Acupuncture can be beneficial for exercise-induced muscle soreness: A randomised controlled trial

Effect of different Volumes of exercise on skin temperature responses over the following 24 hours

Skin temperature responses have been advocated to indicate exercise-induced muscle soreness and recovery status. While the evidence is contradictory, we hypothesize that the presence of muscle damage and the time window of measurement are confounding factors in the skin temperature response. The objective was to determine whether skin temperature is influenced by different workloads and the time course of temperature measurements over the following 24 h. 24 trained male military were assigned to one of three groups: GC group (n = 8) serving as control not performing exercises, GE group (n = 8) performing a simulated military combat protocol in an exercise track with different obstacles but designed not to elicit muscle damage, and the GEMD group (n = 8) performing the simulated military combat protocol plus 5 sets of 20 drop jumps, with 10-sec between repetitions and with 2-min of rest between sets aiming to induce muscle damage. Skin temperature was measured using infrared thermography before exercise (Pre) and 4 (Post4h), 8 (Post8h) and 24h (Post24h) post-exercise. Perception of pain (DOMS) was evaluated Pre, Post24h, and Post48h, and countermovement jump height was evaluated at Pre and Post24h. DOMS did not differ between groups in the Pre and Post24h measures but GEMD presented higher DOMS than the other groups at Post48h (p < 0.001 and large effect size). Jump height did not differ for GEMD and GC, and GE presented higher jump height at Post24h than GC (p = 0.02 and large effect size). Skin temperature responses of GEMD and GG were similar in all measurement moments (p > 0.22), and GE presented higher skin temperature than the GC and the GEMD groups at Post24h (p < 0.01 and large effect sizes). In conclusion, although physical exercise elicits higher skin temperature that lasts up to 24 h following the efforts, muscle soreness depresses this response.

Effect of ST36 electroacupuncture on the switch of skeletal muscle fibres in mice with sciatic nerve dissociation

Skeletal muscle is striated muscle that moves autonomously and is innervated by peripheral nerves. Peripheral nerve injury is very common in clinical treatment. However, the commonly used treatment methods often focus on the regeneration of the injured nerve but overlook the pathological changes in the injured skeletal muscle. Acupuncture, as the main treatment for denervated skeletal muscle atrophy, is used extensively in clinical practice. In the present study, a mouse model of lower limb sciatic nerve detachment was constructed and treated with electroacupuncture Stomach 36 to observe the atrophy of lower limb skeletal muscle and changes in skeletal muscle fibre types before and after electroacupuncture Stomach 36 treatment. Mice with skeletal muscle denervation showed a decrease in the proportion of IIa muscle fibres and an increase in the proportion of IIb muscle fibres, after electroacupuncture Stomach 36. The changes were reversed by specific activators of p38 MAPK, which increased IIa myofibre ratio. The results suggest that electroacupuncture Stomach 36 can reverse the change of muscle fibre type from IIb to IIa after denervation of skeletal muscle by inhibiting p38 MAPK. The results provide an important theoretical basis for the treatment of clinical peripheral nerve injury diseases with electroacupuncture, in addition to novel insights that could facilitate the study of pathological changes of denervated skeletal muscle.

Transcutaneous electrical acupoint stimulation benefits postoperative pain relief of oocyte retrieval: A randomized controlled trial

BACKGROUND

Transvaginal oocyte retrieval is frequently followed by adverse events related to anesthesia and the procedure. Some research showed that transcutaneous electrical acupoint stimulation (TEAS) can relieve intraoperative pain and postoperative nausea.

OBJECTIVE

This study examined whether TEAS can alleviate pain and relieve adverse symptoms after oocyte retrieval.

DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS

Altogether 128 patients were randomly divided into the TEAS group and the mock TEAS group. The two groups received a 30-minute-long TEAS or mock TEAS treatment that began 30 min after oocyte retrieval.

MAIN OUTCOME MEASURES

The primary outcome was the visual analog scale (VAS) pain score. Secondary outcomes were pressure pain threshold, McGill score, pain rating index (PRI), present pain intensity (PPI), VAS stress score, VAS anxiety score, and postoperative adverse symptoms.

RESULTS

The baseline characteristics of the two groups were comparable (P > 0.05). The VAS pain scores of the TEAS group were lower than those of the mock TEAS group at 60 and 90 min after oocyte retrieval (P < 0.05). The McGill score, PRI and PPI in the TEAS group were significantly lower than those in the control group at 60 min after oocyte retrieval (P < 0.05). However, the two groups had equivalent beneficial effects regarding the negative emotions, such as nervousness and anxiety (P > 0.05). The TEAS group was superior to the mock TEAS group for relieving postoperative adverse symptoms (P < 0.05).

CONCLUSION

TEAS treatment can relieve postoperative pain and postoperative adverse symptoms for patients undergoing oocyte retrieval. Please cite this article as: Liu LY, Su Y, Wang RR, Lai YY, Huang L, Li YT, Tao XY, Su MH, Zheng XY, Huang SC, Wu YN, Yu SY, Liang FR, Yang J. Transcutaneous electrical acupoint stimulation benefits postoperative pain relief of oocyte retrieval: A randomized controlled trial. J Integr Med. 2024; 22(1): 32-38.

Practicing Outside the Lines: Using Acupuncture in the Athletic Training Room and on the Field

Acupuncture can be used to treat athletes in an outpatient clinic setting, athletic training room, or even on a football field sideline. This article details 3 scenarios, in 3 illustrative cases, in which acupuncture was used for sports medicine in more unconventional settings. The author describes each case and shares his observations about them. First, acupuncture was used on a high-school football field sideline to help alleviate acute calf cramping in a player. Second, acupuncture was used in a division 2 college athletic training room to treat a player with subacute thoracic pain that was not improving with the usual treatments provided by the athletic trainers. Third, acupuncture was used to treat hamstring strain and tightness in a professional National Football League player to enhance his performance. These situations demonstrate the versatility of acupuncture in the realm of sports medicine. Acupuncture is an added-value service for athletes, and acupuncture providers should not be afraid to promote it in this population that is always looking for a competitive advantage.

Can Acupuncture Improve the Flexibility of Hamstring Muscles? A Randomized, Blinded, and Controlled Pilot Study

(1) Background: The lack of flexibility is frequently reported as a risk factor for hamstring muscle damage. Acupuncture, a therapeutic tool of traditional Chinese medicine (TCM), may play a role in both treatment and prevention by improving muscle strength, microcirculation, and reducing muscle soreness. The primary objective of this pilot study was to examine the immediate effects of acupuncture on hamstring muscle stretching and on the pain or discomfort reported during stretching. (2) Methods: To mitigate heterogeneity effects, and due to the small sample size, the study employed a crossover design in which each participant was tested at three different moments of the experimental period with verum (true acupuncture in selected acupoints), sham (fake acupuncture in zones of the skin not corresponding to any known acupoint but near the selected acupoints), and placebo (stimulation of the selected acupoints with a stainless steel wire and cannula, without puncturing) stimulations. Flexibility and pain or discomfort were assessed using the seat and reach test (SR) and a visual analogic scale (VAS). (3) Results: Significant changes in flexibility were observed after verum acupuncture (p = 0.03), while no significant changes were seen in sham and placebo (p = 0.86 and p = 0.18, respectively). No significant differences were found in pain or discomfort during any of the stimulations (verum, p = 0.55; sham, p = 0.50; placebo, p = 0.58). (4) Conclusions: The results of this pilot study suggest that acupuncture may improve flexibility in the hamstring muscles, though it does not significantly affect pain or discomfort during stretching.

Acupuncture and Dry Needling for Sports Performance and Recovery

ABSTRACT

Acupuncture and dry needling share many similarities in their proposed mechanisms of action and their sports medicine-related applications. Pain is the most common indication for these needling treatments, but there also are some limited studies on their use for ergogenic purposes. Needling can likely improve muscular strength and power, including increasing jump height, and it also can increase flexibility. In terms of sports recovery, acupuncture can not only be used for pain relief after injury, but also can help with routine recovery, such as in delayed onset muscle soreness. There are numerous case reports of acupuncture and dry needling being used to treat athletes for various diagnoses and conditions, however more high quality studies are needed in order to make more specific evidence-based recommendations. Given the high degree of safety and limited adverse events associated with needling treatments, it can likely be promoted in athletes.

The Prevalence of Use of Various Post-Exercise Recovery Methods after Training among Elite Endurance Athletes

There is now compelling evidence of the effectiveness of a range of post-exercise recovery techniques, including extended nights of sleep, cold water immersion, massage, and compression garments. Currently, limited information is available on post-exercise recovery methods used by elite endurance athletes. Therefore, this study investigated the actual methods of recovery used in this group of athletes. Google Forms were used to collect information on the recovery methods used by elite endurance track and field athletes (n = 153, 61.4% men, 38.6% women; average age: 22.7 ± 4.6 years). The most used methods of recovery were sauna bathing (96.7%), massage (86.9%), daytime nap (81.0%), and long night sleep (at least 9h) (61.4%). Recovery methods with proven effectiveness such as cold water immersion and compression garments were rarely used (15.0% and 7.8%, respectively). Overall, recovery methods were used more often when the tiers of the track and field athletes were higher. Massage and sauna bathing were the most used methods of post-exercise recovery among Russian endurance track and field athletes. In most cases, they were used in conjunction with short daytime nap and long night sleep. Higher tier athletes were more likely to use sauna bathing, massage, long night sleep, and daytime nap but not cold water immersion and compression garments as recovery methods; however, all these methods except for cold water immersion were widely used among elite-tier athletes.

Physical therapy interventions for the treatment of delayed onset muscle soreness (DOMS): Systematic review and meta-analysis

OBJECTIVE

To evaluate the impact of interventions on pain associated with DOMS.

DATA SOURCES

PubMed, EMBASE, PEDro, Cochrane, and Scielo databases were searched, from the oldest records until May/2020. Search terms used included combinations of keywords related to "DOMS" and "intervention therapy".

ELIGIBILITY CRITERIA

Healthy participants (no restrictions were applied, e.g., age, sex, and exercise level). To be included, studies should be: 1) Randomized clinical trial; 2) Having induced muscle damage and subsequently measuring the level of pain; 3) To have applied therapeutic interventions (nonpharmacological or nutritional) and compare with a control group that received no intervention; and 4) The first application of the intervention had to occur immediately after muscle damage had been induced.

RESULTS

One hundred and twenty-one studies were included. The results revealed that the contrast techniques (p = 0,002 I² = 60 %), cryotherapy (p = 0,002 I² = 100 %), phototherapy (p = 0,0001 I² = 95 %), vibration (p = 0,004 I² = 96 %), ultrasound (p = 0,02 I² = 97 %), massage (p < 0,00001 I² = 94 %), active exercise (p = 0,0004 I² = 93 %) and compression (p = 0,002 I² = 93 %) have a better positive effect than the control in the management of DOMS.

CONCLUSION

Low quality evidence suggests that contrast, cryotherapy, phototherapy, vibration, ultrasound, massage, and active exercise have beneficial effects in the management of DOMS-related pain.

Can Traditional Chinese Medicine Diagnosis Be Parameterized and Standardized? A Narrative Review

The integration of Traditional Chinese Medicine (TCM) in Western health systems and research requires a rational communicable theory, scientific proof of efficacy and safety, and quality control measures. The existence of clear definitions and the diagnosis standardization are critical factors to establish the patient's vegetative functional status accurately and, therefore, systematically apply TCM therapeutics such as the stimulation of reflex skin areas known as acupoints. This science-based conceptualization entails using validated methods, or even developing new systems able to parameterize the diagnosis and assess TCM related effects by objective measurements. Traditionally, tongue and pulse diagnosis and the functional evaluation of action points by pressure sensitivity and physical examination may be regarded as essential diagnostic tools. Parameterizing these techniques is a future key point in the objectification of TCM diagnosis, such as by electronic digital image analysis, mechanical pulse diagnostic systems, or the systematic evaluation of acupoints' electrophysiology. This review aims to demonstrate and critically analyze some achievements and limitations in the clinical application of device-assisted TCM diagnosis systems to evaluate functional physiological patterns. Despite some limitations, tongue, pulse, and electrophysiological diagnosis devices have been reported as a useful tool while establishing a person's functional status.

Effects of the infrared laser on classical ballerinas' feet: Analysis of plantar foot and static balance

BACKGROUND AND PURPOSE

Overuse injuries and painful symptoms in athletes and dancers (especially classical ballerinas) may lead to reduced functional performance. However, laser application may reduce pain and increase physical conditioning. The aim of the current study was to evaluate the immediate and long-term effects of infrared laser on classical ballerinas' feet.

METHODS

Eight female adults who perform classical ballet training and feel pain in their foot, but report no injuries in the last 6 months participated in the study. Infrared laser (808 nm) was applied on ballerina's feet twice a week during three months. The laser parameters utilized were 100 mW average optical power and spot size of 0.04 cm² applied during 1 min, leading to 6 J and 125 J/cm² per point. Thermography, algometry and unipodal static standing balance test were performed.

RESULTS

There was a significant increase in plantar arch temperature (1.6 °C for center and 2.3 °C for border, p < 0.05) immediately after laser treatment for all ballerinas. The pressure pain thresholds (PPT) were significantly increased for 5 of 7 analyzed sites (p < 0.05). Regarding to the static standing balance, the time on one-foot showed a significant increases (from 23 ± 12 s to 34 ± 13 s, p < 0.05) only when the test was performed on the left foot (support foot).

CONCLUSION

Then, there were pain relief and improvement of functional performance in ballerinas. The possible mechanism of laser action in reducing pain and thus enhancing performance, like higher blood flow of foot due to an increase of cutaneous temperature, will be discussed.

The effectiveness of low intensity exercise and blood flow restriction without exercise on exercise induced muscle damage: A systematic review

OBJECTIVE

To investigate the evidence and provide clinical recommendations for low intensity exercises(LIE) and blood flow restriction(BFR) without exercise on reducing the effects of exercise induced muscle damage(EIMD).

METHOD

PubMed, Embase, Web of science, and PEDro(Physiotherapy Evidence Database) were searched up to December 2019 for studies that included LIE or BFR without exercise and their effect on EIMD.

RESULTS

Out of 3192 studies, 23 were included with 17 on LIE and 6 on BFR without exercise. 11 studies demonstrated positive effects for LIE on EIMD, with two level 2 and nine level 3 studies. Two level 2 and two level 3 studies found benefits for BFR without exercise on reducing the negative effects of EIMD, while two level 2 studies found did not find benefits for BFR without exercise.

CONCLUSION

Moderate to low levels of evidence supported LIE, particularly in the form of protective low load eccentric exercise, in reducing the negative effects of EIMD. Conflicting moderate to low levels of evidence was found regarding BFR without exercise. There does seem to be potential benefit for BFR without exercise in untrained individuals. Clinicians can provide clinical recommendations as LIE and BFR without exercise reducing EIMD.

Effects of Acupuncture on Delayed-Onset Muscle Soreness: A Systematic Review and Meta-Analysis

OBJECTIVES

Evidence for the effects of acupuncture on delayed-onset muscle soreness (DOMS) is inconsistent. The aim of this study was to explore the effects of acupuncture on DOMS.

METHODS

Studies investigating the effect of acupuncture on DOMS in humans that were published before March 2020 were obtained from eight electronic databases. The affected muscles, groups, acupuncture points, treatment sessions, assessments, assessment times, and outcomes of the included articles were reviewed. The data were extracted and analyzed via a meta-analysis.

RESULTS

A total of 15 articles were included, and relief of DOMS-related pain was the primary outcome. The statistical meta-analysis showed that there were no significant differences between acupuncture and sham/control groups, except for acupuncture for DOMS on day 1 (total SMD = -0.62; 95% CI = -1.12∼0.11, P < 0.05) by comparing with control groups.

CONCLUSION

Acupuncture for DOMS exhibited very-small-to-small and small-to-moderate effects on pain relief for the sham and no acupuncture conditions, respectively. Evidence indicating the effects of acupuncture on DOMS was little because the outcome data during the follow-up were insufficient to perform an effective meta-analysis.