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Clinical Study Protocol2024-08-31
Effect of Dry Needling Plus Static Stretching on Plantar Flexors Spasticity in Chronic Stroke Patients
Mahdi Esmaeeli1, Nastaran Ghotbi1,*, Kazem Malmir1, Noureddin Nakhostin Ansari1,2, Pablo Herrero3, Shohreh Jalaei1, Elham Loni4, Sajede Mazidi1J Acupunct Meridian Stud 2024; 17(4): 141-148 https://doi.org/10.51507/j.jams.2024.17.4.141AbstractImportance: Stroke is a leading cause of disability worldwide and is often accompanied by complications such as spasticity. Static stretching (SS) is a common physiotherapy intervention for reducing spasticity, whereas dry needling (DN) is a novel approach. However, the combined effects of DN and SS on spasticity have not been thoroughly investigated. Given the pivotal effect of spasticity on daily activities, mitigating spasticity can significantly contribute to restoring patient independence.Objective: This study will explore the impact of DN plus SS on spasticity, alpha motor neuron excitability, overall function, and quality of life in patients with chronic stroke.Design, Setting, and Population: A double-blind, randomized, sham-controlled trial will be conducted in patients with post-stroke spasticity in the plantar flexor muscles. Twentyeight participants will be randomly assigned to either an intervention or control group. The intervention group will receive DN (60s × 3 days/week; 1 week) plus SS (20 min × 5 days/ week; 1 week). The control group will undergo sham DN (60s × 3 days/week; 1 week) and SS (20 min × 5 days/week; 1 week).Exposures: DN plus SS or sham DN plus SS.Main Outcomes and Measures: Both groups will be assessed at baseline, immediately post-treatment, and after 1 week of follow-up. Outcome measures will include the Modified Modified Ashworth Scale, H-reflex latency, Hmax/Mmax ratio, active and passive ankle dorsiflexion range of motion, timed up and go test, and the EuroQol questionnaire.Results: Results from this randomized, sham-controlled study will provide evidence for the effectiveness of DN in combination with SS for spasticity.Conclusions and Relevance: The additional impact of DN in conjunction with SS, a widely used method for reducing muscle tone, remains unclear and warrants investigation. This study, with a high level of evidence, aims to address this knowledge gap.
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Research Article2024-04-30
Efficacy of Acupuncture on Pain Severity and Frequency of Calf Cramps in Dialysis Patients: a Randomized Clinical Trial
Leila Sadat Mohamadi Jahromi1, Maryam Vejdanpak2, Rezvan Ghaderpanah3, Seyed Hassan Sadrian3, Alireza Dabbaghmanesh4, Sharareh Roshanzamir5,*, Mohammadhossein Dabbaghmanesh6J Acupunct Meridian Stud 2024; 17(2): 47-54 https://doi.org/10.51507/j.jams.2024.17.2.47AbstractBackground: Patients with chronic kidney disease, as a common disorder, usually necessitate the implementation of hemodialysis. Muscle cramps are one of the most disabling complications affecting their quality of life.Objectives: We aimed to investigate the efficacy of acupuncture as a safe alternative to the management of pain severity and frequency of calf cramps in dialysis patients compared to a control group.Methods: Fifty dialysis patients experiencing calf cramps who met the eligibility criteria were randomly allocated to two groups. Group A received routine management, including analgesic consumption, stretching exercises, and nine acupuncture sessions, including acupoints BL57, GV26, CV4, CV6, LV3, KI 1, LU7, LU9, and GB34. Group B underwent sham acupuncture therapy at locations other than the primary acupoints in addition to following the specified routine management. The pain severity was measured using the visual analog scale (VAS), and the daily frequency of calf cramps was evaluated at baseline and one month after treatment completion.Results: VAS scores and the frequency of calf cramps were improved one month after treatment completion in both groups. However, the improvement was significant in group A (p < 0.001), while it was not statistically significant in group B (p > 0.05). There was also a significant difference between both groups regarding reducing pain and the frequency of calf cramps, which showed the efficacy of acupuncture compared to the control group (p < 0.0001).Conclusion: Acupuncture can decrease pain and frequency of calf cramps in dialysis patients.
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Clinical Study Protocol2024-06-30
The Effect of Ankle Muscles Dry Needling on Brain Activity Map Based on fMRI: a Study Protocol for Randomized Controlled Trial
Roshanak Honarpishe1, Soofia Naghdi1,*, Noureddin Nakhostin Ansari1,2, Jan Dommerholt3, Marzieh Hassanabadi4J Acupunct Meridian Stud 2024; 17(3): 94-99 https://doi.org/10.51507/j.jams.2024.17.3.94AbstractImportance: Neuromodulation may be one of the underlying mechanisms of dry needling (DN); however, the mechanism has not yet been fully clarified.Objective: This randomized controlled trial is designed to evaluate DN stimulation of the tibialis anterior and peroneus longus muscles in chronic ankle instability (CAI) and healthy subjects, employing functional magnetic resonance imaging (fMRI).Design: Clinical study protocol, SPIRIT compliant.Setting: Brain Mapping Laboratory.Population: A total of thirty participants aged between 18 and 40 years old will be included in this study. Twenty healthy participants will be randomized into 2 groups (real DN and sham DN). Ten patients with CAI will also be recruited to the third group and receive only real DN for comparison.Exposures: Real and sham DN.Main Outcomes and Measures: The voxel count, coordinates of peak activation, and peak intensity will be obtained as primary outcomes to report brain map activation. Measurements will be taken before, during, and after DN treatment. The strength of the ankle dorsiflexors, active dorsiflexion range of motion, and McGill pain questionnaire short-form will be used as secondary outcome measures.Results: The results from this study will be published in peer-reviewed journals and disseminated as presentations at national and international congresses.Conclusion: This trial will explore brain responses to real and sham DN in healthy participants and to real DN in CAI patients. Overall, our results will provide preliminary evidence of the neural mechanism of DN.
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Perspective Article2024-08-31
A Perspective on the Identity of the Acupoint
Bong Hyo Lee*J Acupunct Meridian Stud 2024; 17(4): 111-115 https://doi.org/10.51507/j.jams.2024.17.4.111AbstractRecently, several previously undiscussed concerns in acupuncture research have been brought to light. Among these, the core issue stems from the ambiguity surrounding the identity of acupoints. Hence, the question “What is the identity of acupoints?” remains of particular importance in acupuncture research. To answer this question, we reviewed the original concept of acupoints explained in Oriental medicine, from which acupuncture treatment originated, and examined scientific research on acupuncture and acupoints. We then proposed a perspective on the identity of acupoints and speculated about a possible reason for their elusive nature: qi, which congregates at and flows in and out of acupoints, might be bioelectricity, making these points inherently difficult to measure anatomically or histologically. Consequently, acupoints are suggested to be spaces where bioelectricity congregates, thus inevitably exhibiting electrical characteristics.
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Research Article2024-04-30
Effectiveness and Safety of Meridian Activation Remedy System for Alleviating Motor Symptoms in Parkinson’s Disease: an Observational Study
InWoo Choi1, Sangsoo Park2, Seung Hyun Lee3, Jeong-Woo Seo4, In-Chan Seol1, Yoon-Sik Kim1, Miso S. Park2,*, Horyong Yoo1,*J Acupunct Meridian Stud 2024; 17(2): 55-68 https://doi.org/10.51507/j.jams.2024.17.2.55AbstractBackground: Parkinson’s disease (PD) lacks disease-modifying drugs or sustainable interventions, creating an unmet treatment need. Investigating complementary and alternative medicines aims to improve PD patients’ quality of life by alleviating symptoms and delaying the course of the disease.Objectives: In this single-center, prospective, observational, single-arm study, we aimed to assess the effectiveness and safety of acupuncture combined with exercise therapy and the Meridian Activation Remedy System (MARS).Methods: From March to October 2021, 13 PD patients with Hoehn and Yahr stages 1 to 3 were recruited. For 8 weeks, MARS intervention was carried out twice a week. T-statistics were used to evaluate functional near-infrared spectroscopy (fNIRS) and GAITRite outcomes. All of the remaining outcome variables were evaluated using the Wilcoxon signed-rank test.Results: The MARS intervention significantly reduced PD patients’ Movement Disorder Society-Sponsored Revision of the Unified Parkinson’s Disease Rating Scale (MDSUPDRS) Part III score (from 20.0 ± 11.8 to 8.8 ± 5.5, p = 0.003), 10-meter walk test speed (from 9.5 ± 1.8 to 8.7 ± 1.3 seconds, p = 0.040), and timed up and go time (from 9.8 ± 1.8 to 8.9 ± 1.4 seconds, p = 0.040). Moreover, the MDS-UPDRS Part II, fNIRS hemodynamics, 360-degree turn test, fall efficacy scale, and Parkinson’s Disease Questionnaire 39 scores improved but not significantly. All participants completed the 8-week intervention without any adverse reactions.Conclusion: An 8-week MARS intervention improved motor symptoms in PD patients. In particular, improvements in UPDRS Part III scores exhibited large clinically important differences. The findings are encouraging, and a randomized controlled trial will be conducted to determine the efficacy and cost-effectiveness of MARS intervention.
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Guideline and recommendation2023-06-30
ACURATE: a Guide for Reporting Sham Controls in Trials Using Acupuncture
Ye-Seul Lee1, Song-Yi Kim2, Hyangsook Lee3, Younbyoung Chae4, Myeong Soo Lee5,*J Acupunct Meridian Stud 2023; 16(3): 119-126 https://doi.org/10.51507/j.jams.2023.16.3.119AbstractThis paper presents the Acupuncture Controls gUideline for Reporting humAn Trials and Experiments (ACURATE) checklist, an extension of The Consolidated Standards for Reporting of Trials (CONSORT), which is to be used with STandards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA) when real and sham acupuncture needles are used in a study. This checklist focuses on a clear depiction of sham needling procedures to enhance replicability and enable a precise appraisal. We encourage researchers to use ACURATE in trials and reviews involving sham acupuncture to assist in the reporting of sham acupuncture procedures and related components.
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Research Article2024-02-29
Warm Acupuncture Reduces Pain and Inflammation in Rats with Lumbar Disc Herniation Induced by Autologous Nucleus Pulposus Transplantation via Regulating p38MAPK/NF-κB Pathway
Feng Pan1,2, Feng Zeng1, Yanbei Chen2, Yongren Zheng3, Zhihong Chen2, Xiaoju Zhu2, Mei Fang Yin2, Yiran Huang4,*, Zheng Liu2,*J Acupunct Meridian Stud 2024; 17(1): 28-37 https://doi.org/10.51507/j.jams.2024.17.1.28AbstractBackground: Warm acupuncture (WA) has analgesic and anti-inflammatory effects. However, the underlying mechanism of these effects remain unclear. Objectives: To explore the analgesic and anti-inflammatory effects of WA and the potential underlying mechanism in male Sprague-Dawley rats with non-compressive lumbar disk herniation (LDH) caused by autologous nucleus pulposus (NP) transplantation. Methods: We used low-frequency (2 Hz) electrical stimulation and WA (40℃) to treat GB30 and BL54 acupoints in rats for 30 mins per day. We monitored the paw withdrawal threshold of rats during the experiment and measured serum cytokine levels using commercial kits. Dorsal root ganglion (DRG) tissue pathology was analyzed via H&E staining. We used qRT-PCR to measure the mRNA expression levels of IL-1β, IL-6, and TNF-α genes in DRG. Western blot was used to analyze the expression levels of IL-1β, IL-6, TNFα, P-p38MAPK, p38MAPK, P-IκBα, IκB α, and NF-κB p65 proteins. Results: WA treatment significantly increased the pain threshold of rats, reduced serum IL-6, PEG2, NO, SP, NP-Y, and MMP-3 levels, and effected histopathological improvements in the DRG in rats. Moreover, WA treatment significantly downregulated the expression levels of inflammation-associated genes (Il-1β, Il-6, and Tnf-α) and proteins (IL-1β, IL-6, TNF-α, P-p38MAPK, P-IκBα, and NF-κB p65) in the DRG of non-compressive LDH rats. Conclusion: WA can alleviate pain and inhibit inflammatory response in rats with non-compressive LDH caused by autologous NP transplantation, and these effects are likely associated with the inhibition of the p38MAPK/NF-κB pathway.
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Research Article2024-04-30
Effects of Frequency-Controlled Ear Acupuncture on COVID-19- related Refractory Olfactory Dysfunction: a Randomized Clinical Trial
Alireza Mohebbi1,*, Seyed Hamidreza Bagheri1, Eiman Raziabadi1, Ashkan Shafiei1, Maryam Roomiani1, Maryam Arab1, Ladan Dehdari2J Acupunct Meridian Stud 2024; 17(2): 69-75 https://doi.org/10.51507/j.jams.2024.17.2.69AbstractBackground: Olfactory dysfunction is a common COVID-19 symptom, posing treatment challenges.Objectives: We aimed to investigate the efficacy of frequency-controlled ear acupuncture in treating COVID-19-related olfactory dysfunction.Methods: A randomized, participant-blind clinical trial occurred at the Rasoul Akram Hospital (IRCT20210311050671N1). Forty patients were recruited, and 20 patients were randomly assigned to either the experimental or control group. The primary outcome was the improvement in patients’ quality of smell. The olfactory dysfunction was confirmed using the Smell Identification Test. The intervention group received two sessions of acupuncture treatment according to auricular frequency treatment, with a one-week interval, while the control group received an equal number of switched-off laser sessions. Both groups were instructed to use nasal betamethasone drops. The patients were asked to rank their ability to smell before and after each intervention on a 10-point visual analog scale. Secondary outcomes were related side effects.Results: Covariance analysis revealed a significant difference in adjusted scores between the groups (F [37, 1] = 37.463; p = 0.000, Eta2 = 0.503). The smell quality improved from 2.80 ± 1.76 to 5.22 ± 3.40 after treatment in the intervention group (p = 0.007), while the control group showed no significant change (p = 0.184). Three patients reported short and transient side effects, such as nausea, headache, and dizziness, in the first hours after the intervention.Conclusion: Frequency-controlled ear acupuncture is an effective option for treating COVID-19-related olfactory dysfunction. The study highlights the potential of alternative therapies in the treatment of this condition, and further research is warranted to investigate its long-term effects.
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Editorial2024-04-30
Exploring Novel Meridian-Based Therapeutic Approaches in Parkinson’s Disease
Chan-Young Kwon*J Acupunct Meridian Stud 2024; 17(2): 45-46 https://doi.org/10.51507/j.jams.2024.17.2.45 -
Review Article2024-08-31
Application Development of Baihui (GV20) Moxibustion in Ancient China: a Data Analysis Study Based on Ancient Books
Ma Yueying1,2, Chen Liming1,2,*, Qu Changcheng1, Ji Jun2,3J Acupunct Meridian Stud 2024; 17(4): 123-132 https://doi.org/10.51507/j.jams.2024.17.4.123AbstractImportance: We compile and analyze ancient literature related to Baihui (GV20) moxibustion and summarize the development of its ancient clinical application.Observations: The Chinese Medical Classic (5th edition) was used as the search source to screen and organize articles related to Baihui moxibustion to establish a database. We created indexing norms according to study characteristics and indexed books, dynasties, literary styles, disease key words, matching acupoints, combinations, moxibustion amounts, and moxa cone sizes. SPSS version 24.0 software was used to calculate the index results. A total of 320 articles that met the requirements were finally included and were attributed to 99 ancient books, spanning from the Western Han Dynasty to the Qing Dynasty. A total of 45 keywords were used for disease evidence: the most frequent occurrences were internal medicine (primary category), limb meridians (secondary category), and head diseases (specific patterns).Conclusions and Relevance: Baihui moxibustion has been updated and developed in the literature over the ages, and the method of Baihui moxibustion is diverse. The main treatment rule of Baihui moxibustion considers the whole body and close treatment of partial diseases. Baihui moxibustion also has the rule of following meridian indications, with treatment based on syndrome differentiation and compatible application. Baihui moxibustion alone has a relatively strong effect of raising yang and lifting the sunken, which can treat the sinking of qi and deficiency.
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Perspective Article2022-12-31
Sham Acupuncture Is Not Just a Placebo
Tae-Hun Kim1,*, Myeong Soo Lee2, Hyangsook Lee3J Acupunct Meridian Stud 2022; 15(6): 333-335 https://doi.org/10.51507/j.jams.2022.15.6.333AbstractSham acupuncture should have two distinct features: first, it must be morphologically similar to verum acupuncture for blinding purposes, and second, it must not exert physiologically expected effects of verum acupuncture. While several types of sham acupuncture are currently used, there are on-going debates on which sham acupuncture can meet the criteria for being an appropriate control intervention in acupuncture research. In view of this situation, it is unreasonable to regard the use of sham acupuncture in acupuncture research as the same as the use of placebo drugs in drug research. Given the current research evidence that sham acupuncture can exert not only the originally expected non-specific effects but also sham acupuncture-specific effects, it would be misleading to simply regard sham acupuncture as the same as placebo. Therefore, researchers should be cautious when using the term sham acupuncture in clinical investigations.
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Review Article2023-10-31
Anatomical and Clinical Characteristics of Scalp Acupuncture Systems: a Scoping Review and Synthesis
Svetlana Wise1,*, Ava Lorenc2J Acupunct Meridian Stud 2023; 16(5): 159-175 https://doi.org/10.51507/j.jams.2023.16.5.159AbstractScalp acupuncture is a therapeutic procedure that involves inserting needles into the scalp to treat various medical conditions, including pain and neurological and psychological disorders. The inter-system variability of scalp acupuncture limits secondary analysis and evidence synthesis, delaying its inclusion into evidence-based healthcare policies and establishment as a treatment intervention recognized by Western medicine. This scoping review aimed to identify the range of scalp acupuncture systems, systematically collect and summarize information on their general, anatomical, and clinical characteristics, and build a framework for understanding scalp acupuncture systems. This review included all English-language publications on scalp acupuncture applied to treat any health condition in humans. Extensive searches were conducted across bibliographic databases, journals, trial registries, and supplementary sources. The detailed general, anatomical, and clinical application characteristics of 19 scalp acupuncture systems were extracted. Data were collected and analyzed using charting and image manipulation software. Framework synthesis was performed using the Standard International Acupuncture Nomenclature Scalp Acupuncture as an a priori framework. The review revealed that the heterogeneity related to scalp acupuncture methods can be attributed to the high variability among the theoretical bases of different systems, intersystem mismatch in anatomical locations of treatment points and areas on the scalp, and inconsistencies in the methods used for locating them. These discrepancies in anatomical and clinical features have limited the synthesis and development of a framework for scalp acupuncture. Discussion and agreement on the anatomical locations of scalp stimulation areas, identification of methods for precise positioning of acupuncture areas on the scalp, and further exploration of theoretical bases will aid in the standardization of scalp acupuncture and improve the quality of research in this area.
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Research Article2023-08-31
Effect of Acupressure on Pain during Inferior Alveolar Nerve Block Injection in Children Aged 5-10 Years Old - An Experimental Study
Ayushi Shashikant Gurharikar, Devendra Nagpal*, Prabhat Singh Yadav, Purva Chaudhari, Kavita Hotwani, Gagandeep LambaJ Acupunct Meridian Stud 2023; 16(4): 127-132 https://doi.org/10.51507/j.jams.2023.16.4.127AbstractBackground: Acupressure, which is related to acupuncture, is a noninvasive therapy suitable for use in children. However, data examining acupressure’s effects on the pain of local anesthetic injection in children are sparse.Objectives: The purpose of this study was to evaluate acupressure’s effects on the pain of local anesthetic injection in children.Methods: This randomized, double-blind, parallel-group clinical study included 37 5- to 10-year-olds who had an inferior alveolar nerve block (IANB) for a mandibular extraction and were randomized to one of two groups: acupressure (study group) or non-acupressure (control group). The Wong-Baker FACES Pain Rating Scale (WBFPS) and the Sound, Eye, Motor (SEM) scale were utilized for subjective and objective pain assessment during injection.Results: The objective and subjective assessment of pain during injection significantly differed between the groups, with the acupressure group displaying lower scores.Conclusion: Acupressure at the extra one point (EX-HN1) reduced pain during IANB injection in 5- to 10-year-olds and can be used as an adjunct to conventional measures like topical anesthesia to reduce pain.
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Review Article2023-02-28
Acupuncture for Management of Endodontic Emergencies: a Review
Gaurav Kumar1,†, Sanjay Tewari2,*,†J Acupunct Meridian Stud 2023; 16(1): 1-10 https://doi.org/10.51507/j.jams.2023.16.1.1AbstractRoot canal treatment (RCT) employed for painful endodontic conditions like apical periodontitis and irreversible pulpitis is associated with a high incidence of postoperative pain. Pharmacological management for this purpose is effective, but not entirely free from side effects and in some cases may fail to provide adequate relief. Furthermore, concerns have been raised regarding the transmission of coronavirus disease-2019 (COVID-19) as a result of the aerosols generated and prolonged chair side time required for RCT. Acupuncture is a traditional Chinese therapy commonly employed as an alternative for the treatment of pain. And what’s more, the use of acupuncture has been recently reported as treatment for the management of endodontic pain as well as on the anesthetic success in patients with irreversible pulpitis. This review aims to evaluate the current evidence for acupuncture in endodontics and its potential role in emergency pain relief and management for patients. To combat this, a thorough search for literature within the field was performed in five electronic databases. Retrieved studies were screened according to the pre-defined eligibility criteria. After both an electronic and manual search, five studies were selected for review. These studies reported the beneficial effects of acupuncture in reducing the failure of nerve block in patients with irreversible pulpitis and in controlling both intraoperative and postoperative pain following RCT. In addition, it was also reported to reduce anxiety surrounding the dental procedure and minimized the intake of analgesics after the endodontic procedure, which can result in some unwanted side effects. However, more in depth clinical research is required before any recommendation regarding the application of acupuncture in endodontic patients can be made.
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Clinical Study Protocol2023-10-31
Dry Needling for Arthrogenic Muscle Inhibition of Quadriceps Femoris in Patients after Reconstruction of Anterior Cruciate Ligament: a Protocol for a Randomized Controlled Trial
Milad Zarrin1,2, Noureddin Nakhostin Ansari1,3,*, Soofia Naghdi1, Scott Hasson4, Bijan Forogh5, Mehdi Rezaee6J Acupunct Meridian Stud 2023; 16(5): 193-202 https://doi.org/10.51507/j.jams.2023.16.5.193AbstractBackground: Dry needling (DN) is recommended as a therapeutic modality for various neuromusculoskeletal disorders. No study has been performed on the impact of DN on arthrogenic muscle inhibition (AMI) after anterior cruciate ligament reconstruction (ACLR). This study protocol is aimed to investigate the impacts of DN on AMI of quadriceps femoris, corticomotor, and spinal reflex excitability in patients with ACLR. Methods: A double-blind, between-subject, randomized, controlled trial will be conducted to measure changes in AMI after DN. Twenty-four subjects with ACLR will be recruited to receive a DN or a sham DN, providing that they met the inclusion criteria. Three sessions of DN on the quadriceps femoris will be applied during a one-week period. The primary outcome measures are the active motor threshold, motor evoked potential, and Hmax – Mmax ratio. The secondary outcomes are the International Knee Documentation Committee subjective knee form questionnaire score and maximum quadriceps isometric torque. Data will be collected at baseline, immediately after the first session, after the third session, and at the one-month follow-up visit. Discussion: The results of this study will provide preliminary evidence regarding the effects of DN on AMI of quadriceps femoris in patients with ACLR.
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Clinical Study Protocol2023-04-30
Effectiveness of Pharmacopuncture Therapy in Adhesive Capsulitis: a Study Protocol for a Pragmatic Randomized Controlled Trial
Hui Yan Zhao1,2,†, Chang-Hyun Han1,2,†, Changsop Yang2, Yoon Jae Lee3, In-Hyuk Ha3, Kyoung Sun Park4,*J Acupunct Meridian Stud 2023; 16(2): 70-78 https://doi.org/10.51507/j.jams.2023.16.2.70AbstractBackground: Adhesive capsulitis is a progressive, idiopathic disorder that significantly impacts individuals̓ daily lives and increases their medical burden. Pharmacopuncture therapy, which combines acupuncture techniques with herbal medicine, involves injecting herbal extracts into specific acupoints. This study aims to determine the effectiveness and safety of pharmacopuncture therapy in comparison to physiotherapy (PT) for treating adhesive capsulitis.Methods: This research protocol outlines a two-arm, parallel, multi-center, pragmatic randomized controlled trial. Fifty participants will be randomly allocated to either the pharmacopuncture therapy or PT group, and they will receive 12 sessions of their respective therapies over a 6-week period. The primary outcome measure is the numeric rating scale for shoulder pain. Secondary outcomes include the visual analog scale score for shoulder pain, Shoulder Pain and Disability Index, Patients̓ Global Impression of Change score, Short Form-12 Health Survey Version 2 score, and EuroQol-5 Dimension. Statistical analysis will be conducted based on the intention-to-treat principle.Discussion: This trial may offer high-quality and reliable clinical evidence for evaluating the effectiveness and safety of pharmacopuncture therapy compared to PT in the treatment of adhesive capsulitis. Furthermore, this study will serve as a valuable guideline for practitioners when making clinical decisions and managing adhesive capsulitis.
