Laser Acupuncture and Auriculotherapy in Postural Instability-A Preliminary Report

Effectiveness of acupuncture vs. core stability training in balance and functional capacity of women with fibromyalgia: a randomized controlled trial

Objective:

This study investigated the effectiveness of a core stability training physiotherapy programme vs. acupuncture for the management of balance and functional capacity impairments of women with Fibromyalgia.

Design:

Single-blind randomized controlled trial.

Setting:

Outpatients setting.

Subjects:

Women with Fibromyalgia and balance impairment.

Interventions:

Participants were randomized to a core stability physiotherapy programme group ( n = 45), acupuncture treatment group ( n = 45) and control group ( n = 45) for 13 weeks.

Main Measures:

Measures were taken at baseline (week 0), postintervention (week 6) and follow-up (week 13). The primary outcome measures were static balance (posturography) and dynamic balance and functional mobility (Berg Balance Scale, timed up and go test and 10-m walk). The secondary outcome measure was functional capacity (Fibromyalgia Health Assessment Questionnaire and the physical function item from the Spanish Fibromyalgia Impact Questionnaire).

Results:

In all, 103 participants completed the study. The results showed statistically significant improvements in the acupuncture and physiotherapy groups vs. the control group at week 6 regarding Berg Balance Scale ( P = 0.00, both groups), timed up and go test ( P = 0.00 and P = 0.01, respectively) and 10-m walk test at comfortable speed ( P = 0.02 and P = 0.03, respectively). The 10-m walk test at maximum speed showed significance when comparing the physiotherapy and control group ( P = 0.03). However, no significant differences were found between the physiotherapy and the acupuncture groups. In relation to functional capacity, the improvements achieved after the treatments were not statistically significant.

Conclusion:

Core stability-based physiotherapy and acupuncture improve dynamic balance and postural control in women with Fibromyalgia.

Fascial neuromodulation: an emerging concept linking acupuncture, fasciology, osteopathy and neuroscience

According to Traditional Chinese Medicine “acupuncture is believed to restore the balance between Yin and Yang” and this can be understood in the Western medicine terminology as a “modulation of the equilibrium between parasympathetic and sympathetic activity”. The vast majority of studies concerning the mechanisms of action of acupuncture have been conducted on its influence on pain, and it has been proposed that acupuncture may indirectly relieve chronic pain by its effects on autonomic nervous system function. Several studies have shown that acupuncture recruits brain networks involved in the integration of multiple other brain functions: for example, the limbic-paralimbic-neocortical network, which plays a major role in modulating the affective dimensions of pain processing and the integration of emotional, sensorimotor, autonomic and immunological functions. It has been recently proposed that mechanical signaling through the connective tissue, along with transmission of the matrix deformation through the fascial system network, can explain the therapeutic effect of acupuncture. This model of acupunture, which involves the transduction of mechanical signals through the connective planes and produces a secondary involvement of neurophysiological mechanism, appears to fit very closely to the ancient model. It is also compatible with the proposed neurophysiological explanation. Furthermore, it appears to be fruitful also in manual therapy approaches. Drawing on the basis of the “Fascial network hypothesis of meridians”, in which there is an overlap between the channels network described by Traditional Chinese Medicine and the newly-defined fascial system, I propose an intervention through a combination of acupoints that have been selected due to their relationship between “extraordinary acupuncture channels”, the myofascial sequences described by Stecco, and the emotional and adaptive function as contemplated by a psychosomatic model used in posturology. This intervention is aimed at treating both stress and postural imbalance.

Impact of Tai Chi Exercise on Balance Disorders: A Systematic Review

Purpose Tai chi is receiving increasing research attention with its benefit of improving flexibility and balance. The objective of this review was to examine the evidence concerning the impact of tai chi as a practical therapy for vestibular rehabilitation on individuals with balance and vestibular disorders. Method A systematic review using 4 electronic databases was conducted. Randomized clinical trials and quasi-experimental studies were included. Results Four studies met the inclusion criteria and were included for data analysis. Results indicate positive effect of tai chi practice on dynamic postural stability in balance of its practitioners. Conclusion Tai chi may be a useful therapy as for vestibular rehabilitation as it improves dynamic balance control and flexibility of individuals with balance and vestibular disorders.

Lower limb auriculotherapy points improves balance in young healthy subjects-assessed by computerized baropodometry

OBJECTIVE

To analyze the effects of Lower Limb (LL) auricular stimulation points on the static equilibrium of healthy subjects, assessed by computerized baropodometry.

METHODS AND MATERIALS

Forty volunteers were assigned to one of two groups: Auriculotherapy (AT) who received unilateral needle stimulation of the coxofemoral, knee, and ankle points. Control (C) who did not receive any stimulation. We analyzed the contact area (CA) and the peak pressure (PP) for both feet at baseline, 20 and 25 min after the baseline was recorded. Three-Way ANOVA (P < 0.05) was used for data analysis.

RESULTS

AT showed an increase in CA (F:6.49) and a decrease in PP (F:3.11) at 20 and 25 min, when compared to C. The PP decreased was only for the right LL at 20 and 25 min (F:6.45).

CONCLUSION

The auriculotherapy points were able to modify the ipsilateral weight discharge on the same side of the stimulated auricular pavilion.

Posturography and dynamic pedobarography in lame dogs with elbow dysplasia and cranial cruciate ligament rupture

BACKGROUND

The usefulness of studying posture and its modifications due to locomotor deficiencies of multiple origins has been widely proven in humans. To assess its suitability in the canine species, static posturography and dynamic pedobarography were performed on lame dogs affected with unilateral elbow dysplasia and cranial cruciate ligament rupture by using a pressure platform. With this objective, statokinesiograms and stabilograms, the percentage of pressure distribution between limbs, paw area, mean pressure, and peak pressure, were obtained from lame and sound dogs. These data were compared with Peak Vertical Force values originated from a force platform in the same recording sessions.

RESULTS

Significant differences were found in the parameters mentioned above between sound and lame dogs and limbs.

CONCLUSIONS

Posturography and pedobarography are useful and reliable for the monitoring of fore and hindlimb lameness in dogs, providing a new set of parameters for lameness detection.

Biolite: A Patented Ultra-Low-Level Laser-Therapy Device for Treating Musculoskeletal Pain and Associated Impairments

After an excursus on state-of-the-art knowledge for low-level laser therapy (LLLT), Biolite, a patented ultra-low-level laser therapy device used to treat musculoskeletal pain and associated impairments, is presented. The application protocols include short stimulation of sequences of acupuncture points. The observed effects seem, however, to be far from those that might be expected after acupuncture. The primary effect seems more likely to be an extracellular soft-tissue matrix reaction. The development of the technique, the studies performed, and the evidence collected over > 10 years suggest that specifically modulated laser light can interact with human tissues at light fluences well under those previously considered as being capable of having any effect. Musculoskeletal pain very often becomes an autonomous dysfunction that is independent of the original injury and that can be effectively treated using specific peripheral acupuncture-like stimulation. Because such acupuncture is capable of reducing motor control "interferences" from noxious stimuli, it can improve motor control performance, thereby reducing the risk of falls in the elderly individuals. The proposal of acupuncture-derived protocols to be applied by Western physiotherapists using an ultra-low-level laser therapy device is a further "bridge" between two different, and sometimes very different, clinical worlds to better serve our patients.

Sham control methods used in ear-acupuncture/ear-acupressure randomized controlled trials: a systematic review

Ear-acupuncture/ear-acupressure (EAP) has been used for a range of health conditions with numerous randomized controlled trials (RCTs) investigating its efficacy and safety. However, the design of sham interventions in these RCTs varied significantly. This study systematically reviewed RCTs on EAP for all clinical conditions involving a number of sham EAPs as a control intervention. The review is guided by the Cochrane Handbook for Systematic Reviews of Interventions 5.1.0 and investigated the types and differences of sham EAP interventions. Four electronic English databases (The Cochrane Library, PubMed, Embase, CINAHL®) and two Chinese databases (CQVIP, CNKI) were searched in December 2012 and 55 published RCTs comparing real and sham EAP for any clinical condition were included. Characteristics of participants, real and sham interventions, and outcomes were extracted. Four types of sham methods were identified. Among the 55 RCTs, 25 studies involved treatment on nonspecific ear acupoints as the sham method; seven studies used nonacupoints on the ear; nine studies selected placebo needles or placebo ear-acupressure on the same ear acupoints for the real treatment; 10 studies employed pseudo-intervention; and five studies combined two of the above methods to be the sham control. Other factors of treatment such as number of points, treatment duration, and frequency also varied greatly. Risk of bias assessment suggests that 32 RCTs were "high risk" in terms of participants blinding, and 45 RCTs were "high risk" in terms of personnel blinding. Meta-analysis was not conducted due to the high clinical heterogeneity across included studies. No relationship was found between the sham designs and efficacy outcomes, or between the sham types and dropout rate. No solid conclusion of which design is the most appropriate sham control of EAP could be drawn in this review.

Auricular acupuncture with laser

Auricular acupuncture is a method which has been successfully used in various fields of medicine especially in the treatment of pain relief. The introduction of lasers especially low-level lasers into medicine brought besides the already existing stimulation with needles and electricity an additional technique to auricular acupuncture. This literature research looks at the historical background, the development and the anatomical and neurological aspects of auricular acupuncture in general and auricular laser acupuncture in detail. Preliminary scientific findings on auricular acupuncture with laser have been described in detail and discussed critically in this review article. The results of the studies have shown evidence of the effect of auricular laser acupuncture. However, a comparison of these studies was impossible due to their different study designs. The most important technical as well as study parameters were described in detail in order to give more sufficient evidence and to improve the quality of future studies.

Treating balance disorders by ultra-low-level laser stimulation of acupoints

BACKGROUND

Balance disorders, a widespread problem in the senior population, are very often related to painful musculoskeletal disabilities and/or to degenerative neurologic pathologies. In a previous work, we investigated the beneficial effects of acupuncture such as laser photobiostimulation, regardless of the etiological origin of the balance dysfunction.

AIMS

Attention was focused on two individuals showing balance deficits with different etiologies. One healthy control individual was receiving treatment, one healthy control individual did not receive any treatment. Balance performances were measured before and after ultra-low-level laser (ULLL) stimulation as a basis for the design of further investigations.

METHODS

Romberg's parameters were measured on a force platform. Of the four tested individuals, one showed dizziness symptoms, one was affected by a mild form of Parkinson's disease, and two showed no dysfunction and were used as controls.

RESULTS

It was found that a ULLL stimulation of peripheral Traditional Chinese Medicine (TCM) acupuncture points can be effective, regardless of the pathology.

DISCUSSION

A specific clinical analysis of the stability of the beneficial result as a function of homogeneous groups of dysfunctional individuals is needed.