Review Article2023-12-31

Acupuncture in Sports Medicine

George G.A. Pujalte^1,2,*, Michael Malone³, Akhil Mandavalli¹, Davong David Phrathep⁴, Neil P. Shah⁵, Adam I. Perlman⁶

J Acupunct Meridian Stud 2023; 16(6): 239-247 https://doi.org/10.51507/j.jams.2023.16.6.239

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Acupuncture is gaining popularity and wider acceptance as a treatment modality within the field of sports medicine. Our objective was to provide a comprehensive review of the existing literature pertaining to acupuncture in sports medicine to shed light on approaches utilized in acupuncture while revealing its personalized nature and its impact on athletes’ preparation, performance, and recovery. We evaluated acupuncture research in the context of medicine and sports-related injury treatment, assessing its impact on athletic performance across demographics of athletes. Athletes participating in most sports have shown positive outcomes from acupuncture interventions. Acupuncture improves peak oxygen levels, maximum heart rate, delayed-onset muscle soreness, pain, swelling, explosive force production, and joint mobility. Furthermore, the efficacy of acupuncture appears to be similar regardless of age and sex. Lastly, the acceptance of acupuncture is influenced by cultural factors, with Western and traditional East Asian cultures exhibiting distinct perspectives on its rationale and mechanisms of action. Traditional East Asian acupuncturists typically employ qi and meridian theories in their acupuncture practices, with the recent incorporation of Western concepts. Acupuncture shows promise as an effective treatment for musculoskeletal pain and neuropathies in athletes across different age groups and for addressing injuries in various sports. Our comprehensive review will enhance our understanding of acupuncture’s potential as a complementary or distinct therapeutic approach compared to conventional therapies. Additionally, our review explores its specific applications within different sports and delves into the cultural dimensions involved in integrating this practice into modern sports medicine.

Review Article2022-10-31

Acupuncture for Osteoporosis: a Review of Its Clinical and Preclinical Studies

Yimiao Tian^1,†, Lili Wang^2,†, Tianshu Xu¹, Rui Li¹, Ruyuan Zhu¹, Beibei Chen¹, Hao Zhang¹, Bingke Xia¹, Yiwen Che³, Dandan Zhao^1,*, Dongwei Zhang^1,*

J Acupunct Meridian Stud 2022; 15(5): 281-299 https://doi.org/10.51507/j.jams.2022.15.5.281

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Acupuncture has gained growing attention in the management of osteoporosis (OP). However, a comprehensive review has not yet been conducted on the efficacy and challenges of acupuncture in preliminary research and clinical trials. Therefore, an extensive literature search was conducted using electronic databases, including PubMed (www.ncbi.nlm.nih.gov/pubmed), CNKI (www.cnki.net), and Web of Science, for studies published from the beginning of 2000 to the end of May 2022. Combinations of synonyms for OP, acupuncture, traditional Chinese medicine, clinical trial, preclinical study, and animal experiments were searched. A total of 290 papers were consulted, including 115 reviews, 109 clinical observations, and 66 preclinical studies. There is accumulating evidence to support the beneficial role of acupuncture in preserving bone quality and relieving clinical symptoms based on clinical and preclinical investigations. The top ten most commonly used acupoints are BL23, ST36, BL20, BL11, CV4, GV4, SP 6, KI3, BL18, and GB39. The underlying mechanisms behind the benefits of acupuncture may be linked with the regulation of the hypothalamic-pituitary-gonadal (adrenal) axis and activation of the Wnt/β-catenin and OPG/RANKL/RANK signaling pathways. In summary, strong evidence may still come from prospective and well-designed clinical trials to shed light on the potential role of acupuncture in preserving bone loss. Future investigations are needed to explore the potential underlying mechanisms, long-term clinical efficacy, and compliance of acupuncture in OP management.

Research Article2022-12-31

Comparison of the Effects of Myofascial Meridian Stretching Exercises and Acupuncture in Patients with Low Back Pain

Dilek Eker Büyükşireci^1,*, Nesrin Demirsoy¹, Setenay Mit², Ersel Geçioğlu², İlknur Onurlu¹, Zafer Günendi¹

J Acupunct Meridian Stud 2022; 15(6): 347-355 https://doi.org/10.51507/j.jams.2022.15.6.347

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Background: Acupuncture and myofascial meridians show great anatomical and clinical compatibility.Objectives: We aimed to compare the effects of myofascial meridian stretching exercises and acupuncture in patients with low back pain.Methods: We randomized 81 subjects with acute/subacute low back pain into three groups: an acupuncture (A) group, a myofascial meridian stretching (MMS) group, and a control (C) group. We recorded the Numerical Rating Scale (NRS) and Roland- Morris Disability Questionnaire (RMQ) scores at baseline and weeks two and six. We evaluated posterior pelvic tilt and transversus abdominis muscle strenghth with a pressure biofeedback unit, back extensor muscle strength by the Sorenson test, and lumbar range of motion (ROM) with an inclinometer. Group A received acupuncture (BL 57 and BL 62 acupoints) and stretching exercises according to the posterior superficial line were applied to the MMS group.Results: Improvements in the NRS score were more prominent in group A than in group C (p = 0.004). The RMQ score improvement between baseline and weeks two and six was more prominent in groups A and MMS (p < 0.001, p = 0.001, respectively). The Sorenson test showed significant improvement between the baseline and week two in groups A and MMS (p = 0.004, p < 0.001, respectively). The increase in lumbar ROM measurement in the MMS group between baseline and week two was significantly higher than in groups A and C (p = 0.009, p < 0.001, respectively).Conclusion: Stretching exercises according to the myofascial meridian system and acupuncture contributed to improved symptoms in the first two weeks in patients with acute/subacute low-back pain.

Research Article2022-10-31

Effect of Acupressure on Dental Anxiety in Children: a Pilot Study for a Randomized Clinical Trial

Maria Eliza Consolação Soares^1,*, Alessandra de Souza Araújo¹, Isabela Carvalhaes Lagares Pinto¹, Luiza Silveira Araújo Barbosa¹, Maria Cristina Borsatto², Rodrigo Galo³

J Acupunct Meridian Stud 2022; 15(5): 307-313 https://doi.org/10.51507/j.jams.2022.15.5.307

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Background: Anxiety is an important problem in children in dental clinics. Acupressure may be a useful tool to assist in dental procedures in anxious children.Objectives: This pilot study was performed to examine the effects of acupressure on dental anxiety in children undergoing restorative procedures.Methods: Fourteen children aged 7-10 years and with at least one primary molar with caries on the dentine were included in the study. The participants also needed to score at least one point on the modified Venham Picture Test (VPTm) for the determination of anxiety. The children were randomly allocated to two groups: group A — non-documented points for the reduction of anxiety and induction of relaxation; group B — documented points (EX-HN3, Shen Men of auricular acupuncture). The anxiety scale was administered on three occasions: prior to the application of acupressure; immediately after sitting in the dental chair to undergo restorative treatment; and after removal of acupressure at the end of the restorative procedure. Heart rate (HR) was measured when each child sat in the dental chair, after the removal of carious tissue, and after the removal of acupressure.Results: After the procedure, HR (as an indicator of anxiety) was statistically significantly lower in group B than group A (p = 0.02). However, there was no significant difference between the groups regarding anxiety before and during the restorative procedure (VPTm and HR: p > 0.05).Conclusion: The children who received acupressure on documented points for the reduction of anxiety had a significantly lower HR after the restorative procedure. No significant between-group difference was found regarding anxiety measured using a psychometric evaluation (VPTm).

Research Article2023-06-30

Ziwuliuzhu Acupuncture Modulates Clock mRNA, Bmal1 mRNA and Melatonin in Insomnia Rats

Ao Huang¹, Gefang Xiao², Yiliu Chen¹, Zuying Hu¹, Pin-Hsuan Lee¹, Yusen Huang¹, Zifeng Zhuang¹, Yuling Zhang¹, Peng Qing^2,*, Canghuan Zhao^2,*

J Acupunct Meridian Stud 2023; 16(3): 109-118 https://doi.org/10.51507/j.jams.2023.16.3.109

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Background: In clinics, Ziwuliuzhu acupuncture is widely considered an effective method of treating insomnia; however, there is currently limited information available regarding its possible mechanisms. Although the method of Ziwuliuzhu acupuncture possesses a unique rhythmic pattern.Objectives: In this study, we have creatively combined the traditional Chinese medicine of Ziwuliuzhu with a modern biological rhythm to investigate the internal mechanism of insomnia.Methods: Pathological tissue from the hypothalamus was analyzed using hematoxylin–eosin staining. The level of TNF (tumor necrosis factor)-α in the SCN (suprachiasmatic nucleus) area of the hypothalamus was detected in situ using the TUNEL fluorescence staining assay. The concentration of hypothalamic melatonin was detected using the enzyme-linked immunosorbent assay (ELISA). The mRNA expression of Clock and Bmal1 was measured using RT-qPCR.Results: In the Ziwuliuzhu acupuncture groups, the structural damage in the hypothalamic neurons was alleviated compared to the model group and the expression of inflammatory factors was reduced. The mRNA expression levels of Clock and Bmal1 were significantly increased (p < 0.05). The concentration of melatonin was significantly increased (p < 0.001). Although there were no significant differences between the treatment groups (diazepam group, Nazi group, Najia group, and routine group) (p > 0.05).Conclusion: Ziwuliuzhu acupuncture alleviated neuronal damage and modulated the inflammatory reaction in the hypothalamus of rats with insomnia. Moreover, Ziwuliuzhu acupuncture increased the expression levels of Clock and Bmal1 mRNA, and MT content. This study has potentially highlighted one of the mechanisms through which Ziwuliuzhu acupuncture can be used to treat insomnia.

Brief Report2022-12-31

Acupuncture Treatment of a Patient with Bradycardia and Idioventricular Rhythm

Oksana Strakhova*, Alexey Ryzhov*

J Acupunct Meridian Stud 2022; 15(6): 356-360 https://doi.org/10.51507/j.jams.2022.15.6.356

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A patient with bradycardia and an idioventricular rhythm was observed. According to cardiologists, there is no reliable drug treatment for bradycardia with an idioventricular rhythm; instead, the sole treatment is a pacemaker. In the course of this case, it was shown that acupuncture can restore the heart rhythm from bradycardia to normocardia, and from idioventricular with third-degree atrioventricular node block and an average heart rate of 34 BPM, to normal sinus rhythm with a heart rate of 71 BPM. Additionally, at the end of the treatment, the patient’s number of episodes of ventricular extrasystole decreased 36 times (3289 versus 91 episodes). These results show that research on this technique should be continued.

Research Article2023-08-31

Response of Lipid Profile to Laser Acupuncture along with Diet and Pilates Exercise in Obese Women with Systemic Lupus Erythematosus: a Randomized Controlled Trial

Ali Mohamed Ali Ismail^1,*, Ahmad Elsayed Saad², Noha Ahmed Fouad Abd-Elrahman³, Ahmed Mohamed Abdelhalim Elfahl⁴

J Acupunct Meridian Stud 2023; 16(4): 152-158 https://doi.org/10.51507/j.jams.2023.16.4.152

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Background: Obesity-induced dyslipidemia is one of the main factors contributing to morbidity and mortality associated with metabolic syndrome, atherosclerosis, and coronary artery disease among patients with systemic lupus erythematosus (SLE).Objectives: This research aimed to assess the effect of adding laser acupuncture therapy (LAT) to a Pilates exercise program (PEP) and low-calorie diet protocol (LCDP) on blood lipids among 60 obese women with SLE.Methods: Study participants were women aged between 23 and 49 years, randomly assigned to one of two groups, A or B, each comprising 30 women. In addition to adherence to the LCDP, both groups were supervised five times weekly during 50-minute PEP sessions. Group A also received LAT three times weekly, with each session lasting 2 minutes on selected acupoints. After the 12-week intervention, plasma total cholesterol, high-density lipoprotein, triglycerides, and low-density lipoprotein were assessed.Results: Both groups demonstrated significant improvement in the aforementioned lipids after the 12-week intervention. A comparison between the post-intervention values of the lipids in the groups revealed a significant improvement favoring group A (the group that received LAT).Conclusion: Adding a 12-week LAT regimen to PEP and LCDP significantly improved lipid profiles among 60 obese women with SLE.

Research Article2023-08-31

Effect of Systemic and Auricular Acupuncture with a 2/100 Hz Frequency and Nogier Frequency in Fibromyalgia: a Randomized Clinical Trial, Pilot Study

Rosa Maria Moreira¹, Rhaynara Coelho Rosário², Érika Almeida Boggiss¹, Rosana Aparecida de Lima¹, Paula Aparecida Silva², Karol Priscila da Silva¹, Caroline Lima de Farias¹, Vanessa de Queiroz dos Santos¹, Josie Resende Torres da Silva³, Rodrigo Polaquini Simões², Andréia Maria Silva Vilela Terra², Adriana Teresa Silva Santos^2,*

J Acupunct Meridian Stud 2023; 16(4): 139-151 https://doi.org/10.51507/j.jams.2023.16.4.139

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Background: Fibromyalgia is a syndrome of chronic, generalized muscular pain, accompanied by sleep disturbances, fatigue and cardic autonomic dysfunction that will affect the quality of life. There is currently no gold standard treatment. There are limitations of studies with electroacupuncture in auricular acupuncture.Objectives: We evaluate the effects of systemic electroacupuncture (EA) with frequencies of 2/100 Hz associated of auricular acupuncture with a Nogier frequency (2.28, 4.56 and 9.12 Hz) for pain intensity, heart rate variability (HRV), and quality of life in fibromyalgia.Methods: Randomized clinical trial, a pilot study. Eighteen volunteers were randomized into a control group (CG, n = 9) and an experimental group (EG, n = 9). Six systemic EA sessions systemic and auricular were applied in the EG for 20 min, twice a week, for six weeks consecutive. The Numerical Pain Assessment Scale (NPRS), 2010 diagnostic criteria of the American College of Rheumatology (FDC 2010), Fibromyalgia Impact Questionnaire (FIQ) and analysis of HRV were the instruments used. The independent t-test compared to the groups was applied.Results: There was no statistically significant difference for the primary outcome for NPRS (p > 0.05). In the secondary outcome there was a significant difference in the total score and in some FIQ domains (p = 0.008) and some variables such as pain (p = 0.02) and anxiety (p = 0.006). There was no significant difference for the FDC 2010 and HRV variables (p > 0.05).Conclusion: 2/100 Hz systemic EA associated with the Nogier frequency positively influenced some quality of life variables; however, pain intensity, diagnostic criteria, and HRV variables did not change.

Brief Report2023-12-31

Effect of Needling at Selected Acupuncture Points (GB39, BL17, LR13) on Hemoglobin Levels in Anemia: a Randomized Placebo Controlled Study

K. Gayathri Devi¹, A. Mooventhan^1,2,*, N. Mangaiarkarasi¹, N. Manavalan³

J Acupunct Meridian Stud 2023; 16(6): 263-267 https://doi.org/10.51507/j.jams.2023.16.6.263

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Iron deficiency anemia (IDA) is an important public health issue in India. This study was performed to determine the impact of acupuncture at the GB39, BL17, and LR13 points on hemoglobin levels, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and red cell distribution width (RDW) in people with IDA. One hundred women with IDA were randomly allocated to the acupuncture group (AG) or placebo control group (PCG). For 30 minutes per day, daily for 2 weeks, the AG received acupuncture at GB39, BL17, and LR13, while the PCG received needling at non-acupuncture points. Outcomes were assessed before and after the intervention. We found a significant increase (p < 0.001) in hemoglobin level (AG 10.39-11.38 g/dl, effect size 0.785; PCG 10.58-10.40 g/dl, effect size 0.191), MCH (AG 25.69-27.50 fl, effect size 0.418; PCG 27.43-27.23 fl, effect size 0.058), and RDW (AG 15.12-16.41 fl, effect size 0.626; PCG 14.91-14.94 fl, effect size 0.017) in the AG compared to the PCG. Results suggest that needling at the GB39, BL17, and LR13 acupuncture points is more effective in treating people with IDA than needling at non-acupuncture points.

Research Article2023-06-30

Effect of Acupressure at PC6 on Nausea and Vomiting During Pregnancy: a Randomized Controlled Trial

Melike Pündük Yılmaz^1,*, Saadet Yazıcı², İsmail Yılmaz³

J Acupunct Meridian Stud 2023; 16(3): 89-94 https://doi.org/10.51507/j.jams.2023.16.3.89

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Background: Nausea and vomiting are among the most common medical problems during pregnancy, affecting 80% of mothers.Objectives: This study was conducted as a randomized controlled experimental study to determine the effect of acupressure applied by a wristband to the pericardium 6 (PC6) point on nausea and vomiting during pregnancy.Methods: The study population consisted of 74 pregnant women between 6-14 weeks of gestation who were experiencing nausea and vomiting. The study data was collected with personal information from the Pregnancy-Unique Quantification of Emesis Scale (PUQE). Experimental and control groups were selected by a simple random method. The experimental group wore acupressure wristbands for one week, while the control group did not use any method to alleviate nausea and vomiting. One week later, the PUQE scale was applied to both groups.Results: The acupressure wristbands decreased the nausea and vomiting scores of the pregnant women in the experimental group without statistical significance but did not change the nausea and vomiting scores of the pregnant women in the control group.Conclusion: Acupressure wristbands can be used to prevent nausea and vomiting during pregnancy.