The acute effect of acupuncture on 20-km cycling performance

Electroacupuncture Reduces Heart Rate and Perceived Exertion During a Bike Test: A Preliminary Analysis

BACKGROUND

Preliminary research suggests that acupuncture can improve cardiovascular function. The purpose of our study was to determine if electroacupuncture can improve performance and post-exercise recovery.

METHODS

Thirty-two healthy people participated in this study (14 men and 18 women, aged 23.6 ± 3.5 years). The first visit included baseline measurements. Then, the participants received daily electroacupuncture at acupuncture point PC6 for a week, followed by a second visit. Heart rate, perceived exertion, and systolic and diastolic blood pressure were measured before, during, and after a YMCA submaximal bike test.

RESULTS

The heart rate was significantly reduced during the final stage of the YMCA test (151.3 ± 7.0 to 146.7 ± 11.8; p = 0.013) on the second visit. The rate of perceived exertion was significantly lower during all stages in Visit 2 (average RPE Visit 2 = 10.71 ± 2.02; average RPE Visit 1 = 11.45 ± 1.98; p = 0.004). Systolic blood pressure significantly decreased during the 5 min post-test recovery (SBP Visit 2 = 116.9 ± 12.0; SBP Visit 1 = 145.7 ± 14.6, p < 0.05).

CONCLUSIONS

A week of electroacupuncture at PC6 led to reduced heart rate and perceived exertion during exercise, making the workload feel less strenuous. Electroacupuncture at PC6 shows potential for increasing participation in physical activities by making them feel easier to accomplish.

Acupuncture and Dry Needling for Sports Performance and Recovery

ABSTRACT

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

Effect of acupuncture in physiological parameters and endurance running performance

BACKGROUND

Few studies have examined the effect of acupuncture (AC) treatment in aerobic capacity and endurance performance in healthy adults. Thus, the aim of the present study was to evaluate the effects of AC on selected physiological parameters and 3 km running performance.

METHODS

Twenty-four healthy subjects with low to moderate aerobic capacity participated in the study and randomly assigned in two groups: AC group (ACG - N.=14) and control group (CG - N.=10). The subjects completed an incremental test to exhaustion and a 3 km race on a treadmill to evaluate their physiological responses and endurance running performance respectively, prior and after 4 weeks (8 sessions, twice a week) of acupuncture treatment.

RESULTS

AC treatment had a significant main effect in T3km [F(1, 21)=7.173, P=0.014, partial η2=0.255], as well as in VT [F(1, 21)=8.476, P=0.008, partial η2=0.288] and HRmax@3km [F(1, 21)=4.930, P=0.038, partial η2=0.190], after controlling for the effect of the pre-test, while no other significant main effects were detected.

CONCLUSIONS

Healthy physically active adults significantly improved their endurance running performance after 4 weeks of AC treatment. This is mainly due to the enhancement of the speed corresponding with VT, comparing with their baseline values.

Prediction model for utilization of complementary and alternative medicine for sports injuries among Korean elite collegiate athletes

Background

The purpose of this study was to describe the use of complementary and alternative medicine (CAM) services by Korean elite collegiate athletes and to examine the factors influencing the utilization of CAM, or Korean Medicine (KM).

Methods

Students in Korea National Sport University (KNSU) enrolled and in training during August to December 2017 completed the survey. Data from the survey was analyzed through path analysis.

Results

Students who were training in the Department of Physical Education, KNSU (n = 624, 70% males, mean age 21.3 ± 1.2) participated in this study. 15% of the respondents chose KM clinics for sports injuries, a higher rate than that of the general population, and 44% of KM interventions involved acupuncture. In the path analysis, sports injuries were positive predictors for utilization of medical services and the perception of KM, and KM utilization and the perception of KM were positive predictors of the willingness to receive KM treatments.

Conclusions

The use of KM such as acupuncture was relatively high in elite collegiate athletes. The perception of KM and willingness to receive KM treatments were mediated by previous KM experiences. A higher accessibility towards KM treatments are necessary.

The Evidence for Common Nonsurgical Modalities in Sports Medicine, Part 1: Kinesio Tape, Sports Massage Therapy, and Acupuncture

There are a number of nonsurgical modalities used by athletes in attempts to improve performance or prevent, treat, and rehabilitate musculoskeletal injuries. A concise review of available evidence on common nonsurgical modalities used today is necessary so that practitioners may appropriately counsel patients.

The effectiveness of acupuncture for pain reduction in delayed-onset muscle soreness: a systematic review

Objective:

The aim of this study was to systematically review the literature on acupuncture for delayed-onset muscle soreness (DOMS) and report upon study quality and treatment outcomes.

Design:

Systematic review.

Data sources:

Searches were conducted in the following electronic databases from their inception to 31 March 2018: CINAHL, MEDLINE, Allied and Complementary Medicine (AMED) and SPORTDiscus. Reference lists of all included studies and relevant reviews were hand-searched for additional studies.

Eligibility criteria for selecting studies:

Randomised controlled trials (RCTs) that evaluated the effectiveness of acupuncture in DOMS in adults measuring the pre-specified primary outcome (pain) were included.

Data collection and analysis:

Data were extracted using pre-defined extraction forms and the Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA) checklist. Quality of studies was evaluated based on the Cochrane risk of bias assessment.

Results:

Five RCTs investigating laboratory-induced DOMS in the upper limbs with a total sample size of 182 healthy participants were included. Of the included studies, three reported superiority of acupuncture over no treatment in DOMS pain reduction as measured by visual analogue scale, pressure pain threshold or electrical pain threshold, while two studies yielded non-significant results. All studies demonstrated risk of bias in one or more areas, commonly lack of blinding of participants and personnel.

Summary/conclusion:

There is conflicting to limited evidence to support the effects of acupuncture on the relief of pain associated with DOMS. The findings were confounded by methodological limitations and reporting insufficiency. More rigorous, high-quality, and well-reported RCTs are required to further evaluate the effectiveness of acupuncture for DOMS.

Therapy and Rehabilitation for Upper Extremity Injuries in Athletes

The approach to rehabilitation of upper extremity injuries in athletes differs from traditional rehabilitation protocols. In general, athletes have higher functional demands and wish to return to competitive sport in a timely manner. Comprehensive rehabilitation must therefore be balanced with a timely and safe return to sport. Several rehabilitation programs and adjunctive therapies are available to hasten convalescence while minimizing the athlete's risks of reinjury. Here, we review techniques for soft tissue mobilization and strength training in athletic populations. We also discuss orthotics, taping, and alternative therapies used in rehabilitation and evaluate the evidence in support of these modalities.

The Feasibility and Effects of Acupuncture in an Adolescent Nordic Ski Population

BACKGROUND

Studies investigating the use and effectiveness of acupuncture in adults after exercise have been well documented. Fewer studies involving acupuncture have been completed in the adolescent athlete population. To our knowledge, there are no published studies that investigate the use of acupuncture in adolescent athletes within their field of play.

OBJECTIVE

To primarily assess the feasibility of performing acupuncture in adolescent Nordic skiers within their athletic environment, and secondarily to measure the effect of acupuncture on muscle soreness and sense of well-being.

DESIGN

Prospective feasibility study.

SETTING

Local outdoor cross country ski trails and indoor lodge.

PARTICIPANTS

Fifteen healthy participants (80% female, 20% male; age 14-17 years) were involved on at least 1 of 5 treatment days.

INTERVENTION

Fifteen-minute treatments were administered using traditional needle acupuncture following the first 5 consecutive Nordic Ski Team practices of the season in an attempt to capture the effect of acupuncture on delayed-onset muscle soreness (DOMS). Acupuncture points specific to muscle groups in the lower limbs that are commonly reported as painful during Nordic skiing were chosen. Pre- and posttreatment surveys included visual analogue scales (VAS) to track participant responses.

OUTCOME MEASURES

Time, cost, side effects, and participant to provider ratio was observed to determine feasibility. Effect on muscle soreness and sense of well-being was measured via pre- and posttreatment VAS (0-10) rating analyses.

RESULTS

Total time required by research staff on treatment days was 90 minutes; total cost, $1500; temperature range, -13.9°C to -2.8°C, and largest participant to acupuncturist ratio, 7:1. No major side effects occurred. The majority (73%) of participants reported minimal side effects; most common was treatment site pain. The overall pre- to posttreatment effect on muscle soreness (average over 5 days) demonstrated significantly improved posttreatment scores (P = .04). The effect of the day (average over pre- and posttreatment values) demonstrated significantly higher muscle soreness scores on day 3 versus day 1 (P = .03). At study completion, all participants indicated that they would consider acupuncture in the future and would recommend treatments to friends or teammates.

CONCLUSION

Providing acupuncture to adolescent Nordic ski athletes in the practice field under extreme temperatures is feasible with the appropriate resources. Despite mild side effects, acupuncture was well received by the athletes. Lessons learned from this trial can provide a framework for delivering acupuncture to other athletes in their training environment.

LEVEL OF EVIDENCE

IV.

Effect of acupuncture and instruction on physiological recovery from maximal exercise: a balanced-placebo controlled trial

Background

This study aimed to investigate the effect of acupuncture administered immediately following a graded exercise test (GXT) on physiological measures of recovery and determine if instruction (expectancy) affected the responses.

Methods

A balanced-placebo 2 × 2 factorial design was used with treatment (real vs placebo acupuncture) and instruction (told real vs told placebo acupuncture) as factors; a no-treatment control group was also included to compare the treatment responses to no treatment. Recreationally active, acupuncture naïve young adults (n = 60) performed a GXT to exhaustion on a cycle ergometer (15 W/min). Heart rate, blood pressure, oxygen consumption, respiratory rate and blood lactate were collected during the test and during 60 min of supine recovery on a plinth. An experienced acupuncturist delivered real or placebo acupuncture within 6 min of completing the GXT (total treatment time = 20 min). Real acupuncture points included Neiguan (PC6), Zusanli (ST36), Lieque (LU7), and Tanzhang (REN17), while placebo acupuncture was delivered using the Park sham needle placed 1–2 cm away from each real acupuncture point. The control group received no intervention.

Results

Linear and quadratic trend analyses over time indicated no significant differences between groups on any dependent variable. However, analysis of specific timepoints (every 10 min of the 60 min recovery) revealed that participants who received some form of treatment had a lower heart rate than participants in the no treatment control group (p = 0.042) at 20 min post-exercise. Further, a significant treatment by instruction interaction effect for heart rate was also found at 50 min (p = 0.042) and 60 min (p = 0.013) post-exercise, indicating that the differences between real and placebo acupuncture were affected by expectancy manipulation. No other significant effects were noted. However, it was interesting to note that participants who believed they were given real acupuncture reported quicker perceived recovery independent of actual treatment (p = 0.006) suggesting that instruction about treatment influenced perceived recovery.

Conclusion

In summary, due to limited evidence, the current study does not support the acute use of acupuncture for exercise recovery. However, importantly, the current study demonstrates that a balanced-placebo design is viable for testing acupuncture and expectancy effects, and this methodology could therefore be implemented in future studies.

Trial registration

ACTRN12612001015831 (Date registered: 20/09/2012).

Effect of acute acupuncture treatment on exercise performance and postexercise recovery: a systematic review

BACKGROUND

Preliminary evidence suggests that acupuncture applied proximally during a single bout of exercise can enhance exercise performance and/or expedite postexercise recovery. The purpose of this investigation was to review trials, systematically and critically, that have investigated such hypotheses and delineate areas for future research.

METHOD

A systematic review using computerized databases was performed.

RESULTS

Four trials were found: Three involved within-subjects designs and one used a parallel group design. Few participants were enrolled (n=10-20). Fourteen acupuncture sites were used across the four trials: DU 20, LI 15, LI 13, PC 6, ST 36, SP 6, PC 5, LU 7, LI 4, GB 37, GB 39, GB 34, and LI 11, and LR 3. PC 6, and ST 36 were the most commonly used sites. Three trials evaluated the effect of acupuncture on exercise performance. One of these trials noted that electroacupuncture stimulation of either PC 5 and PC 6 or LU 7 and LI4 significantly increased peak power output, blood pressure, and rate pressure product (RPP) versus control. However, two trials documented no effect of acupuncture on exercise performance using point combinations of either DU 20, LI 15, LI 13, PC 6, ST 36, and SP 6 or DU 20, ST 36, GB 34, LI 11, LR 3. One trial evaluated the effect of acupuncture on postexercise recovery and found that heart rate, oxygen consumption, and blood lactate were significantly reduced secondary to acupuncturing of PC 6 and ST 36 versus control and placebo conditions at 30 or 60 minutes postexercise.

CONCLUSIONS

There is preliminary support for the use of acupuncture as a means to enhance exercise performance and postexercise recovery, but many limitations exist within this body of literature. Adequately powered, RCTs with thorough and standardized reporting of research methods (e.g., acupuncture and exercise interventions) and results are required to determine more adequately the effect of acupuncture methods on exercise performance and postexercise recovery. Future investigations should involve appropriate placebo methods and blinding of both participants and investigators.