of therapeutic options available to Veterans. For Veterans who have not benefited from “conventional” PTSD treatments or who are seeking complementary approaches, these findings provide foundational evidence supporting the use of acupuncture as an effective treatment option.
The primary analysis [5] demonstrated that acupuncture significantly reduced PTSD symptom severity among Veterans. This current secondary analysis showed additional improvements in quality of life, suggesting that the benefits of acupuncture extend beyond symptom reduction to overall well-being. These findings support the use of acupuncture and the meaningful therapeutic benefits it has for Veterans experiencing PTSD, exemplifying improvements in (both mental health- and physical health-related) quality of life aspects that, unfortunately, PTSD can negatively impact. With continued research showing positive outcomes for acupuncture, more options will become accessible for Veterans to augment traditional treatment.

4.5. Strengths, Limitations, and Future Direction

This study and data analysis exemplify the several strengths of a randomized controlled trial design. By employing a Verum and an active control Sham group, this study allowed the data to control for any potential placebo effects that may have arisen from having received any treatment at all. Although not examined in the current data analysis, the design of the overall study was structured to capture data at several time points throughout the study, including pre-, mid-, and post-treatment, allowing for various data analyses. In addition, the utilization of the VR-12, a well-established questionnaire in the Veteran population, was decided upon in order to capture a more functional perspective rather than purely a symptomatologic perspective of the impact of acupuncture treatment on PTSD symptom severity.
Limitations of this study do exist, such as the geographical recruitment restrictions that only included Southern California and the recruitment of a predominately biologically male study population. While the sample size was adequate for statistical analysis of the primary study objective, it may not have been sufficient for finding differences pre–post-treatment according to the VR-12. Further, complete data collection was challenging and contributed to having incomplete data at the post-treatment mark.
Future directions may include capturing more data timepoints such as an additional follow-up period post-treatment to determine the potential generalizability and durability of acupuncture treatment, stronger efforts and incentives for completing questionnaires at all time points, and the recruitment of a more diverse recruitment population.

5. Conclusions

This study found that Veterans with PTSD who completed Verum acupuncture treatment had a greater improvement in quality of life in mental health symptoms than physical health symptoms. Overall, it was found that acupuncture treatment (both Verum and Sham) resulted in some improvement in both physical and mental health related quality of life symptoms. The current study’s findings support prior foundational findings that acupuncture has a positive effect on quality of life for Veterans with combat-related PTSD. Furthermore, it provides information for clinicians and those affected by PTSD about acupuncture as a viable treatment option for PTSD.

Author Contributions

Conceptualization: A.M., J.L.-T., M.H. and A.-F.H.; methodology: A.M., T.S. and M.H.; software: T.S., A.M., K.C. and R.A.; formal analysis: T.S. and M.H.; investigation: T.C., A.M., K.C., R.A. and N.N.F.; resources: A.K., M.J., S.D.N. and T.J.; data curation: K.C., J.L.-T., A.M. and R.A.; writing—original draft preparation: A.M., M.H., T.S. and J.L.-T.; writing—review and editing: All authors; visualization: A.M., T.S. and J.L.-T.; supervision: M.H., A.-F.H. and N.N.F.; project administration: J.L.-T., C.A., K.C., A.M., N.N.F., T.C. and R.A.; funding acquisition: M.H. All authors have read and agreed to the published version of the manuscript.

Funding

This trial was supported by Veterans Health Administration grant #5I01CX001416-02.

Institutional Review Board Statement

The original study received institutional review board approval by Tibor Rubin VA Medical Center (MIRB #1414; date of approval: 18 June 2016), and data were monitored by Veterans Health Administration Office of Research and Development. This study was registered on 8 August 2016 at ClinicalTrials.gov under NCT02869646 (https://clinicaltrials.gov/study/NCT02869646).

Informed Consent Statement

Informed consent was obtained from all subjects involved in the study.

Data Availability Statement

Data sharing will be considered via negotiation between interested partners and authors with VA IRB participation.

Acknowledgments

Karen Cocozza, Tibor Rubin VA Medical Center, is acknowledged for her clinical contribution to the main study as a study acupuncturist. J. Matthew Brand, University of California, Irvine, is acknowledged for his clinical contribution to the main study as a study acupuncturist while employed at Tibor Rubin VA Medical Center (no additional compensation was received). Chris Reist, Science 57, is acknowledged for the administrative and content support provided for the project (no compensation was received).

Conflicts of Interest

The authors declare no conflicts of interest.

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Traumacare 05 00027 g001
Figure 1. Participant recruitment flowchart.
Figure 1. Participant recruitment flowchart.
Traumacare 05 00027 g001
Table 1. Table of demographics.
Table 1. Table of demographics.
Group
PopulationVerumShamp-Value
N(%)N(%)N(%)
Age Group 0.541
  24–2911(11.8)3(6.4)8(17.4)
  30–3422(23.7)10(21.3)12(26.1)
  35–3922(23.7)13(27.7)9(19.6)
  40–449(9.7)6(12.8)3(6.5)
  45–4916(17.2)8(17.0)8(17.4)
  50+13(14.0)7(14.9)6(13.0)
Sex 0.975
  Male85(91.4)43(91.5)42(91.3)
  Female8(8.6)4(8.5)4(8.7)
Country of Birth 0.491
  USA72(77.4)35(74.5)37(80.4)
  Other21(22.6)12(25.5)9(19.6)
Education Level 0.457
  HS/GED19(20.4)12(25.5)7(15.2)
  Some College39(41.9)18(38.3)21(45.7)
  College Degree35(37.6)17(36.2)18(39.1)
Marital Status 0.292
  Married46(49.5)24(51.1)22(47.8)
  Single20(21.5)13(27.7)7(15.2)
  Divorced21(22.6)8(17.0)13(28.3)
  Other6(6.5)2(4.3)4(8.7)
Religion 0.416
  Buddhist4(4.3)3(6.4)1(2.2)
  Christian46(49.5)22(46.8)24(52.2)
  Muslim2(2.2)002(4.3)
  Other21(22.6)10(21.3)11(23.9)
  None20(21.5)12(25.5)8(17.4)
Live With Self 0.769
  No64(68.8)33(70.2)31(67.4)
  Yes29(31.2)14(29.8)15(32.6)
Live With Spouse 0.751
  No49(52.7)24(51.1)25(54.3)
  Yes44(47.3)23(48.9)21(45.7)
Live With Children 0.883
  No62(66.7)31(66.0)31(67.4)
  Yes31(33.3)16(34.0)15(32.6)
Live With Parents 0.173
  No78(83.9)37(78.7)41(89.1)
  Yes15(16.1)10(21.3)5(10.9)
Live With Relatives 0.673
  No86(92.5)44(93.6)42(91.3)
  Yes7(7.5)3(6.4)4(8.7)
Live With Others 0.533
  No79(84.9)41(87.2)38(82.6)
  Yes14(15.1)6(12.8)8(17.4)
Annual Income 0.174
  Missing1(1.1)1(2.1)00
  USD 0–USD 19,99913(14.0)3(6.4)10(21.7)
  USD 20,000–USD 34,99914(15.1)6(12.8)8(17.4)
  USD 35,000–USD 49,99922(23.7)13(27.7)9(19.6)
  >USD 50,00043(46.2)24(51.1)19(41.3)
Employed 0.078
  No51(54.8)30(63.8)21(45.7)
  Yes42(45.2)17(36.2)25(54.3)
Work Hours 0.108
  <4016(17.2)6(12.8)10(21.7)
  4022(23.7)12(25.5)10(21.7)
  >407(7.5)1(2.1)6(13.0)
  Missing48(51.6)28(59.6)20(43.5)
Race 0.299
  American Indian/Alaskan Native2(2.2)2(4.3)00
  White44(47.3)23(48.9)21(45.7)
  Asian17(18.3)8(17.0)9(19.6)
  Black/African American12(12.9)5(10.6)7(15.2)
  More than one15(16.1)6(12.8)9(19.6)
  Unknown3(3.2)3(6.4)00
Ethnicity 0.598
  Hispanic43(46.2)23(48.9)20(43.5)
  Non-Hispanic50(53.8)24(51.1)26(56.5)
Combat Exposure 0.981
  Light3(3.2)1(2.1)2(4.3)
  Moderate Light16(17.2)8(17.0)8(17.4)
  Moderate31(33.3)16(34.0)15(32.6)
  Moderate Heavy28(30.1)14(29.8)14(30.4)
  Heavy15(16.1)8(17.0)7(15.2)
Deployment Preparedness 0.936
  Low Preparedness7(7.5)4(8.5)3(6.5)
  Moderate Preparedness46(49.5)23(48.9)23(50.0)
  High Preparedness40(43.0)20(42.6)20(43.5)
There were no meaningful group differences in any variable in Table 1, and exact p values have been added for each variable name. Completer analysis (n = 71) also revealed no meaningful group differences in any variable in Table 1.
Table 2. VR-12 MCS mean scores.
Table 2. VR-12 MCS mean scores.
Traumacare 05 00027 i001
Pre-Treatment
M (SD); Sample Size		Post-Treatment
M (SD); Sample Size		Delta (Pre–Post)
Δ (SD); p-Value; Sample Size
Verum31.1 (10.1); n = 4736.7 (11.1); n = 39−5.2 ** (11.5); p = 0.01 **; n = 39
Sham31.6 (8.3); n = 4631.6 (11.3); n = 320.7 (8.8); p = 0.65; n = 32
Total31.3 (9.2); n = 9334.4 (11.4); n = 71−2.6 * (10.7); p = 0.049 *; n = 71
* p < 0.05; ** p < 0.01; M = mean; SD = standard deviation; VR-12 MCS = Veterans RAND 12-item Health Survey mental component summary score.
Table 3. VR-12 PCS mean scores.
Table 3. VR-12 PCS mean scores.
Traumacare 05 00027 i002
Pre-Treatment
M (SD); Sample Size		Post-Treatment
M (SD); Sample Size		Delta (Pre–Post)
Δ (SD); p-Value; Sample Size
Verum39.7 (11.2); n = 4743.3 (11.1); n = 39−3.1 (10.2); p = 0.06; n = 39
Sham39.9 (10.6); n = 4638.8 (10.3); n = 32−2.5 (8.5); p = 0.10; n = 32
Total39.8 (10.8); n = 9341.3 (10.9); n = 712.9 (9.4); p = 0.01 **; n = 71
** = statistically significant findings; M = mean; SD = standard deviation; VR-12 PCS = Veterans RAND 12 item Health Survey physical component summary score.
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MDPI and ACS Style

Munoz, A.; Lai-Trzebiatowski, J.; Smith, T.; Frousakis, N.N.; Hsiao, A.-F.; Norrholm, S.D.; Aden, C.; Calloway, T.; Jung, M.; Carrick, K.; et al. The Impact of Acupuncture on Health-Related Quality of Life in Veterans with Combat Post-Traumatic Stress Disorder: A Secondary Analysis of a Randomized Control Trial. Trauma Care 2025, 5, 27. https://doi.org/10.3390/traumacare5040027

AMA Style

Munoz A, Lai-Trzebiatowski J, Smith T, Frousakis NN, Hsiao A-F, Norrholm SD, Aden C, Calloway T, Jung M, Carrick K, et al. The Impact of Acupuncture on Health-Related Quality of Life in Veterans with Combat Post-Traumatic Stress Disorder: A Secondary Analysis of a Randomized Control Trial. Trauma Care. 2025; 5(4):27. https://doi.org/10.3390/traumacare5040027

Chicago/Turabian Style

Munoz, Andrea, Jennifer Lai-Trzebiatowski, Tyler Smith, Nikki N. Frousakis, An-Fu Hsiao, Seth D. Norrholm, Chelsea Aden, Teresa Calloway, Megan Jung, Kala Carrick, and et al. 2025. "The Impact of Acupuncture on Health-Related Quality of Life in Veterans with Combat Post-Traumatic Stress Disorder: A Secondary Analysis of a Randomized Control Trial" Trauma Care 5, no. 4: 27. https://doi.org/10.3390/traumacare5040027

APA Style

Munoz, A., Lai-Trzebiatowski, J., Smith, T., Frousakis, N. N., Hsiao, A.-F., Norrholm, S. D., Aden, C., Calloway, T., Jung, M., Carrick, K., Alpert, R., Krajec, A., Jovanovic, T., & Hollifield, M. (2025). The Impact of Acupuncture on Health-Related Quality of Life in Veterans with Combat Post-Traumatic Stress Disorder: A Secondary Analysis of a Randomized Control Trial. Trauma Care, 5(4), 27. https://doi.org/10.3390/traumacare5040027

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