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Rodríguez-Huguet M, Rodríguez-Almagro D, Rosety-Rodríguez MA, Vinolo-Gil MJ, Molina-Jiménez J, Góngora-Rodríguez J. Pulsed negative pressure myofascial vacuum therapy and percutaneous electrolysis in the treatment of lateral epicondylalgia: A single-blind randomized controlled trial. J Hand Ther 2024:S0894-1130(24)00004-8. [PMID: 38453573 DOI: 10.1016/j.jht.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 11/09/2023] [Accepted: 02/09/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND Lateral Epicondylalgia (LE) represents one of the most common injuries of the upper limb. It is necessary to find effective treatments that reduce pain and increase functionality. PURPOSE To determine the effects of an integrated intervention of Pulsed Negative Pressure Myofascial Vacuum Therapy (VT), Percutaneous Electrolysis (PE) and eccentric exercise (EE) in the treatment of LE compared versus Manual Therapy soft tissue mobilization (MT) and Ultrasound therapy (US) and EE. STUDY DESIGN Single-blind randomized controlled trial. METHODS Forty participants, with unilateral LE, were randomly divided into two groups: VT + PE + EE group (n = 20) and MT + US + EE group (n = 20). The VT + PE + EE group received one weekly session for four weeks and a regimen of EE daily at-home, and the MT + US + EE group received 10 sessions over a period of two weeks and a regimen of EE daily at-home. Numerical pain rating scale (NPRS), range of motion (ROM) pressure pain threshold (PPT) and function (PRTEE questionnaire) were measured before treatment, at the end of treatment, and at one- and three-month follow-ups. RESULTS The statistically significant improvements were found post-treatment, favoring the VT + PE group in pain intensity (p < 0.001; ES = 0.408), PRTEE-S Pain (p = 0.001; ES = 0.377), PRTEE-S Specific function (p = 0.004; ES = 0.306) and PRTEE-S Total (p = 0.001; ES = 0.355). The VT + PE + EE treatment showed greater effectiveness than the MT + US + EE treatment at immediate post-treatment, as well as at the one-month and three-months follow-up. CONCLUSIONS VT and PE added to an EE program could be an effective treatment for pain, ROM, PPT, and function in patients with LE.
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Affiliation(s)
| | | | - Miguel Angel Rosety-Rodríguez
- MOVE-IT Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Cádiz, Spain; Biomedical Research and Innovation Institute of Cadiz (INiBICA), Research Unit, Puerta del Mar University Hospital, University of Cadiz, Cadiz, Spain
| | - Maria Jesus Vinolo-Gil
- Department of Nursing and Physiotherapy, University of Cádiz, Cádiz, Spain; Biomedical Research and Innovation Institute of Cadiz (INiBICA), Research Unit, Puerta del Mar University Hospital, University of Cadiz, Cadiz, Spain; Rehabilitation Clinical Management Unit, Interlevels-Intercenters Hospital Puerta del Mar, Hospital Puerto Real, Cadiz Bay-La Janda Health District, Cadiz, Spain.
| | | | - Jorge Góngora-Rodríguez
- Department of Nursing and Physiotherapy, University of Cádiz, Cádiz, Spain; Department of Physiotherapy, Osuna School University, University of Sevilla, Sevilla, Spain
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Li Y, Mo PC, Lin CF, Pauly S, Kundal N, Hernandez ME, Jan YK. Using near-infrared spectroscopy to investigate the effects of pressures and durations of cupping therapy on muscle blood volume and oxygenation. JOURNAL OF BIOPHOTONICS 2023:e202200342. [PMID: 37002817 DOI: 10.1002/jbio.202200342] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 03/04/2023] [Accepted: 03/28/2023] [Indexed: 06/19/2023]
Abstract
Cupping therapy has been widely used to manage musculoskeletal impairment. However, the effects of pressure and duration of cupping therapy on the hemodynamic activity of the muscle have not been investigated. A 2 × 2 repeated measures factorial design was used to examine the main effect and interaction of pressure (-225 and -300 mmHg) and duration (5 and 10 min) on biceps muscle blood flow using near-infrared spectroscopy in 18 participants. The results showed that a significant interaction is between pressure and duration on deoxy-hemoglobin (p = 0.045). A significant main effect of pressure is on oxyhemoglobin (p = 0.005) and a significant main effect of duration is on oxyhemoglobin (p = 0.005). Cupping therapy at -300 mmHg for 10 min results in a higher oxyhemoglobin (6.75 ± 2.08 μM) and deoxy-hemoglobin (1.71 ± 0.78 μM) compared to other three combinations. Our study provides first evidence that the pressure and duration factors of cupping therapy can significantly affect muscle blood volume and oxygenation.
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Affiliation(s)
- Yameng Li
- Rehabilitation Engineering Lab, Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
- College of Physical Education and Sports, Beijing Normal University, Beijing, China
| | - Pu-Chun Mo
- Rehabilitation Engineering Lab, Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Cheng-Feng Lin
- Rehabilitation Engineering Lab, Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
- Department of Physical Therapy, National Cheng Kung University, Tainan, Taiwan
| | - Serah Pauly
- Rehabilitation Engineering Lab, Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Nikeeta Kundal
- Rehabilitation Engineering Lab, Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Manuel E Hernandez
- Rehabilitation Engineering Lab, Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Yih-Kuen Jan
- Rehabilitation Engineering Lab, Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
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Effectiveness of Negative Pulsed-Pressure Myofascial Vacuum Therapy and Therapeutic Exercise in Chronic Non-Specific Low Back Pain: A Single-Blind Randomized Controlled Trial. J Clin Med 2022; 11:jcm11071984. [PMID: 35407595 PMCID: PMC8999761 DOI: 10.3390/jcm11071984] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 03/22/2022] [Accepted: 03/28/2022] [Indexed: 02/06/2023] Open
Abstract
Non-specific low back pain is defined as pain located in the lumbar region; this condition is the most frequent musculoskeletal disorder. Negative pulsed-pressure myofascial vacuum therapy (vacuum treatment (VT)) devices mobilize tissue according to previously programmed parameters of force, time and frequency. The purpose of this study was to compare the effects of VT combined with core therapeutic exercise versus a physical therapy program (PTP) based only on core therapeutic exercise. Fifty participants with chronic non-specific low back pain were randomly assigned to two treatment groups, the VT group (n = 25) or the PTP group (n = 25). Pain, pressure-pain threshold, range of motion, functionality and quality of life were measured before treatment, at the end of treatment, and at one-month and three-month follow-ups. Both groups received 15 therapy sessions over 5 weeks. Statistically significant differences in favor of the VT group were shown in the results. In conclusion, the intervention based on myofascial vacuum therapy improved pain, mobility, pressure pain threshold, functionality and quality of life.
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Wang W, Yan Y, Guo Z, Hou H, Garcia M, Tan X, Anto EO, Mahara G, Zheng Y, Li B, Kang T, Zhong Z, Wang Y, Guo X, Golubnitschaja O. All around suboptimal health - a joint position paper of the Suboptimal Health Study Consortium and European Association for Predictive, Preventive and Personalised Medicine. EPMA J 2021; 12:403-433. [PMID: 34539937 PMCID: PMC8435766 DOI: 10.1007/s13167-021-00253-2] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 08/25/2021] [Indexed: 02/07/2023]
Abstract
First two decades of the twenty-first century are characterised by epidemics of non-communicable diseases such as many hundreds of millions of patients diagnosed with cardiovascular diseases and the type 2 diabetes mellitus, breast, lung, liver and prostate malignancies, neurological, sleep, mood and eye disorders, amongst others. Consequent socio-economic burden is tremendous. Unprecedented decrease in age of maladaptive individuals has been reported. The absolute majority of expanding non-communicable disorders carry a chronic character, over a couple of years progressing from reversible suboptimal health conditions to irreversible severe pathologies and cascading collateral complications. The time-frame between onset of SHS and clinical manifestation of associated disorders is the operational area for an application of reliable risk assessment tools and predictive diagnostics followed by the cost-effective targeted prevention and treatments tailored to the person. This article demonstrates advanced strategies in bio/medical sciences and healthcare focused on suboptimal health conditions in the frame-work of Predictive, Preventive and Personalised Medicine (3PM/PPPM). Potential benefits in healthcare systems and for society at large include but are not restricted to an improved life-quality of major populations and socio-economical groups, advanced professionalism of healthcare-givers and sustainable healthcare economy. Amongst others, following medical areas are proposed to strongly benefit from PPPM strategies applied to the identification and treatment of suboptimal health conditions:Stress overload associated pathologiesMale and female healthPlanned pregnanciesPeriodontal healthEye disordersInflammatory disorders, wound healing and pain management with associated complicationsMetabolic disorders and suboptimal body weightCardiovascular pathologiesCancersStroke, particularly of unknown aetiology and in young individualsSleep medicineSports medicineImproved individual outcomes under pandemic conditions such as COVID-19.
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Affiliation(s)
- Wei Wang
- Centre for Precision Health, Edith Cowan University, Perth, Australia
- Beijing Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai’an, China
- First Affiliated Hospital, Shantou University Medical College, Shantou, China
- Suboptimal Health Study Consortium, Kumasi, Ghana
- Suboptimal Health Study Consortium, Perth, Australia
- Suboptimal Health Study Consortium, Beijing, China
- Suboptimal Health Study Consortium, Bonn, Germany
- European Association for Predictive, Preventive and Personalised, Medicine, Brussels, Belgium
| | - Yuxiang Yan
- Beijing Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
- Suboptimal Health Study Consortium, Kumasi, Ghana
- Suboptimal Health Study Consortium, Perth, Australia
- Suboptimal Health Study Consortium, Beijing, China
- Suboptimal Health Study Consortium, Bonn, Germany
- European Association for Predictive, Preventive and Personalised, Medicine, Brussels, Belgium
| | - Zheng Guo
- Centre for Precision Health, Edith Cowan University, Perth, Australia
- Suboptimal Health Study Consortium, Kumasi, Ghana
- Suboptimal Health Study Consortium, Perth, Australia
- Suboptimal Health Study Consortium, Beijing, China
- Suboptimal Health Study Consortium, Bonn, Germany
- European Association for Predictive, Preventive and Personalised, Medicine, Brussels, Belgium
| | - Haifeng Hou
- Centre for Precision Health, Edith Cowan University, Perth, Australia
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai’an, China
- Suboptimal Health Study Consortium, Kumasi, Ghana
- Suboptimal Health Study Consortium, Perth, Australia
- Suboptimal Health Study Consortium, Beijing, China
- Suboptimal Health Study Consortium, Bonn, Germany
- European Association for Predictive, Preventive and Personalised, Medicine, Brussels, Belgium
| | - Monique Garcia
- Centre for Precision Health, Edith Cowan University, Perth, Australia
- Suboptimal Health Study Consortium, Kumasi, Ghana
- Suboptimal Health Study Consortium, Perth, Australia
- Suboptimal Health Study Consortium, Beijing, China
- Suboptimal Health Study Consortium, Bonn, Germany
- European Association for Predictive, Preventive and Personalised, Medicine, Brussels, Belgium
| | - Xuerui Tan
- First Affiliated Hospital, Shantou University Medical College, Shantou, China
- Suboptimal Health Study Consortium, Kumasi, Ghana
- Suboptimal Health Study Consortium, Perth, Australia
- Suboptimal Health Study Consortium, Beijing, China
- Suboptimal Health Study Consortium, Bonn, Germany
- European Association for Predictive, Preventive and Personalised, Medicine, Brussels, Belgium
| | - Enoch Odame Anto
- Centre for Precision Health, Edith Cowan University, Perth, Australia
- Suboptimal Health Study Consortium, Kumasi, Ghana
- Suboptimal Health Study Consortium, Perth, Australia
- Suboptimal Health Study Consortium, Beijing, China
- Suboptimal Health Study Consortium, Bonn, Germany
- European Association for Predictive, Preventive and Personalised, Medicine, Brussels, Belgium
- Department of Medical Diagnostics, College of Health Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Gehendra Mahara
- First Affiliated Hospital, Shantou University Medical College, Shantou, China
- Suboptimal Health Study Consortium, Kumasi, Ghana
- Suboptimal Health Study Consortium, Perth, Australia
- Suboptimal Health Study Consortium, Beijing, China
- Suboptimal Health Study Consortium, Bonn, Germany
- European Association for Predictive, Preventive and Personalised, Medicine, Brussels, Belgium
| | - Yulu Zheng
- Centre for Precision Health, Edith Cowan University, Perth, Australia
- Suboptimal Health Study Consortium, Kumasi, Ghana
- Suboptimal Health Study Consortium, Perth, Australia
- Suboptimal Health Study Consortium, Beijing, China
- Suboptimal Health Study Consortium, Bonn, Germany
- European Association for Predictive, Preventive and Personalised, Medicine, Brussels, Belgium
| | - Bo Li
- Suboptimal Health Study Consortium, Kumasi, Ghana
- Suboptimal Health Study Consortium, Perth, Australia
- Suboptimal Health Study Consortium, Beijing, China
- Suboptimal Health Study Consortium, Bonn, Germany
- European Association for Predictive, Preventive and Personalised, Medicine, Brussels, Belgium
- School of Nursing and Health, Henan University, Kaifeng, China
| | - Timothy Kang
- Suboptimal Health Study Consortium, Kumasi, Ghana
- Suboptimal Health Study Consortium, Perth, Australia
- Suboptimal Health Study Consortium, Beijing, China
- Suboptimal Health Study Consortium, Bonn, Germany
- European Association for Predictive, Preventive and Personalised, Medicine, Brussels, Belgium
- Institute of Chinese Acuology, Perth, Australia
| | - Zhaohua Zhong
- Suboptimal Health Study Consortium, Kumasi, Ghana
- Suboptimal Health Study Consortium, Perth, Australia
- Suboptimal Health Study Consortium, Beijing, China
- Suboptimal Health Study Consortium, Bonn, Germany
- European Association for Predictive, Preventive and Personalised, Medicine, Brussels, Belgium
- School of Basic Medicine, Harbin Medical University, Harbin, China
| | - Youxin Wang
- Centre for Precision Health, Edith Cowan University, Perth, Australia
- Beijing Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
- Suboptimal Health Study Consortium, Kumasi, Ghana
- Suboptimal Health Study Consortium, Perth, Australia
- Suboptimal Health Study Consortium, Beijing, China
- Suboptimal Health Study Consortium, Bonn, Germany
- Department of Medical Diagnostics, College of Health Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Xiuhua Guo
- Beijing Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
- Suboptimal Health Study Consortium, Kumasi, Ghana
- Suboptimal Health Study Consortium, Perth, Australia
- Suboptimal Health Study Consortium, Beijing, China
- Suboptimal Health Study Consortium, Bonn, Germany
- European Association for Predictive, Preventive and Personalised, Medicine, Brussels, Belgium
| | - Olga Golubnitschaja
- Suboptimal Health Study Consortium, Kumasi, Ghana
- Suboptimal Health Study Consortium, Perth, Australia
- Suboptimal Health Study Consortium, Beijing, China
- Suboptimal Health Study Consortium, Bonn, Germany
- European Association for Predictive, Preventive and Personalised, Medicine, Brussels, Belgium
- Predictive, Preventive and Personalised (3P) Medicine, Department of Radiation Oncology, University Hospital Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany
| | - On Behalf of Suboptimal Health Study Consortium and European Association for Predictive, Preventive and Personalised Medicine
- Centre for Precision Health, Edith Cowan University, Perth, Australia
- Beijing Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai’an, China
- First Affiliated Hospital, Shantou University Medical College, Shantou, China
- Suboptimal Health Study Consortium, Kumasi, Ghana
- Suboptimal Health Study Consortium, Perth, Australia
- Suboptimal Health Study Consortium, Beijing, China
- Suboptimal Health Study Consortium, Bonn, Germany
- European Association for Predictive, Preventive and Personalised, Medicine, Brussels, Belgium
- Department of Medical Diagnostics, College of Health Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- School of Nursing and Health, Henan University, Kaifeng, China
- Institute of Chinese Acuology, Perth, Australia
- School of Basic Medicine, Harbin Medical University, Harbin, China
- Predictive, Preventive and Personalised (3P) Medicine, Department of Radiation Oncology, University Hospital Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany
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Wang X, Zhang X, Elliott J, Liao F, Tao J, Jan YK. Effect of Pressures and Durations of Cupping Therapy on Skin Blood Flow Responses. Front Bioeng Biotechnol 2020; 8:608509. [PMID: 33425873 PMCID: PMC7793847 DOI: 10.3389/fbioe.2020.608509] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 11/05/2020] [Indexed: 02/06/2023] Open
Abstract
Cupping therapy has been widely used in treating musculoskeletal impairments. However, there is no specific guideline on selecting the intensity of cupping therapy, including the pressure and duration. The objective of this study was to investigate the effect of different pressures and durations of cupping therapy on skin blood flow responses. A 2 × 2 factorial design, including two negative pressures at -225 and -300 mmHg and two durations at 5 and 10 min, was tested in 12 healthy participants. The four protocols of cupping therapy were tested in four different days. Skin blood flow was measured using laser Doppler flowmetry on the left triceps (the SJ12 acupoint). Skin blood flow after cupping therapy was expressed as a ratio of skin blood flow before cupping therapy. The results showed that -300 mmHg caused a significant increase in peak skin blood flow (16.7 ± 2.6 times) compared to -225 mmHg (11.1 ± 2.2 times, p < 0.05) under 5-min duration. The largest difference in skin blood flow is between -300 mmHg for 5 min (16.7 ± 2.6 times) and -225 mmHg for 10 min (8.1 ± 2.3 times, p < 0.01). Our findings demonstrated that a higher value (300 mmHg) of negative pressure is more effective on increasing skin blood flow compared to a lower value (225 mmHg). Also, a shorter duration (5 min) causes a larger peak and total skin blood flow compared to a longer duration (10 min). This study provides the first evidence showing the effect of pressures and durations of cupping therapy on skin blood flow responses.
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Affiliation(s)
- Xiaoling Wang
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China.,Rehabilitation Engineering Lab, Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Xueyan Zhang
- Rehabilitation Engineering Lab, Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Jeannette Elliott
- Disability Resources and Educational Service, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Fuyuan Liao
- Department of Biomedical Engineering, Xi'an Technological University, Xi'an, China
| | - Jing Tao
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Yih-Kuen Jan
- Rehabilitation Engineering Lab, Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, United States
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Hong M, Lee IS, Choi DH, Chae Y. Attentional Bias Toward Cupping Therapy Marks: An Eye-Tracking Study. J Pain Res 2020; 13:1041-1047. [PMID: 32547169 PMCID: PMC7244446 DOI: 10.2147/jpr.s252675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 05/05/2020] [Indexed: 11/23/2022] Open
Abstract
Objective Despite the many medical benefits, cupping therapy can be difficult for some patients due to unpleasant marks on the skin. As patients are afraid of the potential painful sensation from cupping therapy, the skin reactions might produce vigilance for treatment as pain-related information. We investigated whether individuals show negative emotions and attentional bias toward pain-related residual marks from cupping therapy on the body using an eye-tracking method. Methods Fifty pain-free volunteers were presented with four different kinds of visual stimulation, such as the back or face region and with or without cupping marks on the skin. A cupping and a control image were presented on one screen with one image on the left side of the screen and the other on the right (locations of the images were counterbalanced across participants). The eye movements of the participants were measured while they viewed the pictures. They completed the Empathy Quotient questionnaire before the experiment and evaluated the unpleasantness level to each image during the task. Results Images of the back and face with cupping marks were rated significantly more unpleasant and showed a significant attentional bias (significantly longer percentage fixation time) than the control images (attentional bias score: Back + cupping: 48.1 ± 2.8%; Back: -0.7 ± 3.4%; Face + cupping: 34.5 ± 2.5%; Face: -2.2 ± 2.9%). Individuals with greater empathy exhibited significantly higher unpleasantness (r = 0.323, p < 0.05) and less attentional bias (r = -0.279, p < 0.05) to the images with cupping marks. Conclusion The skin reactions caused by cupping therapy evoked negative emotional responses as well as attentional bias to the reaction sites. Our findings suggest that the emotional and attentional responses to cupping therapy might reflect potential reluctance to this therapy.
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Affiliation(s)
- Minyoung Hong
- Acupuncture & Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - In-Seon Lee
- Acupuncture & Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Dha-Hyun Choi
- Acupuncture & Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Younbyoung Chae
- Acupuncture & Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
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Rodríguez-Huguet M, Rodríguez-Huguet P, Lomas-Vega R, Ibáñez-Vera AJ, Rodríguez-Almagro D. Vacuum myofascial therapy device for non-specific neck pain. A single blind randomized clinical trial. Complement Ther Med 2020; 52:102449. [PMID: 32951712 DOI: 10.1016/j.ctim.2020.102449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 05/13/2020] [Accepted: 05/14/2020] [Indexed: 10/24/2022] Open
Abstract
OBJECTIVES This study aimed to investigate the efficacy of a vacuum myofascial therapy device (VT) for improving pressure pain thresholds (PPTs), range of motion (ROM), neck pain-related disability, pain, and quality of life in patients with non-specific neck pain. METHODS A randomized controlled trial in which thirty-eight participants with non-specific neck pain (NP) were randomly assigned to either an experimental (VT) or a comparison physical therapy program (PTP) group. The VT group (n = 19) received five sessions of treatment with a vacuum myofascial therapy device while the PTP group (n = 19) received five sessions of massage, ultrasound therapy (US), and transcutaneous electric nerve stimulation (TENS) over two weeks. The outcome measures were the numerical pain rating scale (NPRS), range of motion, quality of life (SF-12), neck disability Index (NDI), and PPTs at the end of treatment and at one-month follow-up. RESULTS Although both groups experienced improvements in pain, neck disability, range of motion, and pressure pain, these only were statistically significant in the VT group. At one-month follow-up, the VT group still showed improvements in pain, neck disability, and range of motion. DISCUSSION Vacuum myofascial therapy applied with a device offers similar results to other vacuum-based techniques such as cupping therapy. Moreover, in this device the parameters are digitally controlled, which allows for the precise reproduction of treatment.
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Affiliation(s)
- Manuel Rodríguez-Huguet
- Department of Nursing and Physical Therapy. University of Cádiz. Avenida Ana de Viya, 52. 11009, Cádiz, Spain
| | - Pablo Rodríguez-Huguet
- Department of Traumatology and Orthopedic Surgery. Jerez de la Frontera Hospital. Ronda de Circunvalación. 11407, Jerez de la Frontera, Cádiz, Spain
| | - Rafael Lomas-Vega
- Department of Health Sciences, University of Jaén, Paraje Las Lagunillas s/n. 23071, Jaén, Spain
| | | | - Daniel Rodríguez-Almagro
- Department of Health Sciences, University of Jaén, Paraje Las Lagunillas s/n. 23071, Jaén, Spain
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Cognitive and Emotional Aspects of Cupping Therapy. Brain Sci 2020; 10:brainsci10030144. [PMID: 32143284 PMCID: PMC7139758 DOI: 10.3390/brainsci10030144] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 03/01/2020] [Accepted: 03/02/2020] [Indexed: 11/17/2022] Open
Abstract
Cupping therapy has recently gained public attention and is widely used in many regions. Some patients are resistant to being treated with cupping therapy, as visually unpleasant marks on the skin may elicit negative reactions. This study aimed to identify the cognitive and emotional components of cupping therapy. Twenty-five healthy volunteers were presented with emotionally evocative visual stimuli representing fear, disgust, happiness, neutral emotion, and cupping, along with control images. Participants evaluated the valence and arousal level of each stimulus. Before the experiment, they completed the Fear of Pain Questionnaire-III. In two-dimensional affective space, emotional arousal increases as hedonic valence ratings become increasingly pleasant or unpleasant. Cupping therapy images were more unpleasant and more arousing than the control images. Cluster analysis showed that the response to cupping therapy images had emotional characteristics similar to those for fear images. Individuals with a greater fear of pain rated cupping therapy images as more unpleasant and more arousing. Psychophysical analysis showed that individuals experienced unpleasant and aroused emotional states in response to the cupping therapy images. Our findings suggest that cupping therapy might be associated with unpleasant-defensive motivation and motivational activation. Determining the emotional components of cupping therapy would help clinicians and researchers to understand the intrinsic effects of cupping therapy.
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Abstract
This is a systematic review of the clinical use of cupping therapy. Four domestic databases and 2 foreign databases were searched. Studies that reported the cupping pressure used during cupping therapy were included in this study. The types of cupping, cupping site, pressure, and duration of cupping were the main parameters analyzed. A total of 27 studies, including 24 experimental studies were analyzed. There were 12 constant negative pressure (domestic) studies with a range between 60 mmHg and 600 mmHg. There were 5 maximum negative pressure (domestic) studies and the maximum negative pressure was 620 mmHg. Three studies used a maximum negative pressure of 600 mmHg. There were 4 constant negative pressure (foreign) studies with a range between 75 mmHg to 750 mmHg. There were 3 maximum negative pressure (foreign) studies with a maximum pressure of 420 mmHg. The studies differed with regards to the materials used and the amount of pressure applied. Many studies had limited information and therefore generalizability of the results in this review is limited. Further experimental studies are required to establish the correlation between cupping pressure and treatment effects so that cupping therapy can be standardised.
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Tissue Stiffness is Not Related to Pain Experience: An Individually Controlled Study in Patients with Chronic Neck and Back Pain. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2019:1907168. [PMID: 31929809 PMCID: PMC6942862 DOI: 10.1155/2019/1907168] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 10/04/2019] [Accepted: 11/06/2019] [Indexed: 12/21/2022]
Abstract
Background Massage therapies such as cupping are often applied in patients with chronic neck and back pain with the assumption that they can reduce increased tissue stiffness and, therefore, improve pain. The aim of this study was to clarify whether tissue stiffness is related to pain experience in patients with chronic (>3 months) back and neck pain and whether it can be altered by a cupping massage. Methods The tissue stiffness of the point of subjectively felt maximum pain intensity of 40 patients with neck (n = 20) or lower back pain (n = 20) was measured by a myometer. Exact contralateral side served as an individual control. Side of higher stiffness was then treated with a cupping massage. 5, 10, 15, and 20 minutes as well as 24 hours after treatment, tissue stiffness was measured again. Patients rated their pain on a standardized pain questionnaire (neck pain disability score (NDI) or Oswestry disability index (ODI), respectively) before and 24 hours after treatment. Results Compared to the contralateral control side, the more painful side did not exhibit an increased stiffness of myofascial tissue before treatment (p=0.827). The tissue stiffness and the side difference between treated and nontreated control sides decreased significantly after cupping (p=0.002 and p=0.001, respectively) but returned to baseline after 24 hours. NDI and ODI scores significantly decreased 24 hours after cupping (NDI: p=0.012, ODI: p=0.002). Conclusion Tissue stiffness might not be related to pain experience in patients with chronic neck and lower back pain. Trial registration: German Clinical Trial Register (DRKS00011281).
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Kaki A, Sawsan R, Samiha M, Al Jaouni S, Elalah MA, Ibrahim N. Wet Cupping Reduces Pain and Improves Health-related Quality of Life Among Patients with Migraine: A Prospective Observational Study. Oman Med J 2019; 34:105-109. [PMID: 30918603 PMCID: PMC6425047 DOI: 10.5001/omj.2019.21] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objectives To determine the benefits of wet cupping on pain and health-related quality of life (HRQOL) in adult patients with migraine headaches. Methods We conducted a prospective observational study of wet cupping in 128 patients referred to the cupping clinic at King Abdulaziz University Hospital, Jeddah, Saudi Arabia between January 2013 and December 2015. Bloodletting was performed at the base of the head and between the shoulders monthly four times. We assessed migraine headache pain using the visual analog scale (VAS) and the quality of life of patients before and after each cupping session using the World Health Organization Quality of Life assessment instrument. Results The mean age of the patients was 40.5±11.3 years with a preponderance of females (n = 114, 89.1%). VAS was averaged at 7 before the procedure and reduced to 3 after wet cupping, both during rest and activity (p ≤ 0.005). Ninety-five patients agreed to complete the quality of life questionnaire. There was a significant improvement in the quality of life after wet cupping treatment in most of the displayed items (p < 0.050). None of the patients reported post-procedure complications. Conclusions Wet cupping might be considered a complementary treatment for migraine headache pain relief and improvement to a patient’s quality of life.
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Affiliation(s)
- Abdullah Kaki
- Department of Anesthesia and Critical Care, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Rohaiem Sawsan
- Department of Physiology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mourad Samiha
- Cupping Clinic, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Soad Al Jaouni
- Department of Hematology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | - Nahla Ibrahim
- Department of Epidemiology and Public Health, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
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Yang Y, Ma LX, Niu TL, Niu X, Yang XZ, Wang JX, Lu Y, Gao LJ, Chen TY, Zhang YJ, Wu YJ, Song Y. Effects of Pulsatile Cupping on Body Pain and Quality of Life in People with Suboptimal Health:A Randomized Controlled Exploratory Trial. Med Acupunct 2018; 30:326-335. [PMID: 30671153 DOI: 10.1089/acu.2018.1313] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Objective: The curative effect of pneumatic pulsatile cupping on pain has been shown. This study was conducted to investigate effects of the pulsating frequency of pneumatic pulsatile cupping, compared with traditional cupping (TC), on body pain and quality of life (QoL) in people with suboptimal health status (SHS). Materials and Methods: Ninety-six participants with SHS were randomized to low-frequency (LF; n = 24) or high-frequency (HF; n = 24) pulsating cupping, traditional cupping (TC; n = 24), or wait-list (WL; n = 24) groups. The LF, HF, and TC groups received 4 sessions of cupping over 2 weeks. Visual analogue scale (VAS; 0-100 mm) pain level and Short-Form-36 (SF-36) QoL measurements were taken before and after the intervention. Results: Both LF and HF reduced pain significantly (VAS: -28.26; 95% confidence interval [CI] -36.18 to -20.34; and -31.88, 95% CI -39.81 to -23.96; both P = 0.000) and improved QoL more than WL (SF-36, Bodily Pain dimension: 1.46, 95% CI: 0.85 to 2.07; and 1.75, 95% CI: 1.14 to 2.36, both P = 0.000). Compared to TC, LF and HF significantly reduced pain (VAS: -7.92, 95% CI: -15.75 to -0.08, P LT = 0.048; and -11.54, 95% CI: -19.38 to -3.70, P HT = 0.004) and improved QoL (SF-36, Bodily Pain dimension: 0.61, 95% CI: 0.01 to 1.21, P LT = 0.046; and 0.90, 95% CI: 0.30 to 1.50, P HT = 0.004). There was no significant difference between LF and HF. Conclusions: This study showed that, in patients with SHS, pulsatile cupping therapy could have a more-favorable effect to relieve body pain, compared to TC. LF and HF pulsation produced equivalent pain relief. Further studies investigating the underlying mechanism are needed. Trial registration: This trial was registered in the Chinese Clinical Trial Registry (ChiCTR-INR-16009345).
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Affiliation(s)
- Yang Yang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Liang-Xiao Ma
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Ting-Li Niu
- Affiliated Dong Fang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Xin Niu
- School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Xue-Zhi Yang
- School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Jun-Xiang Wang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Yu Lu
- School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Lu-Jiao Gao
- School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Tian-Yu Chen
- School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Yu-Jing Zhang
- School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Yan-Jing Wu
- School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Yue Song
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
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History of cupping ( Hijama ): a narrative review of literature. JOURNAL OF INTEGRATIVE MEDICINE-JIM 2017; 15:172-181. [DOI: 10.1016/s2095-4964(17)60339-x] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Cupping: The common wealth of world traditional medicine. WORLD JOURNAL OF ACUPUNCTURE-MOXIBUSTION 2016. [DOI: 10.1016/s1003-5257(17)30055-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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15
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Rozenfeld E, Kalichman L. New is the well-forgotten old: The use of dry cupping in musculoskeletal medicine. J Bodyw Mov Ther 2016; 20:173-178. [DOI: 10.1016/j.jbmt.2015.11.009] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Revised: 10/06/2015] [Accepted: 10/30/2015] [Indexed: 10/22/2022]
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Mehta P, Dhapte V. Cupping therapy: A prudent remedy for a plethora of medical ailments. J Tradit Complement Med 2015; 5:127-34. [PMID: 26151023 PMCID: PMC4488563 DOI: 10.1016/j.jtcme.2014.11.036] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Revised: 10/28/2014] [Accepted: 11/21/2014] [Indexed: 12/17/2022] Open
Abstract
Since ancient times, complementary and alternative medicine (CAM; bǔ chōng yǔ tì dài yī xué) have played an important role in human health and welfare. Many therapeutic approaches in healthcare outside the realm of conventional medicine persist in various parts of the world. There is considerable scientific and commercial potential in CAM, which needs to be explored precisely. Cupping therapy ( bá guàn liáo fǎ), one of the CAM, is practiced across the world. This therapy is believed to act by correcting imbalances in the internal bio field, such as by restoring the flow of "Qi (qì)". Cupping involves applying a heated cup to generate a partial vacuum that mobilizes the blood flow and promotes effective healing. This review outlines various tools and techniques of cupping therapy.
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Affiliation(s)
- Piyush Mehta
- Department of Quality Assurance, Poona College of Pharmacy, Bharati Vidyapeeth University, Pune, India
| | - Vividha Dhapte
- Department of Pharmaceutics, Poona College of Pharmacy, Bharati Vidyapeeth University, Pune, India
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El Sayed SM, Baghdadi H, Abou-Taleb A, Mahmoud HS, Maria RA, Ahmed NS, Helmy Nabo MM. Al-hijamah and oral honey for treating thalassemia, conditions of iron overload, and hyperferremia: toward improving the therapeutic outcomes. J Blood Med 2014; 5:219-37. [PMID: 25382989 PMCID: PMC4222535 DOI: 10.2147/jbm.s65042] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Iron overload causes iron deposition and accumulation in the liver, heart, skin, and other tissues resulting in serious tissue damages. Significant blood clearance from iron and ferritin using wet cupping therapy (WCT) has been reported. WCT is an excretory form of treatment that needs more research efforts. WCT is an available, safe, simple, economic, and time-saving outpatient modality of treatment that has no serious side effects. There are no serious limitations or precautions to discontinue WCT. Interestingly, WCT has solid scientific and medical bases (Taibah mechanism) that explain its effectiveness in treating many disease conditions differing in etiology and pathogenesis. WCT utilizes an excretory physiological principle (pressure-dependent excretion) that resembles excretion through renal glomerular filtration and abscess evacuation. WCT exhibits a percutaneous excretory function that clears blood (through fenestrated skin capillaries) and interstitial fluids from pathological substances without adding a metabolic or detoxification burden on the liver and the kidneys. Interestingly, WCT was reported to decrease serum ferritin (circulating iron stores) significantly by about 22.25% in healthy subjects (in one session) and to decrease serum iron significantly to the level of causing iron deficiency (in multiple sessions). WCT was reported to clear blood significantly of triglycerides, low-density lipoprotein (LDL) cholesterol, total cholesterol, uric acid, inflammatory mediators, and immunoglobulin antibodies (rheumatoid factor). Moreover, WCT was reported to enhance the natural immunity, potentiate pharmacological treatments, and to treat many different disease conditions. There are two distinct methods of WCT: traditional WCT and Al-hijamah (WCT of prophetic medicine). Both start and end with skin sterilization. In traditional WCT, there are two steps, skin scarification followed by suction using plastic cups (double S technique); Al-hijamah is a three-step procedure that includes skin suction using cups, scarification (shartat mihjam in Arabic), and second skin suction (triple S technique). Al-hijamah is a more comprehensive technique and does better than traditional WCT, as Al-hijamah includes two pressure-dependent filtration steps versus one step in traditional WCT. Whenever blood plasma is to be cleared of an excess pathological substance, Al-hijamah is indicated. We will discuss here some reported hematological and therapeutic benefits of Al-hijamah, its medical bases, methodologies, precautions, side effects, contraindications, quantitative evaluation, malpractice, combination with oral honey treatment, and to what extent it may be helpful when treating thalassemia and other conditions of iron overload and hyperferremia.
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Affiliation(s)
- Salah Mohamed El Sayed
- Department of Medical Biochemistry, Sohag Faculty of Medicine, Sohag University, Sohag, Egypt ; Department of Clinical Biochemistry and Molecular Medicine, Taibah Faculty of Medicine, Taibah University, Al-Madinah Al-Munawwarah, Kingdom of Saudi Arabia
| | - Hussam Baghdadi
- Department of Clinical Biochemistry and Molecular Medicine, Taibah Faculty of Medicine, Taibah University, Al-Madinah Al-Munawwarah, Kingdom of Saudi Arabia
| | - Ashraf Abou-Taleb
- Department of Pediatrics, Sohag Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Hany Salah Mahmoud
- World Federation of Alternative and Complementary Medicine, Cairo Regional Headquarter, Cairo, Egypt
| | - Reham A Maria
- Department of Clinical Biochemistry and Molecular Medicine, Taibah Faculty of Medicine, Taibah University, Al-Madinah Al-Munawwarah, Kingdom of Saudi Arabia ; Department of Medical Biochemistry, Tanta Faulty of Medicine, Tanta University, Tanta, Egypt
| | - Nagwa S Ahmed
- Department of Medical Biochemistry, Sohag Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Manal Mohamed Helmy Nabo
- Department of Pediatrics, Sohag Teaching Hospital, Sohag, Egypt ; Division of Pediatric Cardiology, Department of Pediatrics, Maternity and Children Hospital, King Abdullah Medical City, Al-Madinah Al-Munawwarah, Kingdom of Saudi Arabia
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El Sayed SM, Abou-Taleb A, Mahmoud HS, Baghdadi H, Maria RA, Ahmed NS, Nabo MMH. Percutaneous excretion of iron and ferritin (through Al-hijamah) as a novel treatment for iron overload in beta-thalassemia major, hemochromatosis and sideroblastic anemia. Med Hypotheses 2014; 83:238-46. [PMID: 24857772 DOI: 10.1016/j.mehy.2014.04.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2013] [Revised: 09/25/2013] [Accepted: 04/01/2014] [Indexed: 11/24/2022]
Abstract
Iron overload is a big challenge when treating thalassemia (TM), hemochromatosis and sideroblastic anemia. It persists even after cure of TM with bone marrow transplantation. Iron overload results from increased iron absorption and repeated blood transfusions causing increased iron in plasma and interstitial fluids. Iron deposition in tissues e.g. heart, liver, endocrine glands and others leads to tissue damage and organ dysfunction. Iron chelation therapy and phlebotomy for iron overload have treatment difficulties, side effects and contraindications. As mean iron level in skin of TM patients increases by more than 200%, percutaneous iron excretion may be beneficial. Wet cupping therapy (WCT) is a simple, safe and economic treatment. WCT is a familiar treatment modality in some European countries and in Chinese hospitals in treating different diseases. WCT was reported to clear both blood plasma and interstitial spaces from causative pathological substances (CPS). Standard WCT method is Al-hijamah (cupping, puncturing and cupping, CPC) method of WCT that was reported to clear blood and interstitial fluids better than the traditional WCT (puncturing and cupping method, PC method of WCT). In other word, traditional WCT may be described as scarification and suction method (double S technique), while Al-hijamah may be described as suction, scarification and suction method (triple S technique). Al-hijamah is a more comprehensive treatment modality that includes all steps and therapeutic benefits of traditional dry cupping therapy and WCT altogether according to the evidence-based Taibah mechanism (Taibah theory). During the first cupping step of Al-hijamah, a fluid mixture is collected inside skin uplifting due to the effect of negative pressure inside sucking cups. This fluid mixture contains collected interstitial fluids with CPS (iron, ferritin and hemolyzed RBCs in thalassemia), filtered fluids (from blood capillaries) with iron and hemolyzed blood cells (hemolyzed RBCs, WBCs and platelets). That fluid mixture does not contain intact blood cells (having diameters in microns) that are too big to pass through pores of skin capillaries (6-12nm in diameter) and cannot be filtered. Puncturing skin upliftings and applying second cupping step excrete collected fluids. Skin scarifications (shartat mihjam in Arabic) should be small, superficial (0.1mm in depth), short (1-2mm in length), multiple, evenly distributed and confined to skin upliftings. Sucking pressure inside cups (-150 to -420mmHg) applied to skin is transmitted to around skin capillaries to be added to capillary hydrostatic pressure (-33mmHg at arterial end of capillaries and -13mmHg at venous end of capillaries) against capillary osmotic pressure (+20mmHg). This creates a pressure gradient and a traction force across skin and capillaries and increases filtration at arterial end of capillaries at net pressure of -163 to -433mmHg and at venous end of capillaries at net pressure of -143 to -413mmHg resulting in clearance of blood from CPS (iron, ferritin and hemolyzed blood cells). Net filtration pressure at renal glomeruli is 10mmHg i.e. Al-hijamah exerts a more pressure-dependent filtration than renal glomeruli. Al-hijamah may benefit patients through inducing negative iron balance. Interestingly, Al-hijamah was reported to decrease serum ferritin significantly (by about 22%) in healthy subjects while excessive traditional WCT was reported to cause iron deficiency anemia. Al-hijamah is a highly recommended treatment in prophetic medicine. In conclusion, Al-hijamah may be a promising adjuvant treatment for iron overload in TM, hemochromatosis and sideroblastic anemia.
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Affiliation(s)
- Salah Mohamed El Sayed
- Department of Clinical Biochemistry and Molecular Medicine, Taibah Faculty of Medicine, Taibah University, Al-Madinah Al-Munawwarah, Saudi Arabia. Department of Medical Biochemistry, Sohag Faculty of Medicine, Sohag University, Egypt
| | - Ashraf Abou-Taleb
- Department of Pediatrics, Sohag Faculty of Medicine, Sohag University, Egypt
| | - Hany Salah Mahmoud
- World Federation of Alternative and Complementary Medicine, Cairo Regional Headquarter, Cairo, Egypt
| | - Hussam Baghdadi
- Department of Clinical Biochemistry and Molecular Medicine, Taibah Faculty of Medicine, Taibah University, Al-Madinah Al-Munawwarah, Kingdom of Saudi Arabia
| | - Reham A Maria
- Department of Clinical Biochemistry and Molecular Medicine, Taibah Faculty of Medicine, Taibah University, Al-Madinah Al-Munawwarah, Kingdom of Saudi Arabia; Department of Medical Biochemistry, Tanta Faulty of Medicine, Tanta University, Egypt
| | - Nagwa Sayed Ahmed
- Department of Medical Biochemistry, Sohag Faculty of Medicine, Sohag University, Egypt
| | - Manal Mohamed Helmy Nabo
- Department of Pediatrics, Sohag Teaching Hospital, Sohag, Egypt; Division of Pediatric Cardiology, Department of Pediatrics, Maternity and Children Hospital, King Abdullah Medical City, Al-Madinah Al-Munawwarah, Kingdom of Saudi Arabia
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Nimrouzi M, Mahbodi A, Jaladat AM, Sadeghfard A, Zarshenas MM. Hijamat in Traditional Persian Medicine. J Evid Based Complementary Altern Med 2014; 19:128-36. [DOI: 10.1177/2156587214524578] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Traditional Persian medicine is based on humoral medical concepts. In the case of abundant blood in the body, tabi’at (body nature) deals with this imbalance by elimination of the morbid substances via some controlling mechanisms. If tabi’at could not react properly, the physician should prescribe an intervention to let the extra blood out. This can be done through phlebotomy, wet cupping, and the use of leech or scarification of the ears. Cupping with scarification may eliminate the morbid substance through the scarified skin, and cupping without scarification evacuates the morbid materials from the compromised organs. Wet cupping in health state is meant to be applied for preventing the blood humor dominance in susceptible individuals. In disease condition, wet cupping is defined as a treatment in which the patients confront the abundance of blood. Wet cupping may have harmful complications in extremely thin or obese patients. Wet cupping should be postponed in patients compromised by diseases especially in the thick phlegm abundance. In Asia, Iranian people, because of religious beliefs, are very interested in cupping therapy. Many unsupervised cupping procedures are performed in Iran, whereas benefits and risks of these procedures are undetermined by providers and clients. In this study, the most important indications and contraindications of wet cupping have been reviewed based on the traditional Persian medicine resources.
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Affiliation(s)
- Majid Nimrouzi
- Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Essence of Parsiyan Wisdom Institute, Traditional Medicine and Medicinal Plant Incubator, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Mahbodi
- Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amir-Mohammad Jaladat
- Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Essence of Parsiyan Wisdom Institute, Traditional Medicine and Medicinal Plant Incubator, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Abbas Sadeghfard
- Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad M. Zarshenas
- Essence of Parsiyan Wisdom Institute, Traditional Medicine and Medicinal Plant Incubator, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Traditional Pharmacy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
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Emerich M, Braeunig M, Clement HW, Lüdtke R, Huber R. Mode of action of cupping--local metabolism and pain thresholds in neck pain patients and healthy subjects. Complement Ther Med 2014; 22:148-58. [PMID: 24559830 DOI: 10.1016/j.ctim.2013.12.013] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Revised: 12/06/2013] [Accepted: 12/28/2013] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVES Cupping worldwide has been part of traditional medicine systems and is in the western world used as CAM therapy mainly for treating pain syndromes. The mode of action is up to now unclear. In order to investigate its mechanism we measured in parallel metabolic changes in the tissue under the cupping glass and pressure pain thresholds. DESIGN AND INTERVENTIONS In 12 volunteers (6 healthy subjects and 6 patients with chronic neck pain) a microdialysis system was implanted subcutaneously on both sides (left and right) above the trapezius muscle. After baseline measures cupping was performed at one randomly selected side (left or right), the other side served as control. Every 20 min during baseline measures and for 280 min after cupping, microdialysis probes for detection of lactate, pyruvate, glucose and glycerin were taken. In addition, pain thresholds were measured before and after cupping with algometry. RESULTS Cupping resulted in a strong increase of lactate (beginning 160 min after cupping until the end of the measurements) and the lactate/pyruvate ratio, indicating an anaerobe metabolism in the surrounding tissue. Baseline pain thresholds were non-significantly lower in neck pain patients compared to healthy controls and slightly increased immediately after cupping (p<0.05 compared to baseline close to the area of cupping in healthy subjects and on the foot in neck pain patients). After 280 min no more significant changes of pain thresholds were detected. CONCLUSIONS Cupping induces >280 min lasting anaerobe metabolism in the subcutaneous tissue and increases immediate pressure pain thresholds in some areas.
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Affiliation(s)
- M Emerich
- Center for Complementary Medicine, Department of Environmental Health Sciences, University Medical Center, 79106 Freiburg, Germany
| | - M Braeunig
- Department Psychosomatic Medicine, University Medical Center, 79106 Freiburg, Germany
| | - H W Clement
- Department Child and Youth Psychiatry, University Medical Center, 79106 Freiburg, Germany
| | - R Lüdtke
- Karl und Veronica Carstens-Foundation, 45276 Essen, Germany
| | - R Huber
- Center for Complementary Medicine, Department of Environmental Health Sciences, University Medical Center, 79106 Freiburg, Germany.
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Teut M, Kaiser S, Ortiz M, Roll S, Binting S, Willich SN, Brinkhaus B. Pulsatile dry cupping in patients with osteoarthritis of the knee - a randomized controlled exploratory trial. Altern Ther Health Med 2012; 12:184. [PMID: 23057611 PMCID: PMC3527288 DOI: 10.1186/1472-6882-12-184] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2012] [Accepted: 10/04/2012] [Indexed: 01/22/2023]
Abstract
Introduction Cupping is used in various traditional medicine forms to relieve pain in musculoskeletal diseases. The aim of this study was to investigate the effectiveness of cupping in relieving the symptoms of knee osteoarthritis (OA). Methods In a two-group, randomized controlled exploratory pilot study patients with a clinically and radiological confirmed knee OA (Kellgren-Lawrence Grading Scale: 2-4) and a pain intensity > 40 mm on a 100 mm visual analogue scale (VAS) were included. 40 Patients were randomized to either 8 sessions of pulsatile dry cupping within 4 weeks or no intervention (control). Paracetamol was allowed on demand for both groups. Outcomes were the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) score, the pain intensity on a VAS (0 mm = no pain to 100 mm = maximum intensity) and Quality of Life (SF-36) 4 and 12 weeks after randomization. Use of Paracetamol was documented within the 4-week treatment period. Analyses were performed by analysis of covariance adjusting for the baseline value for each outcome. Results 21 patients were allocated to the cupping group (5 male; mean age 68 ± SD 7.2) and 19 to the control group (8 male; 69 ± 6.8). After 4 weeks the WOMAC global score improved significantly more in the cupping group with a mean of 27.7 (95% confidence interval 22.1; 33.3) compared to 42.2 (36.3; 48.1) in the control group (p = 0.001). After 12 weeks the WOMAC global score were still significantly different in favor for cupping (31.0 (24.9; 37.2) vs. 40.8 (34.4; 47.3) p = 0.032), however the WOMAC subscores for pain and stiffness were not significant anymore. Significantly better outcomes in the cupping group were also observed for pain intensity on VAS and for the SF-36 Physical Component Scale compared to the control group after 4 and 12 weeks. No significant difference was observed for the SF-36 Mental Component Scale and the total number of consumed Paracetamol tablets between both groups (mean 9.1, SD ± 20.0 vs. 11.5 ± 15.9). Conclusion In this exploratory study dry cupping with a pulsatile cupping device relieved symptoms of knee OA compared to no intervention. Further studies comparing cupping with active treatments are needed. Trial registration Clinicaltrials.gov Identifier: NCT01057043
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