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Romero-García PA, Ramirez-Perez S, Miguel-González JJ, Guzmán-Silahua S, Castañeda-Moreno JA, Komninou S, Rodríguez-Lara SQ. Complementary and Alternative Medicine (CAM) Practices: A Narrative Review Elucidating the Impact on Healthcare Systems, Mechanisms and Paediatric Applications. Healthcare (Basel) 2024; 12:1547. [PMID: 39120250 PMCID: PMC11311728 DOI: 10.3390/healthcare12151547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 06/29/2024] [Accepted: 07/03/2024] [Indexed: 08/10/2024] Open
Abstract
While research on complementary and alternative medicine (CAM) for the general population is expanding, there remains a scarcity of studies investigating the efficacy and utilisation of CAM practices, specifically in the paediatric population. In accordance with the World Health Organization (WHO), the prevalence of the parental utilisation of CAM in their dependents is estimated to reach up to 80%. This literature review identified broad, heterogeneous, and inconclusive evidence regarding CAM's applications and effectiveness, primarily attributed to variance in sociodemographic factors and differences in national healthcare systems. Additionally, the review identified a lack of consensus and polarised positions among mainstream professionals regarding the mechanisms of action, applications, and effectiveness of CAM. This narrative review presents varied results concerning the efficacy of most CAM therapies and their applications; however, some evidence suggests potential benefits for acupuncture, yoga, tai chi, and massage in improving physical and mental health. Moreover, the available evidence indicates that meditation may enhance mental health, while reiki may only influence patients' perceptions of comfort. In light of the intricate and multifaceted nature of herbal medicine, it is imperative to assess its efficacy on a case-by-case basis, taking into account the specific compounds and procedures involved. This comprehensive review serves as a valuable resource for health professionals, offering guidance for personalised healthcare approaches that consider the values and beliefs of patients, thereby facilitating integrated, evidence-based practices aimed at enhancing the quality of healthcare services and patient satisfaction.
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Affiliation(s)
- Patricia Anaid Romero-García
- School of Medicine, Universidad Autónoma de Guadalajara, Zapopan 45129, Jalisco, Mexico; (S.R.-P.); (J.J.M.-G.); (S.G.-S.); (J.A.C.-M.)
| | - Sergio Ramirez-Perez
- School of Medicine, Universidad Autónoma de Guadalajara, Zapopan 45129, Jalisco, Mexico; (S.R.-P.); (J.J.M.-G.); (S.G.-S.); (J.A.C.-M.)
- Instituto de Investigación en Reumatología y del Sistema Músculo-Esquelético (IIRSME), CUCS, Universidad de Guadalajara, Guadalajara 44100, Jalisco, Mexico
| | - Jorge Javier Miguel-González
- School of Medicine, Universidad Autónoma de Guadalajara, Zapopan 45129, Jalisco, Mexico; (S.R.-P.); (J.J.M.-G.); (S.G.-S.); (J.A.C.-M.)
- Departamento de Investigación, Instituto Cardiovascular de Mínima Invasión (ICMI), Zapopan 45116, Jalisco, Mexico
| | - Sandra Guzmán-Silahua
- School of Medicine, Universidad Autónoma de Guadalajara, Zapopan 45129, Jalisco, Mexico; (S.R.-P.); (J.J.M.-G.); (S.G.-S.); (J.A.C.-M.)
- Unidad de Investigación Epidemiológica y en Servicios de Salud, CMNO OOAD Jalisco Instituto Mexicano del Seguro Social, Guadalajara 44160, Jalisco, Mexico
| | - Javier Adan Castañeda-Moreno
- School of Medicine, Universidad Autónoma de Guadalajara, Zapopan 45129, Jalisco, Mexico; (S.R.-P.); (J.J.M.-G.); (S.G.-S.); (J.A.C.-M.)
| | - Sophia Komninou
- Faculty of Health and Life Science, Swansea University, Swansea SA2 8PP, UK;
| | - Simón Quetzalcoatl Rodríguez-Lara
- School of Medicine, Universidad Autónoma de Guadalajara, Zapopan 45129, Jalisco, Mexico; (S.R.-P.); (J.J.M.-G.); (S.G.-S.); (J.A.C.-M.)
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Guillari A, Giordano V, Catone M, Gallucci M, Rea T. Non-pharmacological interventions to reduce procedural needle pain in children (6-12 years): A systematic review. J Pediatr Nurs 2024:S0882-5963(24)00253-7. [PMID: 39013701 DOI: 10.1016/j.pedn.2024.06.025] [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: 01/02/2024] [Revised: 06/26/2024] [Accepted: 06/26/2024] [Indexed: 07/18/2024]
Abstract
PROBLEM Children of different age groups frequently undergo painful procedures involving needles, which can be a source of significant discomfort. Regrettably, this aspect of care often receives insufficient attention from healthcare professionals. The existing literature proposes several methodologies for managing procedural pain, with nonpharmacological techniques being particularly promising. These techniques should be adapted to the patient's age, but literature predominantly emphasizes their use with infants. Thus, it is necessary to evaluate their effectiveness in diverse age groups. Consequently, the purpose of this systematic review is to identify non-pharmacological interventions used to prevent needle-related procedural pain in children (age group 6-12 years). ELIGIBILITY CRITERIA Primary studies in English language on non-pharmacological interventions in children aged 6-12 years undergoing needle-related procedures found on PubMed, CINAHL and Embase. SAMPLE A total of 18 studies were included. RESULTS The results indicate the potential application of various non-pharmacological techniques, with distraction methods standing out. These techniques include activities like utilizing cards, watching cartoons, employing virtual reality and playing video games. CONCLUSIONS Children's procedural pain represents a significant challenge in treatment plans. Literature offers several approaches, including nonpharmacologic methods, to control this problem. Prioritizing procedural pain management is critical both at clinical and organizational levels to improve the quality of pediatric care. IMPLICATIONS These findings offer different options to support clinical practice, holding the potential to enhance the quality of patient care.
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Affiliation(s)
- Assunta Guillari
- Public Health Department, Federico II University Hospital, 80131 Naples, Italy.
| | - Vincenza Giordano
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy.
| | - Maria Catone
- Public Health Department, Federico II University Hospital, 80131 Naples, Italy.
| | - Marco Gallucci
- Nursing student at Federico II University Hospital, 80131 Naples, Italy.
| | - Teresa Rea
- Public Health Department, Federico II University Hospital, 80131 Naples, Italy.
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Gaul C, Zaranek L, Goßrau G. [Complementary and supplementary procedures in the treatment of headache]. Schmerz 2023; 37:448-460. [PMID: 37432483 DOI: 10.1007/s00482-023-00738-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 05/30/2023] [Accepted: 05/30/2023] [Indexed: 07/12/2023]
Abstract
In Germany, headache is one of the illnesses that most frequently leads to health impairments and to consultation with physicians. Even in children, headache is often associated with restricted activities of daily life. Nevertheless, the level of care for headache disorders is disproportionate to the medical needs. As a result, patients regularly use complementary and supportive therapeutic procedures. This review shows the procedures currently used for primary headache in childhood and adulthood, the methodological approaches and existing scientific evidence. The safety of the therapeutic options is also classified. These methods include physiotherapy, neural therapy, acupuncture, homeopathy, phytotherapy and the intake of dietary supplements. For children and adolescents with headaches, there are studies in the field of dietary supplements for coenzyme Q10, riboflavin, magnesium and vitamin D, which indicate specific effects in the reduction of headaches.
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Affiliation(s)
- Charly Gaul
- Kopfschmerzzentrum Frankfurt, Dalbergstr. 2a, 65929, Frankfurt, Deutschland.
| | - Laura Zaranek
- Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsklinikum Dresden, Dresden, Deutschland
| | - Gudrun Goßrau
- Universitäts SchmerzCentrum - USC, Universitätsklinikum Dresden, Medizinische Fakultät, Technische Universität Dresden, Dresden, Deutschland
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Bonemazzi I, Nosadini M, Pelizza MF, Paolin C, Cavaliere E, Sartori S, Toldo I. Treatment of Frequent or Chronic Primary Headaches in Children and Adolescents: Focus on Acupuncture. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1626. [PMID: 37892289 PMCID: PMC10605007 DOI: 10.3390/children10101626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 09/22/2023] [Accepted: 09/28/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Acupuncture is a spreading and promising intervention, which has proven to be very useful in the treatment and prevention of chronic pain, in particular chronic headaches, in adults; the literature about the treatment of pediatric chronic headaches is scarce. In addition, few guidelines advise its use in children. The aim of this review is to collect all relevant studies with available data about the use, effect, and tolerability of acupuncture as a treatment for pediatric primary headaches. METHODS This is a narrative review based on eight studies selected from 135 papers including pediatric cases treated with acupuncture for headache. RESULTS Despite the differences in tools, procedures, and application sites, acupuncture demonstrated a positive effect on both the frequency and intensity of headaches and was well tolerated. There are no studies considering the long-term efficacy of acupuncture. CONCLUSION Further additional studies are needed on acupuncture in children and adolescents, with larger series and standardized procedures, in order to better assess efficacy, tolerability, and long-term prognosis and to define guidelines for the use of this promising and safe treatment. It is particularly relevant to identify safe and well-tolerated treatment options in pediatric patients affected by recurrent and debilitating headaches.
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Affiliation(s)
| | | | | | | | | | | | - Irene Toldo
- Juvenile Headache Center, Department of Woman’s and Child’s Health, University Hospital of Padua, 35128 Padua, Italy; (I.B.); (M.N.); (M.F.P.); (C.P.); (E.C.); (S.S.)
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Song X, Wang J, Bai L, Zou W. Bibliometric Analysis of 100 Most Highly Cited Publications on Acupuncture for Migraine. J Pain Res 2023; 16:725-747. [PMID: 36923648 PMCID: PMC10010187 DOI: 10.2147/jpr.s396909] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 02/15/2023] [Indexed: 03/11/2023] Open
Abstract
Background Migraine is a serious global health concern that imposed a huge economic burden on social health care. Over the past few decades, the analgesic effects of acupuncture have been widely recognized, and there is a growing body of research on acupuncture for migraine. Citation analysis is a branch of bibliometrics that helps researchers analyze and identify historical or landmark studies within the scientific literature. Currently, there is no analysis of the 100 most highly cited publications on acupuncture for migraine. Methods The 100 most highly cited publications on acupuncture for migraine were screened using the Science Citation Index Expanded of the Web of Science Core Collection database. CiteSpace and VOSviewer programs were used for bibliometric analysis. Results A total of 493 publications on acupuncture for migraine were identified. 100 of the most highly cited publications on acupuncture for migraine were published from 1984-2020. These publications were cited 6142 times with an h-index of 44 and 84% were original articles. The highest frequency of citations was 416. A total of 335 authors were involved in the study with 37 lead authors. 212 institutions from 20 countries contributed to the 100 most highly cited publications. The most published studies came from the United States (n=36), followed by China (n=27) and Germany (n=26). The Technical University of Munich published the largest number of papers (n = 15). Top-cited publications mainly came from the Headache (n=13, citations=582). Neuroimaging is gradually emerging as a hot topic of research. Conclusion This is the first bibliometric analysis to offer a thorough list of the 100 most highly cited papers on acupuncture for migraine, demonstrating significant progress and emerging trends in this field to assist researchers in determining the direction for further research.
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Affiliation(s)
- Xue Song
- The First Clinical Medical College, Heilongjiang University of Chinese Medicine, Harbin, People's Republic of China
| | - Jiaqi Wang
- The Second Clinical Medical College, Heilongjiang University of Chinese Medicine, Harbin, People's Republic of China
| | - Lu Bai
- The First Clinical Medical College, Heilongjiang University of Chinese Medicine, Harbin, People's Republic of China
| | - Wei Zou
- First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang, People's Republic of China
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Teng C, Egger S, Blinman PL, Vardy JL. Evaluating laser photobiomodulation for chemotherapy-induced peripheral neuropathy: a randomised phase II trial. Support Care Cancer 2023; 31:52. [PMID: 36526802 PMCID: PMC9758032 DOI: 10.1007/s00520-022-07463-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 11/24/2022] [Indexed: 12/23/2022]
Abstract
PURPOSE This study aims to evaluate the efficacy and safety of laser photobiomodulation (PBM) for treatment of established chemotherapy-induced peripheral neuropathy (CIPN) in cancer survivors. METHODS We conducted a randomised phase II, non-comparative, sham-controlled, single-blinded clinical trial in 44 cancer survivors reporting CIPN symptoms at least 3 months following completion of neurotoxic chemotherapy. Participants were randomised 2:1 to either PBM laser or sham control delivered twice weekly for 12 sessions. Assessments were conducted at baseline, the end of intervention (6 weeks), and 6 weeks post intervention (12 weeks). Participants completed neuropathy, quality of life and function questionnaires, and a clinical neurological assessment. The primary outcome was proportion of participants with CIPN response, defined as either symptom resolution or reduction of minimally clinically important difference. RESULTS In the laser and control groups, CIPN response rates were - 48% and 53% at 6 weeks and 45% and 33% at 12 weeks, respectively. The null hypothesis that the true response rate is 5% in the laser arm was rejected at both 6 and 12 weeks (p < 0.001 for both). Compared to baseline, patient-reported CIPN improved in both laser and control groups after the intervention. At 12 weeks, improvement was sustained in the laser group and approaching baseline in the control group. Clinical signs, quality of life, and function remained stable in both groups. Low-grade "side-effects" were observed in both arms. CONCLUSION PBM may offer clinically meaningful symptom benefit in cancer survivors with established CIPN with improvement potentially continuing beyond completion of the intervention. A larger study is warranted to evaluate this further.
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Affiliation(s)
- Christina Teng
- Concord Cancer Centre, Concord, NSW Australia ,Faculty of Medicine and Health, University of Sydney, Camperdown, NSW Australia ,Central Coast Cancer Centre, Gosford, NSW Australia
| | - Sam Egger
- The Daffodil Centre — a joint venture with Cancer Council NSW and the University of Sydney, Kings Cross, NSW Australia
| | - Prunella L. Blinman
- Concord Cancer Centre, Concord, NSW Australia ,Faculty of Medicine and Health, University of Sydney, Camperdown, NSW Australia
| | - Janette L. Vardy
- Concord Cancer Centre, Concord, NSW Australia ,Faculty of Medicine and Health, University of Sydney, Camperdown, NSW Australia
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Outpatient Approach to Resistant and Refractory Migraine in Children and Adolescents: a Narrative Review. Curr Neurol Neurosci Rep 2022; 22:611-624. [PMID: 36018499 DOI: 10.1007/s11910-022-01224-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2022] [Indexed: 01/27/2023]
Abstract
PURPOSE OF REVIEW Migraine is one of the top reasons for consulting a pediatric neurologist. Although the majority of children and adolescents who receive evidence-based first-line interventions for migraine will improve substantially, a subset of patients develop resistant or refractory migraine. RECENT FINDINGS In this review, we summarize the level of evidence for a variety of acute and preventive treatment options to consider in children and adolescents with resistant or refractory migraine. We describe the level of evidence for interventional procedures (onabotulinumtoxinA injections, greater occipital and other nerve blocks), neuromodulation (single-pulse transcranial magnetic stimulation, external trigeminal nerve stimulation, remote electrical neuromodulation, and non-invasive vagal nerve stimulation), calcitonin gene-related peptide (CGRP) pathway antagonists (anti-CGRP monoclonal antibodies and gepants), psychological therapies, and manual therapies (acupuncture, craniosacral therapy, massage and physical therapy, and spinal manipulation).
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Irwin SL, Greene KA, Pavitt SJ, Ross AC. Headache in the Pediatric Population: Focus on Migraine. Semin Neurol 2022; 42:479-488. [DOI: 10.1055/s-0042-1757927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractPediatric headache is a common condition with significant impact on quality of life and ability to function in academic, social, and extracurricular activities. Most pediatric patients seen in primary care and neurology clinics with headache have primary headache disorders. Diagnosis is largely based on clinical history. Imaging is rarely needed in the absence of red flag features. Careful diagnosis is important to guide appropriate treatment. Treatment focuses on a biopsychosocial model integrating lifestyle, pharmacologic and nonpharmacologic treatment modalities. As few therapies are approved in the pediatric population, treatments are often used off-label based on evidence extrapolated from adult studies. Outcomes vary over time but are generally favorable when headache disorders are diagnosed promptly and managed in a multidisciplinary setting.
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Affiliation(s)
- Samantha L. Irwin
- Department of Neurology, University of California, San Francisco (UCSF), California
| | - Kaitlin A. Greene
- Division of Pediatric Neurology, Department of Pediatrics, Oregon Health and Science University (OHSU), Portland, Oregon
| | - Sara J. Pavitt
- Department of Neurology, University of Texas, Austin, Texas
| | - Alexandra C. Ross
- Department of Pediatrics, University of California, San Francisco (UCSF), California
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Brase A, Brauchle D, Kermad A, Volk T, Morinello E, Gottschling S, Schneider SO. Postoperative Pain Therapy with Laser Acupuncture after Cesarean Section under Spinal Anesthesia: A Double-Blinded, Randomized, Placebo-Controlled Trial. Complement Med Res 2022; 29:235-241. [PMID: 35134798 DOI: 10.1159/000522470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 02/02/2022] [Indexed: 11/19/2022]
Abstract
Purpose The aim of our prospective, randomized, double blind, placebo-controlled study was to investigate the effect of laser acupuncture on postoperative pain in women undergoing cesarean section. Methods 80 women (mean age 32 ±5 years) scheduled for cesarean section under spinal anesthesia at Saarland University Hospital Medical Center, Homburg (Germany) were enrolled in this trial after giving written consent. Patients were randomized in two groups receiving a course of 3 treatments over 3 days with either active or placebo laser. Each acupuncture session treated Di-4 and Shen-men of both hands and ears. Primary outcome was defined as the pain severity at rest measured by Numeric Rating Scale (NRS) on the first postoperative day. Secondary outcome measures included analgesic consumption, time to mobilisation and length of stay. Treatment occurred on the operation day and on the following two days. Data were collected by a standardized questionnaire. Results No statistical difference between both groups were observed for pain severity at rest on the first postoperative day after cesarean section (Mann-Whitney U-test, p=0,850, verum group: 3.3±2.1 Vs. Placebo group: 3.2±1.9). Secondary outcome measures regarding analgesic consumption showed no difference in NSAID or opioid between treatment and placebo group. Laser acupuncture showed no effect on time to mobilisation and length of stay. Conclusion Our study could not demonstrate significant effects by the application of laser acupuncture on postoperative pain in women undergoing cesarean section.
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Affiliation(s)
- Annika Brase
- Department of Anesthesiology, Intensive Care Medicine and Pain Medicine, Saarland University Hospital Medical Center, Homburg/Saar, Germany
| | - Dominik Brauchle
- Department of Anesthesiology, Intensive Care Medicine and Pain Medicine, Saarland University Hospital Medical Center, Homburg/Saar, Germany
| | - Azzeddine Kermad
- Department of Anesthesiology, Intensive Care Medicine and Pain Medicine, Saarland University Hospital Medical Center, Homburg/Saar, Germany
| | - Thomas Volk
- Department of Anesthesiology, Intensive Care Medicine and Pain Medicine, Saarland University Hospital Medical Center, Homburg/Saar, Germany
| | - Emanuela Morinello
- Department of Anesthesiology, Intensive Care Medicine and Pain Medicine, Saarland University Hospital Medical Center, Homburg/Saar, Germany
| | - Sven Gottschling
- Center for Palliative Medicine, Saarland University Hospital Medical Center, Homburg/Saar, Germany
| | - Sven Oliver Schneider
- Department of Anesthesiology, Intensive Care Medicine and Pain Medicine, Saarland University Hospital Medical Center, Homburg/Saar, Germany
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Zhao T, Guo J, Song Y, Chen H, Sun M, Chen L, Geng H, Pei L, Sun J. A Bibliometric Analysis of Research Trends of Acupuncture Therapy in the Treatment of Migraine from 2000 to 2020. J Pain Res 2021; 14:1399-1414. [PMID: 34079357 PMCID: PMC8164719 DOI: 10.2147/jpr.s306594] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 04/23/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Migraine is the second-leading cause of disability worldwide. It is often characterized by attacks of severe, mostly unilateral, pulsating headache associated with symptoms such as photophobia, phonophobia, nausea, vomiting, and cutaneous allodynia. Acupuncture therapy has been used worldwide for the treatment of migraine. However, no visual bibliometric analysis has been conducted on the effects of acupuncture on migraine over the past 20 years. Therefore, this study aimed to explore the current status and trends on the use of acupuncture in the treatment of migraine from 2000 to 2020. PURPOSE The objective of this study is to identify the current status and emerging trends of the global use of acupuncture on migraine from 2000 to 2020 using CiteSpace and VOSviewer. METHODS Web of Science databases were searched for publications related to acupuncture therapy for treating migraine between 2000 and 2020. CiteSpace and VOSviewer were used to analyze the number of publications per year, countries, institutions, authors, journals, references, and keywords. RESULTS A total of 572 publications were included in the final analysis. The total number of publications has continued to increase with some fluctuations over the past 20 years. The most productive country and institution in this field were the USA, and Chengdu University of Traditional Chinese Medicine, respectively. The most active and cited authors were Liang FR and Linde K, respectively. Cephalalgia was the most productive, cited, and co-cited journal. The Linde K (2005) had the highest co-citation, citation number and centrality. The keywords "migraine" ranked first in frequency. The common type of migraine (tension-type headache), research method (randomized controlled trial, multicenter, double-blind), acupuncture's role (prophylactic, quality of life, pain), and evaluation (meta-analysis, systematic review) were the hotspots and frontier trends of acupuncture therapy on migraine between 2000 and 2020. CONCLUSION The present study examined the research-related trend in acupuncture therapy on migraine using bibliometric methods and identified the statement and research frontiers over the past two decades. This may help researchers to identify potential hotspots and new directions for future research in this field.
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Affiliation(s)
- Tingting Zhao
- Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, People’s Republic of China
| | - Jing Guo
- Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, People’s Republic of China
| | - Yafang Song
- Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, People’s Republic of China
| | - Hao Chen
- Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, People’s Republic of China
| | - Mengzhu Sun
- Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, People’s Republic of China
| | - Lu Chen
- Jiangsu Province Hospital of Chinese Medicine, Nanjing, Jiangsu Province, People’s Republic of China
| | - Hao Geng
- Jiangsu Province Hospital of Chinese Medicine, Nanjing, Jiangsu Province, People’s Republic of China
| | - Lixia Pei
- Jiangsu Province Hospital of Chinese Medicine, Nanjing, Jiangsu Province, People’s Republic of China
| | - Jianhua Sun
- Jiangsu Province Hospital of Chinese Medicine, Nanjing, Jiangsu Province, People’s Republic of China
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Yang J, Mallory MJ, Wu Q, Bublitz SE, Do A, Xiong D, Chen CYY, Dorsher PT, Chon TY, Bauer BA. The Safety of Laser Acupuncture: A Systematic Review. Med Acupunct 2020; 32:209-217. [PMID: 32874405 PMCID: PMC7455477 DOI: 10.1089/acu.2020.1419] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objective: Laser acupuncture has become increasingly attractive in clinical practice, especially for patients with needle phobias well as elderly people and children. However, literature concerning the safety of laser acupuncture has been limited. This systematic review synthesizes the current available literature on the safety of laser acupuncture. Methods: Ovid MEDLINE,® Epub Ahead of Print, In-Process & Other Non-Indexed Citations Daily, Ovid Embase, Scopus, and EBM Reviews-Cochrane Central Register of Controlled Trials databases were searched for available randomized controlled trials (RCTs) on laser acupuncture. Safety data were extracted from the included studies. Adverse events (AEs) data were extracted and assessed in terms of severity and causality. Results: Of 737 articles, 21 RCTs were included. The majority of these RCTs reported that laser acupuncture was safe, without AEs; 6 trials reported AEs (including tingling, pain flare-ups, and transient fatigue). All AEs were mild and resolved spontaneously within 24 hours. The causal relationship between AEs and laser acupuncture was felt to be "certain" in 4 studies, "probable" in 1 study, and "possible" in 1 study. AEs were collected and monitored by evaluation methods in 7 trials: 5 with AE questionnaires, 1 with a checklist, and 1 with oral reports. Conclusions: Laser acupuncture appears to be a safe therapy associated with few mild and transient AEs. However, given the heterogeneity of current studies, large, well-designed placebo-controlled RCTs with rigorous evaluation methods are needed to assess the safety of laser acupuncture more completely.
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Affiliation(s)
- Juan Yang
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA.,Department of Pain Medicine, Shenzhen Nanshan People's Hospital, Shenzhen, Guangdong, China
| | - Molly J Mallory
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Qinglong Wu
- College of Acupuncture and Rehabilitation, Guangzhou University of Traditional Chinese Medicine, Guangzhou, Guangdong, China
| | - Sara E Bublitz
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Alexander Do
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Donglin Xiong
- Department of Pain Medicine, Shenzhen Nanshan People's Hospital, Shenzhen, Guangdong, China
| | | | - Peter T Dorsher
- Department of Physical Medicine & Rehabilitation, Mayo Clinic, Jacksonville, FL, USA
| | - Tony Y Chon
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Brent A Bauer
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
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Zwolińska J, Gąsior M. Physical therapy modalities in neurological disorders at developmental age - Assessment of the methodological value of research papers. NeuroRehabilitation 2020; 46:437-453. [PMID: 32508336 DOI: 10.3233/nre-203045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Physical therapy modalities are often applied in treatment of neurological conditions in children and adolescents. OBJECTIVE Evaluation of the methodological quality of research focusing on the application of physical therapy modalities in children and adolescents with neurological conditions. METHODS Papers published between 2007 and 2018 were included in the review. 149 papers were analyzed and finally 26 studies investigating the use of physical therapy modalities in children and adolescents with neurological conditions were included in the review. Jadad scale (0-5) was used to assess the methodological value of the studies. RESULTS The mean Jadad score was 1.46 (researcher 1) and 1.38 (researcher 2). A score of 0 was awarded to nine (r1) and eight papers (r2). A score of 5 points was awarded to three (r1) and two papers (r2). CONCLUSION 1. The evidence showing the effectiveness of the use of physical therapy modalities is mainly of low quality. 2. The Jadad scale is a valuable tool to assess the quality of research, although it does not always reflect the real value in the case children participate in studies. 3. The analyzed studies show that physical therapy modalities are effective in the treatment of children and adolescents with neurological disorders.
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Affiliation(s)
- Jolanta Zwolińska
- St Queen Jadwiga's Regional Clinical Hospital No. 2 in Rzeszow, Rzeszów, Poland.,University of Rzeszow, Institute of Physiotherapy, Faculty of Medicine, Rzeszów, Poland.,Centre for Innovative Research in Medical and Natural Sciences, Medical Faculty of University of Rzeszow, Rzeszów, Poland
| | - Monika Gąsior
- St Queen Jadwiga's Regional Clinical Hospital No. 2 in Rzeszow, Rzeszów, Poland
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13
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Koç Özkan T, Balcı S. The Effect of Acupressure on Acute Pain During Venipuncture in Children: Implications for Evidence-Based Practice. Worldviews Evid Based Nurs 2020; 17:221-228. [PMID: 32320139 DOI: 10.1111/wvn.12437] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/23/2018] [Indexed: 11/30/2022]
Abstract
AIMS The study was conducted as a randomized controlled trial in order to determine the effects of acupressure on acute pain during venipuncture in children. METHODS The population of the study consisted of children, aged between 9 and 12 years, who received venipuncture between September 2015 and June 2016 at a university hospital in Istanbul. The sample consisted of a total of 90 children, including 45 children in the acupressure group and 45 children in the control group, who met the sample inclusion criteria. The results of the study were obtained by using an information form, the State Anxiety Inventory for Children (STAIC), the visual analog scale (VAS), and the Faces Pain Scale-Revised (FPS-R). Acupressure was applied to the children in the acupressure group for 10 min before the venipuncture procedure. Pain, heart rate, and oxygen saturation levels of the children in the acupressure and control groups were evaluated both before and after the venipuncture procedure. RESULTS The children in the acupressure and control groups were found to be similar in terms of age, gender, parents' educational levels and working status, number of venipuncture procedures, and mean anxiety scores. In the evaluation that was conducted before the venipuncture procedure, no statistically significant differences were observed between the heat rates, oxygen saturation levels, and expected pain scores from the venipuncture procedure in the children in the acupressure and control groups. On the other hand, it was observed that the children in the acupressure group (VAS: 19.51 ± 4.98; FPS-R: 2.08 ± 0.41) experienced less pain than the children in the control group (VAS: 47.37 ± 9.89; FPS-R: 4.84 ± 1.08), and there was a significant difference between the two groups (p< .000). LINKING EVIDENCE TO ACTION Acupressure administration is effective in reducing the pain that is experienced by children during a venipuncture procedure.
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Affiliation(s)
- Tuba Koç Özkan
- Midwifery Department, Adiyaman University Faculty of Health Sciences, Adiyaman, Turkey
| | - Serap Balcı
- Department of Child Health and Diseases Nursing, Florence Nightingale Faculty of Nursing, Istanbul University, Istanbul, Turkey
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14
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Lin YC, Perez S, Tung C. Acupuncture for pediatric pain: The trend of evidence-based research. J Tradit Complement Med 2019; 10:315-319. [PMID: 32695647 PMCID: PMC7365776 DOI: 10.1016/j.jtcme.2019.08.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 08/14/2019] [Accepted: 08/16/2019] [Indexed: 11/26/2022] Open
Abstract
Background and aim Acupuncture is part of thousand years Traditional Chinese Medicine. There was promising evidence to support the efficacy of acupuncture in reducing postoperative surgery and dental pain, as well as chemotherapy-related nausea and vomiting. The US National Health Statistics Report indicated that there was significant increase in the use of acupuncture. Research on acupuncture has allowed for its integration into common adult pain practice. Acupuncture can also be utilized in pediatric patients. Experimental procedure We evaluate the evidence-based acupuncture for pediatric pain research from 2008 to 2017. Results and Conclusions: Acupuncture treatment is well supported to be effective treatment for pediatric procedural pain, infantile colic, adolescent pelvic pain, and headaches under specific intervention methods. There is increasing interest in using acupuncture and related techniques for pediatric pain management. However, the evidence-based randomized controlled trials using acupuncture for pediatric pain management is very limited. Further randomized controlled trial research in pediatric pain is urgently needed.
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Affiliation(s)
- Yuan-Chi Lin
- Medical Acupuncture Service, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, USA
| | - Sierra Perez
- Medical Acupuncture Service, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, USA
| | - Cynthia Tung
- Medical Acupuncture Service, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, USA
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15
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Papetti L, Ursitti F, Moavero R, Ferilli MAN, Sforza G, Tarantino S, Vigevano F, Valeriani M. Prophylactic Treatment of Pediatric Migraine: Is There Anything New in the Last Decade? Front Neurol 2019; 10:771. [PMID: 31379721 PMCID: PMC6646427 DOI: 10.3389/fneur.2019.00771] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 07/02/2019] [Indexed: 12/25/2022] Open
Abstract
Migraine is a frequent and very disabling disease, especially at pediatric age. Despite this, there are few controlled data on the prophylactic treatment of primary headaches in this category of age. Given that the recently introduced calcitonin gene-related peptide (CGRP) inhibitors (CGRP-r) are still limited to adulthood, there is no drug with exclusive indication for migraine treatment in pediatric age. This raises several limitations in terms of adherence and effectiveness of the therapy. Moreover, the scenario is complicated by placebo response, which is larger in children and adolescents than in adults and often leads to an improvement in the attack frequency even in absence of any active pharmacological treatment. Our aim was to investigate the real evidence concerning the prophylactic therapy of pediatric migraine by reviewing the clinical studies published between 2010 and 2019.
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Affiliation(s)
- Laura Papetti
- Department of Neuroscience, Headache Center, Bambino Gesù Children Hospital, Rome, Italy
| | - Fabiana Ursitti
- Department of Neuroscience, Headache Center, Bambino Gesù Children Hospital, Rome, Italy
| | - Romina Moavero
- Department of Neuroscience, Headache Center, Bambino Gesù Children Hospital, Rome, Italy.,Child Neurology Unit, Systems Medicine Department, Tor Vergata University Hospital of Rome, Rome, Italy
| | | | - Giorgia Sforza
- Child Neurology Unit, Systems Medicine Department, Tor Vergata University Hospital of Rome, Rome, Italy
| | - Samuela Tarantino
- Department of Neuroscience, Headache Center, Bambino Gesù Children Hospital, Rome, Italy
| | - Federico Vigevano
- Department of Neuroscience, Headache Center, Bambino Gesù Children Hospital, Rome, Italy
| | - Massimiliano Valeriani
- Department of Neuroscience, Headache Center, Bambino Gesù Children Hospital, Rome, Italy.,Center for Sensory-Motor Interaction, Aalborg University, Aalborg, Denmark
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16
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Multidisciplinary Pain Management for Pediatric Patients with Acute and Chronic Pain: A Foundational Treatment Approach When Prescribing Opioids. CHILDREN-BASEL 2019; 6:children6020033. [PMID: 30795645 PMCID: PMC6406753 DOI: 10.3390/children6020033] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 02/07/2019] [Accepted: 02/13/2019] [Indexed: 12/13/2022]
Abstract
Opioid therapy is the cornerstone of treatment for acute procedural and postoperative pain and is regularly prescribed for severe and debilitating chronic pain conditions. Although beneficial for many patients, opioid therapy may have side effects, limited efficacy, and potential negative outcomes. Multidisciplinary pain management treatments incorporating pharmacological and integrative non-pharmacological therapies have been shown to be effective in acute and chronic pain management for pediatric populations. A multidisciplinary approach can also benefit psychological functioning and quality of life, and may have the potential to reduce reliance on opioids. The aims of this paper are to: (1) provide a brief overview of a multidisciplinary pain management approach for pediatric patients with acute and chronic pain, (2) highlight the mechanisms of action and evidence base of commonly utilized integrative non-pharmacological therapies in pediatric multidisciplinary pain management, and (3) explore the opioid sparing effects of multidisciplinary treatment for pediatric pain.
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17
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Kemper KJ. “Let there be light.” Research on phototherapy, light therapy, and photobiomodulation for healing – Alternative therapy becomes mainstream. Complement Ther Med 2018; 41:A1-A6. [DOI: 10.1016/j.ctim.2018.10.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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18
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White PF, Elvir Lazo OL, Galeas L, Cao X. Use of electroanalgesia and laser therapies as alternatives to opioids for acute and chronic pain management. F1000Res 2017; 6:2161. [PMID: 29333260 PMCID: PMC5749131 DOI: 10.12688/f1000research.12324.1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/11/2017] [Indexed: 12/28/2022] Open
Abstract
The use of opioid analgesics for postoperative pain management has contributed to the global opioid epidemic. It was recently reported that prescription opioid analgesic use often continued after major joint replacement surgery even though patients were no longer experiencing joint pain. The use of epidural local analgesia for perioperative pain management was not found to be protective against persistent opioid use in a large cohort of opioid-naïve patients undergoing abdominal surgery. In a retrospective study involving over 390,000 outpatients more than 66 years of age who underwent minor ambulatory surgery procedures, patients receiving a prescription opioid analgesic within 7 days of discharge were 44% more likely to continue using opioids 1 year after surgery. In a review of 11 million patients undergoing elective surgery from 2002 to 2011, both opioid overdoses and opioid dependence were found to be increasing over time. Opioid-dependent surgical patients were more likely to experience postoperative pulmonary complications, require longer hospital stays, and increase costs to the health-care system. The Centers for Disease Control and Prevention emphasized the importance of finding alternatives to opioid medication for treating pain. In the new clinical practice guidelines for back pain, the authors endorsed the use of non-pharmacologic therapies. However, one of the more widely used non-pharmacologic treatments for chronic pain (namely radiofrequency ablation therapy) was recently reported to have no clinical benefit. Therefore, this clinical commentary will review evidence in the peer-reviewed literature supporting the use of electroanalgesia and laser therapies for treating acute pain, cervical (neck) pain, low back pain, persistent post-surgical pain after spine surgery (“failed back syndrome”), major joint replacements, and abdominal surgery as well as other common chronic pain syndromes (for example, myofascial pain, peripheral neuropathic pain, fibromyalgia, degenerative joint disease/osteoarthritis, and migraine headaches).
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Affiliation(s)
- Paul F White
- P.O. Box 548, Gualala, CA 95445, USA.,The White Mountain Institute, The Sea Ranch, CA, USA.,Department of Anesthesiology, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Los Angeles, CA 95445, USA
| | - Ofelia Loani Elvir Lazo
- Department of Anesthesiology, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Los Angeles, CA 95445, USA
| | | | - Xuezhao Cao
- Department of Anesthesiology, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Los Angeles, CA 95445, USA.,First Hospital of China Medical University, Shenyang, China
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19
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Toldo I, Rattin M, Perissinotto E, De Carlo D, Bolzonella B, Nosadini M, Rossi LN, Vecchio A, Simonati A, Carotenuto M, Scalas C, Sciruicchio V, Raieli V, Mazzotta G, Tozzi E, Valeriani M, Cianchetti C, Balottin U, Guidetti V, Sartori S, Battistella PA. Survey on treatments for primary headaches in 13 specialized juvenile Headache Centers: The first multicenter Italian study. Eur J Paediatr Neurol 2017; 21:507-521. [PMID: 28082014 DOI: 10.1016/j.ejpn.2016.12.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 12/06/2016] [Accepted: 12/21/2016] [Indexed: 01/03/2023]
Abstract
AIM The purpose of this retrospective multicenter study was to evaluate the use and the self-perceived efficacy and tolerability of pharmacological and non-pharmacological treatments in children and adolescents with primary headaches. METHODS Study of a cohort of children and adolescents diagnosed with primary headache, consecutively referred to 13 juvenile Italian Headache Centers. An ad hoc questionnaire was used for clinical data collection. RESULTS Among 706 patients with primary headaches included in the study, 637 cases with a single type of headache (migraine 76% - with and without aura in 10% and 67% respectively; tension-type headache 24%) were selected (mean age at clinical interview: 12 years). Acetaminophen and non-steroidal anti-inflammatory drugs (in particular ibuprofen) were commonly used to treat attacks, by 76% and 46% of cases respectively. Triptans were used overall by 6% of migraineurs and by 13% of adolescents with migraine, with better efficacy than acetaminophen and non-steroidal anti-inflammatory drugs. Preventive drugs were used by 19% of migraineurs and by 3% of subjects with tension-type headache. In migraineurs, flunarizine was the most frequently used drug (18%), followed by antiepileptic drugs (7%) and pizotifen (6%), while cyproheptadine, propanolol and amitriptyline were rarely used. Pizotifen showed the best perceived efficacy and tolerability. Melatonin and nutraceuticals were used by 10% and 32% of subjects, respectively, both for migraine and tension-type headache, with good results in terms of perceived efficacy and tolerability. Non-pharmacological preventive treatments (i.e. relaxation techniques, biofeedback, cognitive-behavioral therapy, acupuncture) were used only by 10% of cases (migraine 9%, tension-type headache 15%). DISCUSSION Non-steroidal anti-inflammatory drugs, especially ibuprofen, should be preferred to acetaminophen for acute attacks of migraine or tension-type headache, because they were usually more effective and well tolerated. Triptans could be used more frequently as first or almost second choice for treating migraine attack in adolescents. Non-pharmacological preventive treatments are recommended by some pediatric guidelines as first-line interventions for primary headaches and their use should be implemented in clinical practice. Prospective multicenter studies based on larger series are warranted to better understand the best treatment strategies for young people with primary headaches.
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Affiliation(s)
- Irene Toldo
- Juvenile Headache Centre, University Hospital of Padua, Italy.
| | - Martina Rattin
- Juvenile Headache Centre, University Hospital of Padua, Italy.
| | - Egle Perissinotto
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Italy.
| | - Debora De Carlo
- Juvenile Headache Centre, University Hospital of Padua, Italy.
| | | | | | | | - Angelo Vecchio
- Child Neuropsychiatry Division, University of Palermo, Italy.
| | | | | | - Cinzia Scalas
- Juvenile Headache Centre, University Hospital of Florence, Italy.
| | | | - Vincenzo Raieli
- Child Neuropsychiatry Division, "G.F. Ingrassia" Hospital, AUSL n°6, Palermo, Italy.
| | - Giovanni Mazzotta
- Child and Juvenile Neuropsychiatry Unit, ASL n°4, Terni, University of Perugia, Italy.
| | - Elisabetta Tozzi
- Department of Experimental Medicine, University of L'Aquila, Italy.
| | | | - Carlo Cianchetti
- Child and Adolescent Neuropsychiatry, University Hospital of Cagliari, Italy.
| | - Umberto Balottin
- Child Neuropsychiatry Unit, C. Mondino National Neurological Institute, Pavia, Italy.
| | - Vincenzo Guidetti
- Department of Pediatrics and Child and Adolescent Neuropsychiatry, University "La Sapienza" of Rome, Italy.
| | - Stefano Sartori
- Juvenile Headache Centre, University Hospital of Padua, Italy.
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20
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Oates A, Benedict KA, Sun K, Brakeman PR, Lim J, Kim C. Laser acupuncture reduces pain in pediatric kidney biopsies: a randomized controlled trial. Pain 2017; 158:103-109. [PMID: 27749608 PMCID: PMC5234680 DOI: 10.1097/j.pain.0000000000000734] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Evaluate laser acupuncture (LA) as an adjuvant therapy in pain management during percutaneous kidney biopsy procedure in children and adolescents. This prospective, double-blinded, randomized controlled trial enrolled patients aged 7 to 26 years admitted to a children's hospital for percutaneous kidney biopsy. Patients received LA to treatment points (acupuncture group) or sham points (control group) before the procedure. The laser delivered a dose of 42 J/cm over 10 acupoints. Patients and parents rated the pain during and after the biopsy, and change in pain scores were calculated for each patient. Anxiety, vital signs, sedation medication, and patient's biopsy experience were secondary outcomes. Sixty-nine treatments (33 in the acupuncture group and 36 in the control group) were eligible for analysis. Patients in the acupuncture group reported a significantly improved change in the pain score after the biopsy compared with the controls (0.8 vs -0.5, P = 0.044). Patients in the acupuncture group had a statistically significant decrease in procedure vital signs including heart rate (-1.8 vs 5.6, P = 0.043) and respiratory rate (-2.4 vs 0.4, P = 0.045) when compared with controls. Parents also perceived a correspondingly greater improvement in their child's pain for those in the acupuncture group compared with the controls (2.3 vs 0.3, P = 0.04). Adjunctive LA significantly improved pain after pediatric percutaneous kidney biopsies.
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Affiliation(s)
- Aris Oates
- UCSF Benioff Children’s Hospital, University of California, San Francisco, San Francisco, CA
| | - Kelly A Benedict
- UCSF Benioff Children’s Hospital, University of California, San Francisco, San Francisco, CA
| | - Karen Sun
- UCSF Benioff Children’s Hospital, University of California, San Francisco, San Francisco, CA
| | - Paul R Brakeman
- UCSF Benioff Children’s Hospital, University of California, San Francisco, San Francisco, CA
| | - Jessica Lim
- UCSF Benioff Children’s Hospital, University of California, San Francisco, San Francisco, CA
| | - Cynthia Kim
- UCSF Benioff Children’s Hospital, University of California, San Francisco, San Francisco, CA
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Abstract
AbstractChronic daily headache (CDH) is a multi-faceted, often complex pain syndrome in children and adolescents. Chronic daily headache may be primary or secondary. Chronic migraine and chronic tension-type are the most frequent subtypes. Chronic daily headache is co-morbid with adverse life events, anxiety and depressive disorders, possibly with other psychiatric disorders, other pain syndromes and sleep disorders; these conditions contribute to initiating and maintaining CDH. Hence, early management of episodic headache and treatment of associated conditions are crucial to prevention. There is evidence for the benefit of psychological therapies, principally relaxation and cognitive behavioral, and promising information on acupuncture for CDH. Data on drug treatment are based primarily on open label studies. The controversies surrounding CDH are discussed and proposals for improvement presented. The multifaceted nature of CDH makes it a good candidate for a multi-axial classification system. Such an approach should facilitate biopsychosocial management and enhance consistency in clinical research.
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22
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Brittner M, Le Pertel N, Gold MA. Acupuncture in Pediatrics. Curr Probl Pediatr Adolesc Health Care 2016; 46:179-83. [PMID: 26867822 DOI: 10.1016/j.cppeds.2015.12.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 12/04/2015] [Indexed: 12/20/2022]
Abstract
There has been extensive research on the use of acupuncture in adults with a wide array of conditions. Much less research has been conducted on the use of acupuncture in children. In this article, we review the history and philosophy of acupuncture, and the literature on its effectiveness and safety in children and adolescents, giving special attention to the pediatric and adolescent conditions that have been most studied in high-quality randomized controlled trials (RCTs).
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Affiliation(s)
- Mindy Brittner
- Department of Pediatrics, Columbia University Medical Center, New York, NY; Department of Population and Family Health, Columbia University Medical Center, New York, NY
| | - Noemie Le Pertel
- Department of Pediatrics, Columbia University Medical Center, New York, NY; Department of Population and Family Health, Columbia University Medical Center, New York, NY
| | - Melanie A Gold
- Department of Pediatrics, Columbia University Medical Center, New York, NY; Department of Population and Family Health, Columbia University Medical Center, New York, NY
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23
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Tornøe B, Andersen LL, Skotte JH, Jensen R, Jensen C, Madsen BK, Gard G, Skov L, Hallström I. Specific strength training compared with interdisciplinary counseling for girls with tension-type headache: a randomized controlled trial. J Pain Res 2016; 9:257-70. [PMID: 27217794 PMCID: PMC4862389 DOI: 10.2147/jpr.s97826] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Childhood tension-type headache (TTH) is a prevalent and debilitating condition for the child and family. Low-cost nonpharmacological treatments are usually the first choice of professionals and parents. This study examined the outcomes of specific strength training for girls with TTH. METHODS Forty-nine girls aged 9-18 years with TTH were randomized to patient education programs with 10 weeks of strength training and compared with those who were counseled by a nurse and physical therapist. Primary outcomes were headache frequency, intensity, and duration; secondary outcomes were neck-shoulder muscle strength, aerobic power, and pericranial tenderness, measured at baseline, after 10 weeks intervention, and at 12 weeks follow-up. Health-related quality of life (HRQOL) questionnaires were assessed at baseline and after 24 months. RESULTS For both groups, headache frequency decreased significantly, P=0.001, as did duration, P=0.022, with no significant between-group differences. The odds of having headache on a random day decreased over the 22 weeks by 0.65 (0.50-0.84) (odds ratio [95% confidence interval]). For both groups, neck extension strength decreased significantly with a decrease in cervicothoracic extension/flexion ratio to 1.7, indicating a positive change in muscle balance. In the training group, shoulder strength increased $10% in 5/20 girls and predicted [Formula: see text] increased $15% for 4/20 girls. In the training group, 50% of girls with a headache reduction of $30% had an increase in [Formula: see text] >5%. For the counseling group, this was the case for 29%. A 24-month follow-up on HRQOL for the pooled sample revealed statistically significant improvements. Fifty-five percent of the girls reported little to none disability. CONCLUSION The results indicate that both physical health and HRQOL can be influenced significantly by physical exercise and nurse counseling. More research is needed to examine the relationship between physical exercise, [Formula: see text], and TTH in girls. Thus, empowering patient education to promote maximum possible outcomes for all children needs more attention.
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Affiliation(s)
- Birte Tornøe
- Department of Health Sciences, Lund University, Lund, Sweden
- Department of Pediatrics E, Children’s Headache Clinic, University of Copenhagen, Herlev and Gentofte Hospitals, Copenhagen, Denmark
- Department of Physiotherapy and Occupational Therapy, University of Copenhagen, Glostrup Hospital, Copenhagen, Denmark
- Department of Physiotherapy, University of Copenhagen, Herlev and Gentofte Hospitals, Copenhagen, Denmark
| | - Lars L Andersen
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Physical Activity and Human Performance group, SMI, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Jørgen H Skotte
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Rigmor Jensen
- Department of Neurology, Danish Headache Centre, University of Copenhagen, Glostrup Hospital, Copenhagen, Denmark
| | | | - Bjarne K Madsen
- Department of Neurology, Danish Headache Centre, University of Copenhagen, Glostrup Hospital, Copenhagen, Denmark
| | - Gunvor Gard
- Department of Health Sciences, Lund University, Lund, Sweden
| | - Liselotte Skov
- Department of Pediatrics E, Children’s Headache Clinic, University of Copenhagen, Herlev and Gentofte Hospitals, Copenhagen, Denmark
| | - Inger Hallström
- Department of Health Sciences, Lund University, Lund, Sweden
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Linde K, Allais G, Brinkhaus B, Fei Y, Mehring M, Shin B, Vickers A, White AR. Acupuncture for the prevention of tension-type headache. Cochrane Database Syst Rev 2016; 4:CD007587. [PMID: 27092807 PMCID: PMC4955729 DOI: 10.1002/14651858.cd007587.pub2] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Acupuncture is often used for prevention of tension-type headache but its effectiveness is still controversial. This is an update of our Cochrane review originally published in Issue 1, 2009 of The Cochrane Library. OBJECTIVES To investigate whether acupuncture is a) more effective than no prophylactic treatment/routine care only; b) more effective than 'sham' (placebo) acupuncture; and c) as effective as other interventions in reducing headache frequency in adults with episodic or chronic tension-type headache. SEARCH METHODS We searched CENTRAL, MEDLINE, EMBASE and AMED to 19 January 2016. We searched the World Health Organization (WHO) International Clinical Trials Registry Platform to 10 February 2016 for ongoing and unpublished trials. SELECTION CRITERIA We included randomised trials with a post-randomisation observation period of at least eight weeks, which compared the clinical effects of an acupuncture intervention with a control (treatment of acute headaches only or routine care), a sham acupuncture intervention or another prophylactic intervention in adults with episodic or chronic tension-type headache. DATA COLLECTION AND ANALYSIS Two review authors checked eligibility; extracted information on participants, interventions, methods and results; and assessed study risk of bias and the quality of the acupuncture intervention. The main efficacy outcome measure was response (at least 50% reduction of headache frequency) after completion of treatment (three to four months after randomisation). To assess safety/acceptability we extracted the number of participants dropping out due to adverse effects and the number of participants reporting adverse effects. We assessed the quality of the evidence using GRADE (Grading of Recommendations Assessment, Development and Evaluation). MAIN RESULTS Twelve trials (11 included in the previous version and one newly identified) with 2349 participants (median 56, range 10 to 1265) met the inclusion criteria.Acupuncture was compared with routine care or treatment of acute headaches only in two large trials (1265 and 207 participants), but they had quite different baseline headache frequency and management in the control groups. Neither trial was blinded but trial quality was otherwise high (low risk of bias). While effect size estimates of the two trials differed considerably, the proportion of participants experiencing at least 50% reduction of headache frequency was much higher in groups receiving acupuncture than in control groups (moderate quality evidence; trial 1: 302/629 (48%) versus 121/636 (19%); risk ratio (RR) 2.5; 95% confidence interval (CI) 2.1 to 3.0; trial 2: 60/132 (45%) versus 3/75 (4%); RR 11; 95% CI 3.7 to 35). Long-term effects (beyond four months) were not investigated.Acupuncture was compared with sham acupuncture in seven trials of moderate to high quality (low risk of bias); five large studies provided data for one or more meta-analyses. Among participants receiving acupuncture, 205 of 391 (51%) had at least 50% reduction of headache frequency compared to 133 of 312 (43%) in the sham group after treatment (RR 1.3; 95% CI 1.09 to 1.5; four trials; moderate quality evidence). Results six months after randomisation were similar. Withdrawals were low: 1 of 420 participants receiving acupuncture dropped out due to adverse effects and 0 of 343 receiving sham (six trials; low quality evidence). Three trials reported the number of participants reporting adverse effects: 29 of 174 (17%) with acupuncture versus 12 of 103 with sham (12%; odds ratio (OR) 1.3; 95% CI 0.60 to 2.7; low quality evidence).Acupuncture was compared with physiotherapy, massage or exercise in four trials of low to moderate quality (high risk of bias); study findings were inadequately reported. No trial found a significant superiority of acupuncture and for some outcomes the results slightly favoured the comparison therapy. None of these trials reported the number of participants dropping out due to adverse effects or the number of participants reporting adverse effects.Overall, the quality of the evidence assessed using GRADE was moderate or low, downgraded mainly due to a lack of blinding and variable effect sizes. AUTHORS' CONCLUSIONS The available results suggest that acupuncture is effective for treating frequent episodic or chronic tension-type headaches, but further trials - particularly comparing acupuncture with other treatment options - are needed.
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Affiliation(s)
- Klaus Linde
- Klinikum rechts der Isar, Technical University MunichInstitute of General PracticeOrleansstrasse 47MünchenGermany81667
| | - Gianni Allais
- University of TorinoWomen's Headache Center and Service for Acupuncture in Gynecology and Obstetrics, Department of Surgical SciencesVia Ventimiglia 3TorinoItaly10126
| | - Benno Brinkhaus
- Charité ‐ Universitätsmedizin BerlinInstitute for Social Medicine, Epidemiology and Health EconomicsLuisenstrasse 57BerlinGermany10117
| | - Yutong Fei
- Beijing University of Chinese MedicineCentre for Evidence‐Based Chinese Medicine11 Bei San Huan Dong Lu, Chaoyang DistrictBeijingChina100029
| | - Michael Mehring
- Klinikum rechts der Isar, Technical University MunichInstitute of General PracticeOrleansstrasse 47MünchenGermany81667
| | - Byung‐Cheul Shin
- School of Korean Medicine, Pusan National UniversityRehabilitation MedicineBeom‐eu, MeulgeumYangsanKyungnamKorea, South626‐870
| | - Andrew Vickers
- Memorial Sloan‐Kettering Cancer CenterDepartment of Epidemiology and Biostatistics1275 York AvenueNew YorkUSA10021
| | - Adrian R White
- Plymouth University Peninsula Schools of Medicine and DentistryPrimary Care25 Room N32, ITTC BuildingTamar Science ParkPlymouthUKPL6 8BX
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Non-pharmacologic Management of Pain and Anxiety in the Pediatric Patient. CURRENT EMERGENCY AND HOSPITAL MEDICINE REPORTS 2016. [DOI: 10.1007/s40138-016-0090-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Abstract
In this article, the use of complementary and integrative medicine for the management of pediatric headache is reviewed. Despite limited numbers of studies for pediatric headaches, children and families seek these services. Integrative medicine focuses on treating the whole person, integrating conventional medicine with mind-body-spirit methods. Nutriceuticals include dietary supplements in the form of vitamins (vitamin D), minerals (magnesium), coenzyme Q, butterbur, and melatonin. Acupuncture, stimulation, physical therapy and Transcutaneous Electrical Nerve Stimulations (TENS) or Transcranial Magnetic Stimulation (TMS) may also be useful in selected patients. The efficacy of all these therapeutic alternatives in pediatric headache is presented here. Primary care providers, neurologists, and headache specialists alike need to be informed of such interventions and integrate these approaches, when appropriate, in the management of children with headaches.
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Affiliation(s)
- Sita Kedia
- PALM Integrative Health, St. Louis, MO; Department of Pediatrics, University of Colorado Denver School of Medicine, Aurora, CO; Adult and Child Center for Health Outcomes Research and Delivery of Science, Aurora, CO.
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Liu Y, Yu S. Recent Approaches and Development of Acupuncture on Chronic Daily Headache. Curr Pain Headache Rep 2015; 20:4. [DOI: 10.1007/s11916-015-0535-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Raith W, Schmölzer GM, Resch B, Reiterer F, Avian A, Koestenberger M, Urlesberger B. Laser Acupuncture for Neonatal Abstinence Syndrome: A Randomized Controlled Trial. Pediatrics 2015; 136:876-84. [PMID: 26504123 DOI: 10.1542/peds.2015-0676] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Neonatal abstinence syndrome (NAS) is usually treated with opiate derivatives and supported with nonpharmacological treatment. METHODS This prospective, randomized, controlled, blinded, single-center study was carried out between March 2009 and November 2014. Newborn infants diagnosed with NAS after maternal opioid substitution therapy were eligible for inclusion. Infants were randomly allocated to the acupuncture group (combining laser acupuncture and pharmacological therapy of morphine and phenobarbital) or control group (pharmacological therapy alone). Laser acupuncture was performed with a LABpen MED 10 (675 nm/10 mW) at 5 ear and 4 body acupuncture points, bilaterally, and sessions were repeated every day. The primary outcome measure was duration of oral morphine therapy for NAS. Secondary outcomes included highest single Finnegan score, time to highest single Finnegan score, maximum amount of oral morphine solution (in milliliters per kilogram and milligrams per kilogram), time to maximum amount of oral morphine solution, and length of hospital stay. RESULTS Twenty-eight newborns (14 in each group) were eligible for analysis. Duration of oral morphine therapy was significantly reduced in the acupuncture group compared with the control group (28 vs 39 days, respectively, P = .019). In addition, we observed a significantly reduced length of hospital stay in the acupuncture group compared with the control group (35 days [interquartile range 25 to 47] vs 50 days [36 to 66], P = .048). CONCLUSIONS Adjunctive laser acupuncture significantly reduced the duration of morphine therapy in newborns with NAS.
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Affiliation(s)
- Wolfgang Raith
- Division of Neonatology, Department of Paediatrics and Adolescent Medicine, Research Group for Paediatric Traditional Chinese Medicine, TCM Research Center Graz (Acupuncture Research),
| | - Georg M Schmölzer
- Division of Neonatology, Department of Paediatrics and Adolescent Medicine, Department of Paediatrics, University of Alberta, Edmonton, Canada; Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, Alberta, Canada; and Alberta Health Services, Edmonton, Alberta, Canada
| | - Bernhard Resch
- Division of Neonatology, Department of Paediatrics and Adolescent Medicine
| | - Fritz Reiterer
- Division of Neonatology, Department of Paediatrics and Adolescent Medicine
| | - Alexander Avian
- Institutes for Medical Informatics, Statistics, and Documentation, and
| | - Martin Koestenberger
- Division of Paediatric Cardiology, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
| | - Berndt Urlesberger
- Division of Neonatology, Department of Paediatrics and Adolescent Medicine, Research Group for Paediatric Traditional Chinese Medicine, TCM Research Center Graz (Acupuncture Research)
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The Depths from Skin to the Major Organs at Chest Acupoints of Pediatric Patients. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:126028. [PMID: 26457105 PMCID: PMC4592721 DOI: 10.1155/2015/126028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/30/2015] [Revised: 08/28/2015] [Accepted: 09/06/2015] [Indexed: 11/25/2022]
Abstract
Background. Acupuncture is applied to treat numerous diseases in pediatric patients. Few reports have been published on the depth to which it is safe to insert needle acupoints in pediatric patients.
We evaluated the depths to which acupuncture needles can be inserted safely in chest acupoints in pediatric patients and the variations in safe depth according to sex, age, body weight, and body mass index (BMI). Methods. We retrospectively studied computed tomography (CT) images of pediatric patients aged 4 to 18 years who had undergone chest CT at China Medical University Hospital from December 2004 to May 2013. The safe depth of chest acupoints was directly measured from the CT images. The relationships between the safe depth of these acupoints and sex, age, body weight, and BMI were analyzed. Results. The results demonstrated significant differences in depth among boys and girls at KI25 (kidney meridian), ST16 (stomach meridian), ST18, SP17 (spleen meridian), SP19, SP20, PC1 (pericardium meridian), LU2 (lung meridian), and GB22 (gallbladder meridian). Safe depth significantly differed among the age groups (P < 0.001), weight groups (P < 0.05), and BMI groups (P < 0.05). Conclusion. Physicians should focus on large variations in needle depth during acupuncture for achieving optimal therapeutic effect and preventing complications.
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Abbasoglu A, Cabioglu MT, Tugcu AU, Yapakci E, Tekindal MA, Tarcan A. Laser acupuncture before heel lancing for pain management in healthy term newborns: a randomised controlled trial. Acupunct Med 2015; 33:445-50. [PMID: 26438556 DOI: 10.1136/acupmed-2015-010765] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2015] [Indexed: 01/29/2023]
Abstract
BACKGROUND Healthy term newborns commonly undergo painful procedures during routine follow-up visits. Non-pharmacological strategies have currently become more important than pharmacological analgesic agents in neonatal pain management. Acupuncture is a new non-pharmacological method for preventing pain in newborns. OBJECTIVE We aimed to investigate the effect of laser acupuncture (LA) at the Yintang point before heel lancing as a non-pharmacological intervention for procedural pain management in infants. METHODS Forty-two term newborns, who were undergoing heel lancing between postnatal days 3 to 8 as part of routine neonatal screening, were randomly assigned to the LA group or the oral sucrose group. In the LA group, 2 min before the heel lancing, 0.3 J of energy was applied to the Yintang point using a Laser PREMIO-30 unit for 30 s. In the sucrose group, each infant received 0.5 mL of 24% sucrose orally via syringe 2 min before the heel lancing. Each baby's behaviour was scored using the Neonatal Infant Pain Scale (NIPS), assessed blinded to group. RESULTS There were no significant differences between the LA and oral sucrose groups with respect to means for gestational week of age at birth, birth weight, actual weight, or Apgar score. Mean procedure time was significantly shorter in the LA group; however, mean crying time was longer and NIPS score was lower compared to the oral sucrose group. CONCLUSIONS Our results indicate that 0.3 J of LA at the Yintang point before heel lancing is less effective than oral sucrose for reducing the discomfort of this procedure. TRIAL REGISTRATION NUMBER KA14/09.
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Affiliation(s)
- Aslihan Abbasoglu
- Division of Neonatology, Department of Pediatrics, Başkent University Faculty of Medicine, Ankara, Turkey
| | | | - Ali Ulas Tugcu
- Division of Neonatology, Department of Pediatrics, Başkent University Faculty of Medicine, Ankara, Turkey
| | - Ece Yapakci
- Division of Neonatology, Department of Pediatrics, Güven Hospital, Ankara, Turkey
| | | | - Aylin Tarcan
- Division of Neonatology, Department of Pediatrics, Başkent University Faculty of Medicine, Ankara, Turkey
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Wang CY, Yen SF, Chang SC, Chiu YH, Kuo CC, Wu CE. Implementation of laser acupuncture with lifting-thrusting through the use of mechanically immobile components. APPLIED OPTICS 2015; 54:E129-E135. [PMID: 26479642 DOI: 10.1364/ao.54.00e129] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Lifting and thrusting constitute an important manipulation method in traditional Chinese acupuncture. Lifting and thrusting enables the implementation of various features, such as reinforcement and reduction, which enhance acupuncture effectiveness. Laser acupuncture stimulates acupoints through laser light, which is a noninvasive treatment, but can still achieve effects similar to those obtained from traditional acupuncture. Lifting and thrusting can be achieved by moving the laser focal point back and forth, thus concentrating the energy, as does the tip of the acupuncture needle when it is moved upward and downward in the acupoint. This article presents a novel optical design of a laser acupuncture device, in which a focus-tunable lens is used to move the position of the focused light in order to achieve the lifting and thrusting mechanism through programmable changes to the control current of the focus-tunable lens. The device employs an infrared laser with a wavelength of 808 nm and a maximum power of 150 mW. The focus-tunable lens used in this study had a diopter of -10 to +5. The results revealed that by controlling the lens diopter, the focused light can be moved from 4.5 to 9.5 cm. Therefore, the range of the lift and thrust for the laser acupuncture device was 5 cm. The area of the focal point was approximately 6×10(-3) mm2, which is comparable to that of the commonly used traditional acupuncture needle tip. Because the components are immobile, no additional space is required for the moving lens. Therefore, the size of the laser acupuncture head can be minimized, and the effectiveness of focus tuning can be improved.
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de Oliveira RF, da Silva CV, Cersosimo MCP, Borsatto MC, de Freitas PM. Laser therapy on points of acupuncture: Are there benefits in dentistry? JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2015; 151:76-82. [PMID: 26188388 DOI: 10.1016/j.jphotobiol.2015.07.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Revised: 07/08/2015] [Accepted: 07/09/2015] [Indexed: 11/28/2022]
Abstract
Studies have shown the use of laser therapy at points of acupuncture as an alternative to metal needles. The scientific literature in the area of laser acupuncture is rather large; however, the actual mechanisms and effects have not yet been proven in detail. Therefore, the current manuscript reviews the existing literature regarding the effects of laser acupuncture in Dentistry, seeking treatment modalities in which this technique is used and which are able to generate positive clinical results. Thus, the literature survey was conducted in electronic databases--Medline/Pubmed, VHL and Science Direct--using the uniterms "alternative medicine", "low-power laser and acupuncture", "laser acupuncture and dentistry" and "laser therapy and acupuncture". Retrospective and prospective clinical studies were considered. According to the findings of the literature, laser therapy at points of acupuncture was effective for the treatment of various orofacial problems encountered in dentistry, but there are still many differences among the parameters used for irradiation and there is a lack of important information reported by the studies, such as the wavelength, dose, power density, irradiation time and frequency, points of acupuncture selected for irradiation and therapy outcomes. Although these results indicate the potential benefit of the use of laser therapy at points of acupuncture on Dentistry, further double-blinded, controlled clinical trials should be carried out in order to standardize protocols for clinical application.
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Affiliation(s)
- Renata Ferreira de Oliveira
- Special Laboratory of Lasers in Dentistry (LELO), Department of Restorative Dentistry, School of Dentistry, University of São Paulo (FO-USP), São Paulo, SP, Brazil
| | - Camila Vieira da Silva
- Special Laboratory of Lasers in Dentistry (LELO), Department of Restorative Dentistry, School of Dentistry, University of São Paulo (FO-USP), São Paulo, SP, Brazil
| | - Maria Cecília Pereira Cersosimo
- Special Laboratory of Lasers in Dentistry (LELO), Department of Restorative Dentistry, School of Dentistry, University of São Paulo (FO-USP), São Paulo, SP, Brazil
| | - Maria Cristina Borsatto
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo (FORP-USP), Ribeirão Preto, SP, Brazil
| | - Patrícia Moreira de Freitas
- Special Laboratory of Lasers in Dentistry (LELO), Department of Restorative Dentistry, School of Dentistry, University of São Paulo (FO-USP), São Paulo, SP, Brazil.
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Laser Acupuncture for Postoperative Pain Management in Cats. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:653270. [PMID: 26170879 PMCID: PMC4480929 DOI: 10.1155/2015/653270] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/26/2014] [Revised: 03/04/2015] [Accepted: 03/16/2015] [Indexed: 11/18/2022]
Abstract
UNLABELLED The aim of this study was to evaluate laser acupuncture as an adjuvant for postoperative pain management in cats. Twenty cats, undergoing ovariohysterectomy, were sedated with intramuscular (IM) ketamine (5 mg kg(-1)), midazolam (0.5 mg kg(-1)), and tramadol (2 mg kg(-1)). Prior to induction of anaesthesia, the subjects were randomly distributed into two groups of 10 cats: Laser: bilateral stomach 36 and spleen 6 acupoints were stimulated with infrared laser; CONTROL no acupuncture was applied. Anaesthesia was induced using intravenous propofol (4 mg kg(-1)) and maintained with isoflurane. Postoperative analgesia was evaluated by a blinded assessor for 24 h following extubation using the Dynamic Interactive Visual Analogue Scale and Multidimensional Composite Pain Scale. Rescue analgesia was provided with IM tramadol (2 mg kg(-1)), and the pain scores were reassessed 30 min after the rescue intervention. If the analgesia remained insufficient, meloxicam (0.2 mg kg(-1) IM, single dose) was administered. Data were analyzed using t-tests, the Mann-Whitney test, and the Friedman test (P < 0.05). The pain scores did not differ between groups. However, postoperative supplemental analgesia was required by significantly more cats in the CONTROL (5/10) compared with the Laser group (1/10) (P = 0.038). Laser acupuncture reduced postoperative analgesic requirements in cats undergoing ovariohysterectomy.
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Changes of locoregional skin temperature in neonates undergoing laser needle acupuncture at the acupuncture point large intestine 4. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:571857. [PMID: 25922612 PMCID: PMC4398935 DOI: 10.1155/2015/571857] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 03/06/2015] [Indexed: 12/15/2022]
Abstract
Laser acupuncture bears a potential risk for the skin surface, especially in neonates whose skin has histological and physiological peculiarities. We evaluated thermal changes of skin temperature in neonates during laser acupuncture by using a thermal camera (Flir i5, Flir Systems Inc., Portland, USA). Laserneedles (Laserneedle GmbH, Glienicke/Nordbahn, Germany) were fixed to the skin at Large Intestine 4 (LI 4, Hegu), bilaterally. Before application of laser acupuncture (685 nm, 15 mW, 500 μm), as well as after 1, 5, and 10 min, thermographic pictures of both hands were taken. The measuring was carried out on the 23rd day after birth (20 neonates, mean postmenstrual gestational age 38 + 2, mean weight 2604 g). Compared to the initial temperature of 34.2°C on the right hand, the skin temperature had increased to 35.3°C (P < 0.05) after 5 min and up to 36.1°C (P < 0.05) after 10 min of stimulation. Equally, on the left hand, an increase of the skin temperature from 34.5°C to 35.9°C (P < 0.05) and 35.9°C (P < 0.05) was measured. The highest measured skin temperature after 10 min of stimulation amounted to 38.7°C, without any clinically visible changes on the skin surface.
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Golianu B, Yeh AM, Brooks M. Acupuncture for Pediatric Pain. CHILDREN (BASEL, SWITZERLAND) 2014; 1:134-48. [PMID: 27417472 PMCID: PMC4928723 DOI: 10.3390/children1020134] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/07/2014] [Revised: 07/14/2014] [Accepted: 08/07/2014] [Indexed: 12/12/2022]
Abstract
Chronic pain is a growing problem in children, with prevalence as high as 30.8%. Acupuncture has been found to be useful in many chronic pain conditions, and may be of clinical value in a multidisciplinary treatment program. The basic principles of acupuncture are reviewed, as well as studies exploring basic mechanisms of acupuncture and clinical efficacy. Conditions commonly treated in the pediatric pain clinic, including headache, abdominal pain, fibromyalgia, juvenile arthritis, complex regional pain syndrome, cancer pain, as well as perioperative pain studies are reviewed and discussed. Areas in need of further research are identified, and procedural aspects of acupuncture practice and safety studies are reviewed. Acupuncture can be an effective adjuvant in the care of pediatric patients with painful conditions, both in a chronic and an acute setting. Further studies, including randomized controlled trials, as well as trials of comparative effectiveness are needed.
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Affiliation(s)
- Brenda Golianu
- Department of Anesthesiology and Pain Medicine, Pediatric Anesthesiology, Stanford University, 300 Pasteur Dr. Stanford, CA 94304, USA.
| | - Ann Ming Yeh
- Pediatric Gastroenterology, Stanford University, 750 Welch Road, Suite 116, Palo Alto CA 94304, USA.
| | - Meredith Brooks
- Department of Anesthesiology and Pain Medicine, Pediatric Anesthesiology, Stanford University, 300 Pasteur Dr. Stanford, CA 94304, USA.
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Huang TP, Liu PH, Lien ASY, Yang SL, Chang HH, Yen HR. A nationwide population-based study of traditional Chinese medicine usage in children in Taiwan. Complement Ther Med 2014; 22:500-10. [DOI: 10.1016/j.ctim.2014.04.002] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Revised: 03/01/2014] [Accepted: 04/24/2014] [Indexed: 12/18/2022] Open
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Quah-Smith I. Laser Ear Acupuncture: How Much is Enough? A Prospective Observational Study on Laser Dosages Required in the Healing Patient During Posturology and During the Treatment of Mental Distress. Med Acupunct 2014. [DOI: 10.1089/acu.2014.1027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Im Quah-Smith
- Centre for Healthy Brain Aging, UNSW Medicine, University of New South Wales (UNSW), Randwick, and Roseville Wellness Group, Roseville, both in New South Wales Australia
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Near-infrared spectroscopy for objectifying cerebral effects of laser acupuncture in term and preterm neonates. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2013; 2013:346852. [PMID: 23762122 PMCID: PMC3671269 DOI: 10.1155/2013/346852] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Revised: 04/22/2013] [Accepted: 04/26/2013] [Indexed: 12/22/2022]
Abstract
Laser acupuncture (LA) becomes more and more relevant in neonates and infants. With near-infrared spectroscopy (NIRS), a continuous and noninvasive measurement of tissue oxygenation is possible. Aim was to investigate, whether the application of LA was associated with any changes in regional cerebral oxygen saturation (rcSO2) in term and preterm neonates. The study included 20 neonates (12 males, 8 females). The Large Intestine 4 acupuncture point (LI 4, Hegu) was stimulated by a microlaser needle (10 mW, 685 nm laser needle EG GmbH, Germany) for 5 minutes, bilaterally. All neonates underwent polygraphic recording during undisturbed daytime sleep, including heart rate (HR), peripheral oxygen saturation (SpO2), and measurement of nasal flow. Using NIRS, rcSO2 was measured continuously. Cerebral fractional tissue oxygen extraction (cFTOE) was calculated. We did not observe any significant changes in SpO2 and HR values during the whole observation period. However, there was a significant decrease in rcSO2 (P = 0.003) within postintervention period, accompanied by a significant increase in cFTOE (P = 0.010) in postintervention period.
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Quah-Smith I, Smith C, Crawford JD, Russell J. Laser acupuncture for depression: a randomised double blind controlled trial using low intensity laser intervention. J Affect Disord 2013; 148:179-87. [PMID: 23337655 DOI: 10.1016/j.jad.2012.11.058] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2012] [Revised: 11/26/2012] [Accepted: 11/27/2012] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Trials of acupuncture for the treatment of depression have produced mixed results. We examined the effectiveness of laser acupuncture compared with placebo acupuncture for the treatment of major depression. METHODS A randomised, double blinded, placebo controlled trial was conducted in Sydney, Australia. Participants aged 18-50 years with DSM-IV major depressive disorder were eligible to join the study. Forty-seven participants were randomised to receive laser acupuncture or placebo laser at acupoints LR14, CV14, LR8, HT7 and KI3. The intervention was administered twice a week for 4 weeks and once a week for another four weeks, for a total of 12 sessions. The primary outcome assessed the change in severity of depression using the Hamilton-Depression Rating Scale (HAM-D), and secondary outcomes assessed the change in severity of depression using the Quick Inventory for Depression-Self Reporting (QID-SR), the Quick Inventory for Depression-Clinician (QIDS-CL), with outcomes assessed at eight weeks. The treatment response (greater than 50% improvement in HAM-D) and remission (HAM-D<8) were analysed. RESULTS At eight weeks participants showed greater improvement in the active laser group on the primary and clinician-rated secondary outcome measures (HAM-D (mean 9.28 (SD 6.55) vs. mean 14.14 (SD 4.78 p<0.001); QIDS-CL (mean 8.12 (SD 6.61 versus 12.68 (mean SD 3.77)) p<0.001). The self-report QIDS-SR scores improved in both groups but did not differ significantly between the groups. In the active laser group, QIDS-SR scores remained significantly lower than baseline at 3 months follow-up. Response rates (active laser, placebo laser) on ITT (intention to treat) analyses were 72.0% and 18.2% (p<0.001), respectively. Remission rates on ITT analyses (active laser, placebo laser) were 56.0% and 4.5% (p<0.001). Transient fatigue was the only adverse effect reported. LIMITATIONS There was no follow-up for the placebo group at one and 3 months. CONCLUSION Laser acupuncture showed a clinically and statistically significant benefit with reducing symptoms of depression on objective measures.
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Affiliation(s)
- Im Quah-Smith
- School of Psychiatry University of New South Wales, NSW 2052, Australia.
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Ferreira LA, de Oliveira RG, Guimarães JP, Carvalho ACP, De Paula MVQ. Laser acupuncture in patients with temporomandibular dysfunction: a randomized controlled trial. Lasers Med Sci 2013; 28:1549-58. [PMID: 23380907 DOI: 10.1007/s10103-013-1273-x] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2011] [Accepted: 01/22/2013] [Indexed: 11/25/2022]
Abstract
A prospective, double-blind, randomized, and placebo-controlled trial was conducted in patients with chronic temporomandibular disorder (TMD) to check the analgesic efficacy of infrared low-power GaAlAs diode laser applied to acupuncture points. Forty female subjects, ranging in age from 20 to 40 years, with diagnoses of chronic myofascial pain and arthralgia were randomly allocated to two groups: an experimental group (EG) who received the laser acupuncture as adjunct to reversible occlusal splint therapy and a control group (CG) who received a placebo laser associated with occlusal splint therapy. Both approaches were applied once a week for 3 months. Laser acupuncture was defined by the following parameters: 50-mW continuous radiation for 90 s to acupoints ST6, SI19, GB20, GB43, LI4, LR3, NT3, and EX-HN3; defining 4.5-J energy; 1250-W/cm(2) density point; and 112.5-J/cm(2) total density. The outcome measurements included a symptom evolution assessment carried out by checking spontaneous and palpation pain intensity, which was indicated on a visual analog scale (VAS). All evaluations were made by an assessor who was blind to the treatment. The symptom reduction was significant in both groups (EG: VAS = 0, n = 20; CG: VAS between 2 and 4, n = 18). The measurements showed significantly faster and lower pain intensity values in the EG (p ≤ 0.002), where there was a higher proportion of patients with remission of symptoms related to the action of laser acupuncture. For patients in whom conservative treatment was adopted, the laser acupuncture is a secure, noninvasive, and effective treatment modality because it improves the chronic pain associated with TMD and has no side effects.
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Affiliation(s)
- Luciano Ambrosio Ferreira
- Diagnostic and Guidance Center for Patients with Temporomandibular Disorders, Federal University of Juiz de Fora, Rua José Lourenço Kelmer, S/N, Campus Universitário, São Pedro, Juiz de Fora, Minas Gerais, 36036-900, Brazil,
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Connelly M, Bickel J. Chronic daily headache in children and adolescents: science and conjecture. Pain Manag 2013; 3:47-58. [DOI: 10.2217/pmt.12.75] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
SUMMARY Chronic daily headache comprises a group of headache disorders in which headaches occur almost daily or continuously over several months. Although chronic daily headache is one of the most common chronic pain disorders in pediatrics, data on pathophysiological mechanisms and relative efficacy of treatments remain sparse. In this review, we aim to provide contemporary information on classification, epidemiology, etiology and treatment of pediatric chronic daily headache based on extant empirical data when available, or general consensus in the field when not.
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Affiliation(s)
- Mark Connelly
- Children’s Mercy Hospitals and Clinics, 2401 Gillham Road, Kansas City, MO 64108, USA
| | - Jennifer Bickel
- Children’s Mercy Hospitals and Clinics, 2401 Gillham Road, Kansas City, MO 64108, USA
- University of Missouri-Kansas City School of Medicine, 2411 Holmes Street, Kansas City, MO 64110, USA
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Sun SH. Case Series Report on the Effect of Hand Acupuncture - Focusing on 29 Patients with Headache -. J Pharmacopuncture 2011. [DOI: 10.3831/kpi.2011.14.3.091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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The Problem of Metal Needles in Acupuncture-fMRI Studies. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2011; 2011:808203. [PMID: 21423640 PMCID: PMC3057644 DOI: 10.1155/2011/808203] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2010] [Accepted: 01/11/2011] [Indexed: 11/17/2022]
Abstract
Acupuncture is a therapy based on sensory stimulation of the human body by means of metal needles. The exact underlying mechanisms of acupuncture have not been clarified so far. Functional magnetic resonance imaging (fMRI) has become an important tool in acupuncture research. Standard acupuncture needles, which are made of ferromagnetic steel, however, are problematic in acupuncture-fMRI studies for several reasons, such as attraction by the scanner's magnetic field, significant image distortions and signal-dropouts, when positioned close to the head or even heating due to absorption of radio frequency (RF). The aim of this study was to compare two novel types of acupuncture needles with a standard needle for their effect on MRI image quality. The standard needle severely reduced image quality, when located inside the RF coil. The nonferromagnetic metal needle may pose a risk due to RF heating, while the plastic needle has a significantly larger diameter. In conclusion, our recommendations are: (1) standard needles should not be used in MRI; (2) Nonferromagnetic metal needles seem to be the best choice for acupoints outside of the transmitter coil; and (3) only plastic needles are suited for points inside the coil. Laser acupuncture may be a safe alternative, too.
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Lee SWH, Liong ML, Yuen KH, Leong WS, Khan NK, Krieger JN. Validation of a sham acupuncture procedure in a randomised, controlled clinical trial of chronic pelvic pain treatment. Acupunct Med 2011; 29:40-6. [PMID: 21245238 DOI: 10.1136/aim.2010.003137] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Acupuncture is an attractive treatment option for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) that has proved refractory to conventional medical treatments. Unfortunately, it is difficult to determine the benefit of acupuncture because few studies have employed controls or had physiological outcome measures. OBJECTIVE To determine the feasibility of a sham, or minimally invasive, acupuncture as a control for studies evaluating the efficacy of acupuncture treatment for chronic pelvic pain. METHODS Participants were recruited from a double-blind randomised trial comparing acupuncture with a sham procedure for patients with CP/CPPS. Acupuncture or sham procedures were performed over a 10-week period. Sham acupuncture involved placement of short needles at sites 0.5 cm away from true acupuncture points (CV1, CV4, SP6 and SP9). Participants were asked to determine their procedure allocation at the end of treatment. A total of 35 participants also agreed to have blood analyses for cortisol, β-endorphin and leucine-enkephalin. RESULTS Thirty-five (78%) of the 45 participants randomised to the sham treatment thought they had received acupuncture compared with 27 (61%) of the 44 participants randomised to acupuncture (p=0.11). Biochemical data showed no differences between the groups immediately after treatment. Thirty-two (73%) of 44 acupuncture participants met the predefined clinical response criterion compared with 21 (47%) of 45 sham acupuncture participants (p=0.017, relative risk 1.81, 95% CI 1.3 to 3.1). At the end of the study, β-endorphin and leucine-enkephalin levels were both higher in the acupuncture group (p<0.01). CONCLUSIONS Minimally penetrating acupuncture was found to be a valid sham control and may prove useful for evaluating the efficacy of acupuncture for other conditions.
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Affiliation(s)
- Shaun Wen Huey Lee
- Department of Urological Surgery, University of Washington, 1660 S Columbian Way, Seattle, WA 98108, USA
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The role of acupuncture in the treatment of orthodontic patients with a gagging reflex: a pilot study. Br Dent J 2010; 208:E19. [DOI: 10.1038/sj.bdj.2010.483] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2010] [Indexed: 11/08/2022]
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Affiliation(s)
- Kathi J Kemper
- Wake Forest University School of Medicine, Winston-Salem, NC, USA
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Bibliography. Current world literature. Curr Opin Obstet Gynecol 2009; 21:296-300. [PMID: 19458522 DOI: 10.1097/gco.0b013e32832c972c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This bibliography is compiled by clinicians from the journals listed at the end of this publication. It is based on literature entered into our database between 1 February 2008 and 31 January 2009 (articles are generally added to the database about two and a half months after publication). In addition, the bibliography contains every paper annotated by reviewers; these references were obtained from a variety of bibliographic databases and published between the beginning of the review period and the time of going to press. The bibliography has been grouped into topics that relate to the reviews in this issue.
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Abstract
BACKGROUND Acupuncture is often used for tension-type headache prophylaxis but its effectiveness is still controversial. This review (along with a companion review on 'Acupuncture for migraine prophylaxis') represents an updated version of a Cochrane review originally published in Issue 1, 2001, of The Cochrane Library. OBJECTIVES To investigate whether acupuncture is a) more effective than no prophylactic treatment/routine care only; b) more effective than 'sham' (placebo) acupuncture; and c) as effective as other interventions in reducing headache frequency in patients with episodic or chronic tension-type headache. SEARCH STRATEGY The Cochrane Pain, Palliative & Supportive Care Trials Register, CENTRAL, MEDLINE, EMBASE and the Cochrane Complementary Medicine Field Trials Register were searched to January 2008. SELECTION CRITERIA We included randomized trials with a post-randomization observation period of at least 8 weeks that compared the clinical effects of an acupuncture intervention with a control (treatment of acute headaches only or routine care), a sham acupuncture intervention or another intervention in patients with episodic or chronic tension-type headache. DATA COLLECTION AND ANALYSIS Two reviewers checked eligibility; extracted information on patients, interventions, methods and results; and assessed risk of bias and quality of the acupuncture intervention. Outcomes extracted included response (at least 50% reduction of headache frequency; outcome of primary interest), headache days, pain intensity and analgesic use. MAIN RESULTS Eleven trials with 2317 participants (median 62, range 10 to 1265) met the inclusion criteria. Two large trials compared acupuncture to treatment of acute headaches or routine care only. Both found statistically significant and clinically relevant short-term (up to 3 months) benefits of acupuncture over control for response, number of headache days and pain intensity. Long-term effects (beyond 3 months) were not investigated. Six trials compared acupuncture with a sham acupuncture intervention, and five of the six provided data for meta-analyses. Small but statistically significant benefits of acupuncture over sham were found for response as well as for several other outcomes. Three of the four trials comparing acupuncture with physiotherapy, massage or relaxation had important methodological or reporting shortcomings. Their findings are difficult to interpret, but collectively suggest slightly better results for some outcomes in the control groups. AUTHORS' CONCLUSIONS In the previous version of this review, evidence in support of acupuncture for tension-type headache was considered insufficient. Now, with six additional trials, the authors conclude that acupuncture could be a valuable non-pharmacological tool in patients with frequent episodic or chronic tension-type headaches.
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Affiliation(s)
- Klaus Linde
- Centre for Complementary Medicine Research, Department of Internal Medicine II, Technische Universitaet Muenchen, Wolfgangstr. 8, Munich, Germany, 81667.
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