The immediate effects of local and adjacent acupuncture on the tibialis anterior muscle: a human study

Evaluating Dielectric Properties for Assessing Water Content at Acupuncture Points: New Methodology

Importance

Understanding acupuncture point microenvironments is vital for optimizing treatment efficacy. Evaluating changes in water content at these points can provide further insights into the effects of acupuncture on tissues.

Objective

This study aimed to measure tissue dielectric constant (TDC) and assess changes in water content, specifically at stomach 36 (ST36, Zusanli) and spleen 6 (SP6, Sanyinjiao) acupuncture points.

Methods

In a controlled, blinded, randomized trial, 113 healthy volunteers were divided into six groups based on TDC sensor diameters (XS, M, and L): three control groups and three acupuncture groups. They were assessed at three time points: T1, baseline; T2, 20 min post-needle withdrawal; and T3, 40 min post-needle withdrawal. Electrical impedance (EI) was also analyzed. Significance level was set at p < 0.001.

Results

TDC at ST36 and SP6 significantly decreased with the XS probe at T2 and T3 compared with that at T1 (F8, 452: 54.61). TDC did not significantly vary between T2 and T3 with M and L probes. EI data indicated that the current passage increased in the SP (F2, 226: 39.32) and ST (F2, 226: 37.32) groups during T2 and T3 compared with that during T1 within their respective groups and controls.

Conclusions

and Relevance: This study demonstrated the efficacy of TDC measurements in detecting water content fluctuations at acupuncture points and their responses to needles. TDC measurements, which were validated against EI, provide valuable insights into acupuncture point microenvironments and thus help optimize treatments.

Effect of Acupuncture on Timeliness of Male Shoulder Joint Endurance

Acupuncture as a traditional and commonly used treatment has been used to improve the performance of athletes. In the improvement of female shoulder joint explosive force and muscle endurance also has an immediate effect. However, whether the effect of acupuncture therapy can be maintained after improving athletic performance still worth further discussion. The purpose of this study was to explore the timeless of the physical neurophysiological response induced by acupuncture at specific acupoints in improving endurance performance. Seventeen healthy male participants completed six groups of shoulder joint isokinetic exercises. The isokinetic exercise completed in the first group was taken as the baseline. After acupuncture for 15 min, the following 5 isokinetic experiments were completed. Acupuncture acupoints included Binao (LI14), Jianliao (SJ14), Naohui (SJ13), Zhongfu (LU1), Xiabai (LU4), Tianfu (LU3) and Xiaoluo (SJ12). The results show that acupuncture can improve physical performance for 10–20 min. After acupuncture, the maximum torque, average power, average work and total work values significantly increased (p < 0.05). Stimulation of acupoints can effectively improve the performance of periarticular muscle endurance around the shoulder, but this improvement is limited by time.

Electroacupuncture and Manual Acupuncture Increase Joint Flexibility but Reduce Muscle Strength

The objective of this study was to investigate the immediate effects of electroacupuncture and manual acupuncture on hip flexion range of motion (ROM), knee joint (flexion replication at 15° and 45°) and quadriceps (strength and activation) function. Forty-five neurologically healthy adults participated in this randomized controlled laboratory study. Straight leg raise test, modified Thomas test, and hip abductors strength test were performed to determine acupoints. Afterwards, one of three 15-min treatments (control—no treatment, electroacupuncture, or manual acupuncture) was randomly applied using determined acupoints. Measurements (hip flexion ROM, and knee joint and quadriceps function) were recorded at baseline, and at 0, 20, and 40 min post treatment. Both electroacupuncture (4.0°, ES = 0.41) and manual acupuncture (5.4°, ES = 0.95) treatment immediately increased hip flexion ROM, and the increased values persisted for 40-min (p = 0.01). Knee flexion replication (at 15°: p = 0.17; 45°: p = 0.19) and quadriceps activation (p = 0.71) did not change at any of the time points. Post-treatment, both electroacupuncture and manual acupuncture decreased quadriceps strength at 0-min (electroacupuncture: 9.2%, p < 0.0001, ES = 0.60) and 40-min (electroacupuncture: 7.3%, p = 0.005, ES = 0.55; manual acupuncture: 8.7%, p = 0.01, ES = 0.54). A single session of either electroacupuncture or manual acupuncture treatment (selected acupoints based on physical examination) may immediately improve joint flexibility but reduce muscle strength.

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.

Ipsilateral proprioceptive neuromuscular facilitation patterns improve overflow and reduce foot drop in patients with demyelinating polyneuropathy

The purpose of this study was to evaluate the response of the tibialis anterior muscle (TAm) using surface electromyography in patients with Charcot-Marie-Tooth disease (CMT-IA), after ipsilateral proprioceptive neuromuscular patterns (PNF). Thirteen CMT-IA patients (both sexes) were treated twice a week, for 5 weeks, with bilateral PNF pattern, four times per treatment. During the execution of the patterns, we recorded the bilateral activation of the TAm in root mean square (RMS). We used the Student paired t-test for the first and last treatments, P-value set at <0.05. Clinical significance (CS) was obtained by subtracting the values of the first treatment from the last. Chopping pattern to the right side increased RMS for the right (t=−3.52, CS=52%), but not the left TAm (t= −3.35). Flexion-abduction with external rotation pattern to the right (t= −2.46, CS=55%) and left (t=−2.07, CS=53%) significantly increased RMS for TAm on both sides. Extension-adduction with internal rotation pattern to the right (t=−0.25) and left (t=−1.84) did not produce any changes in TAm. Ipsilateral PNF patterns selectively produce TAm overflow in peripheral polyneuropathy patients and can be successfully used as supportive therapy for foot drop.

The Effect of Auricular and Systemic Acupuncture on the Electromyographic Activity of the Trapezius Muscle with Trigger Points-A Pilot Study

The purpose of this study was to analyze and compare intra and intergroup the immediate effect of the auricular and LR8 systemic acupuncture on the electromyographic activity of the trapezius with the trigger points. This is an experimental clinical trial; 40 people were split in 4 distinct groups (n = 10): GI mustard seed application in the auricular acupoint; GII bilateral needle application in the LR8 acupoint; GIII combination of the techniques; GIV/Control Group mustard seed application in an acupoint not linked to the muscle tension. The EMG was used to assess the muscle contraction for 5 seconds during the resting time and during the isometric contraction time. The EMG signal was first collect without the acupuncture intervention; then both techniques were applied for 5 minutes; and the EMG was collected again right after these applications. The Shapiro-Wilk test was used, the t test was paired with the Wilcoxon test to the intragroup comparison; One-way analysis of variance test for intergroup comparison. There was no statistical difference in the intragroup comparison for the groups. The same happened to the intergroup comparison before and after application. Systemic and auricular acupuncture did not promote immediate changes in the EMG activity of the trapezius muscle in individuals with MTrPs.

Unilateral and Immediate Stimulation of Acupuncture Points Xiaohai (SI8) and Jianwaishu (SI14) of the Small Intestine Meridian Increases Electromyographic Activity and Strength in the Ipsilateral and Contralateral Upper Trapezius Muscle

We previously showed that a yin meridian of the upper limb decreased electromyographic activity (root mean square) and muscle strength ipsilateral and contralateral to the side of stimulation. Here, we tested the upper trapezius (UT) muscle response after stimulation of a yang meridian of the upper limb, the small intestine (SI). Thirty-eight healthy volunteers were randomized into the following groups: UT muscle (SI14), distant of the UT muscle (SI8), without stimulation (CG), and sham (R3). An acupuncturist certificated by the Brazilian Society of Physical Therapists and Acupuncturists performed the needle insertion. Each volunteer received only one stimulation to the right upper limb. The evaluation occurred before, 5 minutes after, and 20 minutes after needle withdrawal. The root mean square activity increased on the right side in the UT muscle for the SI8 and SI14 groups (F_3,37 = 4.67; p < 0.025) at the 20-minute evaluation. The most vigorous response occurred on the contralateral side because the effects were maintained for 5 minutes after withdrawal (F_3,37 = 4.52; p < 0.025). Both groups showed an increase in the UT muscle strength at the 20-minute evaluation (F_3,37 = 3.41; p < 0.025). The CG and R3 groups did not show any changes. Our data indicate that SI a yang meridian increases the UT muscle response.

The Intervention Effects of Acupuncture on Fatigue Induced by Exhaustive Physical Exercises: A Metabolomics Investigation

In this study, the antifatigue effects of acupuncture had been investigated at the metabolic level on the young male athletes with exhaustive physical exercises. After a series of exhaustive physical exercises and a short-term rest, the athletes either were treated with needling acupuncture on selected acupoints (TA group) or enjoyed an extended rest (TR group). NMR-based metabolomics analysis was then applied to depict the metabolic profiles of urine samples, which were collected from the athletes at three time points including the time before exercises, the time before and after the treatment of acupuncture, or taking the extended rest. The results from multivariate statistical analysis indicated that the recoveries of disturbed metabolites in the athletes treated with acupuncture were significantly faster than in those only taking rest. After the treatment with acupuncture, the levels of distinguished metabolites, 2-hydroxybutyrate, 3-hydroxyisovalerate, lactate, pyruvate, citrate, dimethylglycine, choline, glycine, hippurate, and hypoxanthine were recovered at an accelerated speed in the TA group in comparison with the TR group. The above-mentioned results indicated that the acupuncture treatment ameliorated fatigue by backregulating the perturbed energy metabolism, choline metabolism, and attenuating the ROS-induced stress at an accelerated speed, which demonstrated that acupuncture could serve as an alternative fatigue-relieving approach.

Electromyographic and strength analyses of activation patterns of the wrist flexor muscles after acupuncture

This study analyzed the electromyographic and strength responses of the flexor muscles of the wrist following stimulation of acupuncture points. A total of 52 participants were randomly divided into four groups: local (heart 3, HT3), distant (heart 4, HT4), control (bladder 60, BL60), and naïve control groups. To obtain the root mean square electromyographic activity, we placed surface electrodes over the wrist flexors. To obtain kilogram force (kgf) values, we attached a force transducer to the floor and to the hands of participants. Both values were recorded over three repetitions of maximal isometric wrist flexion contractions. Data were analyzed using one-way analyses of variance, followed by Dunnett's post-hoc tests. We found reductions in electromyographic activity contralateral to the stimulated point in the distant group 10 minutes after removal of the needles (F(3,48) = 3.25; p < 0.05). Regarding muscle strength, ipsilateral and contralateral stimulation in the distant group produced kgf levels prior to and 10 minute and 20 minutes after withdrawal of the acupuncture needle that were lower than that obtained prior to insertion of the needle (F(3,48) = 5.82; p < 0.05). Thus, stimulation of the acupuncture points distant from the wrist flexors reduced ipsilateral and contralateral muscle strength and decreased the root mean square values contralateral to the site of stimulation.

Effect of acupuncture at tender points for the management of fibromyalgia syndrome: a case series

BACKGROUND

Affecting more women than men, fibromyalgia syndrome (FMS) is a rheumatic disorder characterized by chronic, diffuse and widespread musculoskeletal pain, and its pathogenesis is still unknown. Among the recommended treatments, acupuncture (for its analgesic effects) is an effective option for reducing the pain sensitivity and improving quality of life. Therefore, this study aimed to investigate whether acupuncture at tender points could effectively manage FMS.

METHODS

Eight female patients, with a previous diagnosis of fibromyalgia, underwent an initial assessment involving pressure algometer measurements for pain tolerance and questionnaires [Fibromyalgia Impact Questionnaire (FIQ), Heath Assessment Questionnaire (HAQ), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI)], followed by treatment. Over a 2-month period, acupuncture was performed once per week at five tender points, located bilaterally at the occipital bone, trapezius, rhomboid, upper chest and lateral epicondyle. At the end of treatment, the participants underwent a reassessment for a final review of the applied methods.

RESULTS

We observed a reduction in the pain threshold and sensitivity and improvement in the areas of anxiety and depression and quality of life, which were demonstrated using the FIQ, BDI and BAI but not the HAQ.

CONCLUSION

The results demonstrated the effectiveness of tender-point acupuncture treatment on the patients' overall well-being, not only by improving quality of life, but also by reducing the pain sensitivity of FMS.

Evaluation of the immediate effects of manual acupuncture on brachial bicep muscle function in healthy individuals and post stroke patients: a study protocol of a parallel-group randomized clinical trial

BACKGROUND

Stroke is a morbid entity in Chinese medicine recognized for over 2 000 years with sensory-motor impairments reported by several classical authors. However, the majority of controlled clinical trials of acupuncture in the treatment of post stroke recovery failed to obtain significant long-term results on functional recovery. Moreover, contradictory results have been obtained regarding the immediate effects of acupuncture stimulation on the electrical activity of human skeletal muscles as observed using surface electromyography. These results raise the question of whether acupuncture has any effect on the neuromuscular level. This study aims to evaluate the immediate effects of manual acupoint stimulation on the electrical activity and strength of the biceps brachii of healthy individuals and patients with chronic hypertonic hemiparesis.

METHODS AND DESIGN

The study proposes a single-blinded randomized clinical trial with four parallel groups. Healthy subjects and post stroke patients with chronic spastic hemiparesis will be submitted to a single acupuncture intervention puncturing either Quchi (LI11) or Tianquan (PC2). The immediate effects on muscle function will be assessed by surface electromyography and isometric force of the biceps brachii muscle as the primary outcome. Secondary outcomes comprise the frequency of patterns in each group, as well as the frequency distribution of manifestations.

DISCUSSION

The proposed study design includes some improvements on common methodological issues on clinical trials with an integrative design. This study design is expected to provide new insights on the neuromuscular effects of acupuncture stimulation in healthy subjects and post stroke patients.

TRIAL REGISTRATION

Brazilian Clinical Trials Registry (www.ensaiosclinicos.gov.br) in English and Portuguese in October 2011.

REGISTRATION NUMBER

RBR-5g7xqh.

Immediate effects of acupuncture on biceps brachii muscle function in healthy and post-stroke subjects

Background

The effects of acupuncture on muscle function in healthy subjects are contradictory and cannot be extrapolated to post-stroke patients. This study evaluated the immediate effects of manual acupuncture on myoelectric activity and isometric force in healthy and post-stroke patients.

Methods

A randomized clinical trial, with parallel groups, single-blinded study design, was conducted with 32 healthy subjects and 15 post-stroke patients with chronic hemiparesis. Surface electromyography from biceps brachii during maximal isometric voluntary tests was performed before and after 20-min intermittent, and manual stimulation of acupoints Quchi (LI11) or Tianquan (PC2). Pattern differentiation was performed by an automated method based on logistic regression equations.

Results

Healthy subjects showed a decrease in the root mean-squared (RMS) values after the stimulation of LI11 (pre: 1.392 ± 0.826 V; post: 0.612 ± 0.0.320 V; P = 0.002) and PC2 (pre: 1.494 ± 0.826 V; post: 0.623 ± 0.320 V; P = 0.001). Elbow flexion maximal isometric voluntary contraction (MIVC) was not significantly different after acupuncture stimulation of LI11 (pre: 22.2 ± 10.7 kg; post: 21.7 ± 9.5 kg; P = 0.288) or PC2 (pre: 18.8 ± 4.6 kg; post: 18.7 ± 6.0 kg; P = 0.468). Post-stroke patients did not exhibit any significant decrease in the RMS values after the stimulation of LI11 (pre: 0.627 ± 0.335 V; post: 0.530 ± 0.272 V; P = 0.187) and PC2 (pre: 0.601 ± 0.258 V; post: 0.591 ± 0.326 V; P = 0.398). Also, no significant decrease in the MIVC value was observed after the stimulation of LI11 (pre: 9.6 ± 3.9 kg; post: 9.6 ± 4.7 kg; P = 0.499) or PC2 (pre: 10.7 ± 5.6 kg; post: 10.2 ± 5.3 kg; P = 0.251). Different frequency of patterns was observed among healthy subjects and post-stroke patients groups (χ² = 9.759; P = 0.021).

Conclusion

Manual acupuncture provides sufficient neuromuscular stimuli to promote immediate changes in motor unit gross recruitment without repercussion in maximal force output in healthy subjects. Post-stroke patients did not exhibit significant reduction on the myoelectric activity and maximal force output after manual acupuncture and needs further evaluation with a larger sample.

Trial registration

Brazilian Clinical Trials Registry RBR-5g7xqh.

Applied kinesiology methods for a 10-year-old child with headaches, neck pain, asthma, and reading disabilities

OBJECTIVE

The purpose of this case report is to describe the chiropractic care of a 10-year-old boy who presented with developmental delay syndromes, asthma, and chronic neck and head pain and to present an overview of his muscular imbalances during manual muscle testing evaluation that guided the interventions offered to this child.

CLINICAL FEATURES

The child was a poor reader, suffered eye strain while reading, had poor memory for classroom material, and was unable to move easily from one line of text to another during reading. He was using 4 medications for the asthma but was still symptomatic during exercise.

INTERVENTION AND OUTCOME

Chiropractic care, using applied kinesiology, guided evaluation, and treatment. Following spinal and cranial treatment, the patient showed improvement in his reading ability, head and neck pain, and respiratory distress. His ability to read improved (in 3 weeks, after 5 treatments), performing at his own grade level. He has remained symptom free for 2 years.

CONCLUSION

The care provided to this patient seemed to help resolve his chronic musculoskeletal dysfunction and pain and improve his academic performance.

Investigation of electroacupuncture and manual acupuncture on carnitine and glutathione in muscle

Electroacupuncture (EA) and manual acupuncture (MA) have therapeutic effects on muscle fatigue in muscle disease. The deficiencies of carnitine and glutathione induce muscle fatigue. This report investigated the effects of EA and MA on carnitine and glutathione in muscle. After the mice of EA group were fixed in the animal cage, right Zusanli (ST36) and Jiexi (ST41) were acupunctured and stimulated with uniform reinforcing and reducing method by twirling the acupuncture needle for 15 min. And then, the needle handles were connected to an electric stimulator for stimulating the acupoint with dense-sparse waves. After the mice of MA group were fixed in an animal cage, right ST36 and ST41 were acupunctured and allowed for 15 min. The mice of normal control group were not acupunctured and stimulated for 15 min. The mice of all groups were killed for collecting muscle tissue 1 h after the final treatment. Carnitine and glutathione in homogenate of muscle tissue were determined with carnitine (Kainos Laboratories Co., Tokyo, Japan) and glutathione assay kit (Dojin Chemicals Co., Kumamoto, Japan). Carnitine level in muscle tissue of MA group was significantly higher than those of EA group and normal control group. Carnitine level in muscle tissue of EA group was not significantly different from that of normal control group. Glutathione levels in muscle tissue of EA group and MA group were significantly higher than that of normal control group. This report presented that carnitine in muscle is increased by MA, and not increased by EA, and that glutathione in muscle is increased by EA and MA.

Evaluation of Applied Kinesiology meridian techniques by means of surface electromyography (sEMG): demonstration of the regulatory influence of antique acupuncture points

Background

The use of Applied Kinesiology techniques based on manual muscle tests relies on the relationship between muscles and acupuncture meridians. Applied Kinesiology detects body dysfunctions based on changes in muscle tone. Muscle tonification or inhibition within the test setting can be achieved with selected acupoints. These acupoints belong to either the same meridian or related meridians. The aim of this study is to analyze muscle sedation and tonification by means of surface electromyography.

Methods

Manual muscle tests were carried out using standard Applied Kinesiology (AK) techniques. The investigation included basic AK procedures such as sedation and tonification with specific acupoints. The sedation and tonification acupoints were selected from related meridians according to the Five Elements. The tonification effect of these acupoints was also tested while interfering effects were induced by manual stimulation of scars. The effects of selective neural therapy, i.e. individually tested and selected anesthetic agent, for the treatment of scars were also studied. The characteristics of muscle action were documented by surface electromyographys (sEMG).

Results

The sEMG data showed a diminution of signal intensity when sedation was used. Graded sedation resulted in a graded diminution of signal amplitude. Graded increase in signal amplitude was observed when antique acupuncture points were used for tonification. The tactile stretch stimulus of scars localized in meridian-independent places produced diminution of signal intensity on a reference muscle, similar to sedation. These changes, however, were not corrected by tonification acupoints. Correction of these interferences was achieved by lesion specific neural therapy with local anesthetics.

Conclusion

We demonstrated the central working principles, i.e. sedation and tonification, of Applied Kinesiology through the use of specific acupoints that have an influence on manual muscle tests. Sedation decreases RMS signal in sEMG, whereas tonification increases it. Interfering stimuli from scars were corrected by selective neural therapy.