Short-Time Effects of Laser Needle Stimulation on the Peripheral Microcirculation Assessed by Laser Doppler Spectroscopy and Near-Infrared Spectroscopy

Intrarater and Interrater Reliability of Infrared Image Analysis of Forearm Acupoints before and after Moxibustion

The objective of this study was to determine the intrarater and interrater reliabilities of infrared image analysis of forearm acupoints before and after moxibustion. In this work, infrared images of acupoints in the forearm of 20 volunteers (M/F, 10/10) were collected prior to and after moxibustion by infrared thermography (IRT). Two trained raters performed the analysis of infrared images in two different periods at a one-week interval. The intraclass correlation coefficient (ICC) was calculated to determine the intrarater and interrater reliabilities. With regard to the intrarater reliability, ICC values were between 0.758 and 0.994 (substantial to excellent). For the interrater reliability, ICC values ranged from 0.707 to 0.964 (moderate to excellent). Given that the intrarater and interrater reliability levels show excellent concordance, IRT could be a reliable tool to monitor the temperature change of forearm acupoints induced by moxibustion.

Difference in the metabolic characteristics of chronic obstructive pulmonary disease patients and healthy adults

INTRODUCTION

By detecting the metabolic difference of the Heart and Lung meridians, the present study aims to investigate the specificity of different meridians and verify whether functional near infrared spectroscopy is validated as an add-on technique to assist diagnosis of chronic obstructive pulmonary disease (COPD).

METHODS AND ANALYSIS

The Lung and Heart meridians are chosen as the target for comparison; accordingly, 120 eligible participants will be included and divided into the COPD group, healthy control group, and healthy intervention group. Functional near infrared spectroscopy will be adopted to measure the metabolic characteristics of the Heart and Lung meridians. On one hand, the specificity of the meridian-visceral association will be investigated by comparing the metabolic difference in the Heart and Lung meridians between the healthy control group and COPD group. On the other hand, the specificity of site-to-site association will be determined by comparing the metabolic change between the 2 meridians that induced by moxibustion in the Heart meridian and Lung meridian, respectively, in the healthy control group. The primary outcome will be regional oxygen saturation of corresponding regions along the Heart and Lung meridians.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04046666.

[Lasernadel-Akupunktur bei hyperaktiver Blase: Eine Kasuistik]

In diesem Fallbericht wird die Lasernadel-Akupunktur bei einer Patientin mit Hyperaktive-Blase(OAB)-Symptomatik beschrieben. Nach 7 Behandlungen mit dieser neuen, nichtinvasiven Therapie war eine deutliche Verbesserung der Symptome - häufiger und verstärkter Harndrang, Nykturie und Inkontinenz - zu verzeichnen, und das Patientenempfinden der Blasenbeschwerden war auf der visuellen Analogskala um 60% verbessert. Die invasive sakrale Neuromodulation über den Sakrallöchern am Becken und die perkutane tibiale Nervenstimulation über dem medialen Knöchel am Fuss sind in der Schulmedizin anerkannte Methoden zur Behandlung der OAB. Genau diese Punkte aus der Schulmedizin wurden mit der nichtinvasiven, schmerzlosen Lasernadel mit positivem Patientenempfinden bezüglich der OAB therapiert. Dabei handelte es sich um die Akupunkturpunkte Bl 27, 28, 29, 30 und MP 6. Die schmerzlose Lasernadel-Therapie scheint zukunftsweisend für die Behandlung der OAB zu sein.

Contrast Baths, Intramuscular Hemodynamics, and Oxygenation as Monitored by Near-Infrared Spectroscopy

CONTEXT:

Contrast baths (CB) is a thermal treatment modality used in sports medicine, athletic training, and rehabilitation settings. Proposed physiological effects of CB include increasing tissue blood flow and oxygenation and decreasing tissue swelling and edema to promote better healing, improved limb function, and quicker recovery.

OBJECTIVE:

To investigate the physiological effects of CB on the intramuscular hemodynamics and oxygenation of the lower leg muscles using near-infrared spectroscopy (NIRS), an optical method for monitoring changes in tissue oxygenated (O2Hb), deoxygenated (HHb), and total hemoglobin (tHb) as well as tissue oxygen saturation index (TSI%).

DESIGN:

Descriptive laboratory study.

PATIENTS OR OTHER PARTICIPANTS:

Ten healthy men and women with a mean age of 29 (range = 17 ± 42) years, mean body mass index of 24.6 ± 3.2, and mean adipose tissue thickness of 6.4 ± 2.2 mm.

INTERVENTION(S):

Conventional CB (10-minute baseline, 4 : 1-minute hot : cold ratio) was applied to the left lower leg.

MAIN OUTCOME MEASURE(S):

Changes in chromophore concentrations of O2Hb, HHb, tHb, and TSI% of the gastrocnemius muscle were monitored during 10 minutes of baseline measurement, a 30-minute CB protocol, and 10 minutes of recovery using a spatially resolved NIRS.

RESULTS:

After a 30-minute CB protocol, increases ( P < .05) in tissue O2Hb (7.4 ± 4 μM), tHb (7.6 ± 6.1 μM), and TSI% (3.1% ± 2.3%) were observed as compared with baseline measures.

CONCLUSIONS:

Application of CB induced a transient change in the hemodynamics and oxygenation of the gastrocnemius muscle in healthy individuals. The effect of CB application in improving tissue hemodynamics and oxygenation may, therefore, support the therapeutic benefits of CB in the treatment of muscle injuries.

Modern acupuncture-like stimulation methods: a literature review

Acupuncture therapy has been proved to be effective for diverse diseases, symptoms, and conditions in numerous clinical trials. The growing popularity of acupuncture therapy has triggered the development of modern acupuncture-like stimulation devices (ASDs), which are equivalent or superior to manual acupuncture with respect to safety, decreased risk of infection, and facilitation of clinical trials. Here, we aim to summarize the research on modern ASDs, with a focus on featured devices undergoing active research and their effectiveness and target symptoms, along with annual publication rates. We searched the popular electronic databases Medline, PubMed, the Cochrane Library, and Web of Science, and analyzed English-language studies on humans. Thereby, a total of 728 studies were identified, of which 195 studies met our inclusion criteria. Electrical stimulators were found to be the earliest and most widely studied devices (133 articles), followed by laser (44 articles), magnetic (16 articles), and ultrasound (2 articles) stimulators. A total of 114 studies used randomized controlled trials, and 109 studies reported therapeutic benefits. The majority of the studies (32%) focused on analgesia and pain-relief effects, followed by effects on brain activity (16%). All types of the reviewed ASDs were associated with increasing annual publication trends; specifically, the annual growth in publications regarding noninvasive stimulation methods was more rapid than that regarding invasive methods. Based on this observation, we anticipate that the noninvasive or minimally invasive ASDs will become more popular in acupuncture therapy.

The Effects of Acupuncture on Cerebral and Muscular Microcirculation: A Systematic Review of Near-Infrared Spectroscopy Studies

Acupuncture produces physiological effects via stimulating acupoints, proximal or distal to the region of effect. Near-infrared spectroscopy (NIRS) noninvasively measures tissue-level hemodynamics in real time. We review the literature investigating the effect of acupuncture on muscular and/or cerebral microcirculation. As the basis, we queried PubMed in June 2014 for articles mentioning both acupuncture and NIRS in title/abstract. The reviewed papers investigated either cerebral (n = 11) or muscular hemodynamics (n = 5) and, based on STRICTA for reporting acupuncture methodology, were overall poor in quality. Acupuncture was found to influence regional oxygen saturation in cerebral and muscular tissue. The cortical response in healthy subjects varied across studies. For subjects with stroke or cerebrovascular dementia, findings suggest that acupuncture may modulate dysfunction in cerebral autoregulation. The muscular response to pressure techniques was more intense than that to needling or laser. Probe proximity could impact measurement sensitivity. No one study simultaneously investigated the direct and remote responses. Research utilizing NIRS to investigate the hemodynamics of acupuncture presently lacks in scope and quality. Improved designs, for example, placebo-controlled, randomized trials, and standardized intervention reporting will raise study quality. Exploiting NIRS in clinical settings, such as stroke, migraine, or other pain conditions, is worthwhile.

The Problem of Metal Needles in Acupuncture-fMRI Studies

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.

The effect of acupuncture on oral microcirculation in healthy volunteers: an exploratory study

BACKGROUND

acupuncture is a therapeutic technique currently used in the treatment of many pathologies. The aim of this study is to evaluate the potential effect of acupuncture on "in vivo" variations in oral microcirculation in healthy subjects.

METHODS

an exploratory study was conducted on 40 healthy subjects: 20 cases (mean 55.90, SD 16.04) and 20 controls (mean 51, SD 11.91). Videocapillaroscopy was used to detect variations in oral microcirculation. This method permits an accurate and non-invasive in vivo study of the capillaries of the oral mucous. The site selected for this pilot study is the lower lip since it is the simplest to investigate and is more readily accessible. Assessments were carried out in three phases: t(0) before the application of the needles; t(1) one minute after the application; t(2) five minutes after the application; similar time points were used for the control group. Data were compared using the Mann-Whitney test.

RESULTS

the study showed characteristic changes in oral microcirculation induced by acupuncture. The tortuousness of capillary loops and in the diameter of the afferent loop changed significantly (p<0.05) over time in the acupuncture group but not in the controls.

CONCLUSIONS

the findings lend support to our expectation that acupuncture may generate significant variations in oral microcirculation in healthy adults. Further research is needed to confirm these findings and evaluate the therapeutic role of acupuncture in oral pathologies.

The use of light photobiomodulation on the treatment of second-degree burns: a histological study of a rodent model

OBJECTIVE

The aim of this investigation was to compare, by light microscopy, the effects of the use of laser photobiomodulation (LPBM) and polarized light (PL) on second-degree burns on rodents.

BACKGROUND DATA

Burns are severe injuries that result in the loss of tissue fluids, destruction of tissues, infection, and shock. With severe and widespread third-degree burns death may occur. Several light sources have been suggested as being effective for improving wound healing.

MATERIALS AND METHODS

Forty five rats were used in this study. A second-degree burn was created on the dorsum of each animal, and the animals were divided into four groups: PL (400-2000 nm, 40 mW, 2.4 J/cm(2)/min); LPBM-1 (780 nm, 35/40 mW, theta approximately 2 mm, 4 x 5 J/cm(2)); LPBM-2 (660 nm, 35/40 mW, theta approximately 2 mm, 4 x 5 J/cm(2)); and untreated animals acted as controls. The treatment was started immediately post-burn at four points around the burned area (laser: 5 J/cm(2) per site). The illumination with PL was performed according to the manufacturer's instructions. Treatments were repeated at 24-h intervals for 7 d. The animals were sacrifice at 3, 5, and 7 d post-burn. The specimens were routinely cut and stained and analyzed by light microscopy using hematoxylin and eosin and Sirius red.

RESULTS

The analysis of the results demonstrated that the damaged tissue was able to efficiently absorb and process the light at all tested wavelengths. LPBM at 660 nm showed better results at early stages of wound healing. However, the use of 780-nm laser light had beneficial effects throughout the experimental period, with the animals growing newly-formed tissue similar to normal dermis.

CONCLUSION

Despite our findings that the use of both types of light energy improved the healing of second-degree burns at the early stages, long-term assessment is needed to verify if this improvement will influence the final results of treatment.

Laser-needle therapy for spontaneous osteonecrosis of the knee

OBJECTIVE

This case report describes the treatment of a 63-year-old patient with spontaneous osteonecrosis of the knee (SONK).

BACKGROUND DATA

SONK usually appears in the elderly patient without the typical risk factors for osteonecrosis. It is characterized by acute and sudden pain, mostly occurring at the medial side of the knee joint. Symptoms usually worsen with physical activity and improve with rest. Besides physical therapy, limited weight-bearing and the use of analgesics and nonsteroidal anti-inflammatory drugs, we propose low-level laser therapy (LLLT) as a conservative treatment option.

METHODS

LLLT was carried out using laser needles emitting radiation with wavelengths of 685 and 885 nm, and a power density of 17.8 W/cm(2). Therapy sessions lasted 60 min and were performed daily over a period of 3 mo. The total irradiation dose emitted by 8 laser needles in 60 min of treatment was 1008 J.

RESULTS

Magnetic resonance imaging revealed distinct restitution of the spongiosa edema 5 wk after treatment onset, and the final check-up at 35 wk demonstrated complete restoration of integrity.

CONCLUSION

The present case report provides the first indication that laser-needle therapy may be a promising tool for complementary and alternative therapeutic intervention for those with SONK.

Laser Needle Acupuncture at Neiguan (PC6) Does Not Mediate Heart Rate Variability in Young, Healthy Men

OBJECTIVE

The aim of this randomized, double-blinded, placebo-controlled trial was to evaluate specific effects of laser needle acupuncture at the Neiguan point (PC6) on sympathetic and parasympathetic nerve activity in healthy subjects using heart rate variability (HRV) analysis.

BACKGROUND DATA

Acupuncture at the Neiguan point (PC6) has been shown to modulate the autonomic nervous system.

METHODS

Forty-five healthy non-smoking males were randomly divided into a placebo group (n = 20) with no laser irradiation and into an intervention group (n = 25) for which laser needle irradiation (36.8 kJ/cm(2)) was performed on the right forearm. Monitoring of HRV was performed before, during, and after intervention.

RESULTS

Repeated-measures MANOVA did not show statistically significant main effects of time (F = 1.29, p = 0.27) or of group (F = 1.67, p = 0.16). The time by group interaction was also not statistically significant (F = 0.95, p = 0.54).

CONCLUSION

Our results suggest that heart rate variability was not influenced by laser needle acupuncture at the Neiguan point (PC6).