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.

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.

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

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.

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.

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.

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 Article2023-06-30

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.

Research Article2023-02-28

Lipid Profile Response to Acupuncture in Obese Patients with Subjective Tinnitus: a Randomized Controlled Trial

Ali Mohamed Ali Ismail*

J Acupunct Meridian Stud 2023; 16(1): 11-19 https://doi.org/10.51507/j.jams.2023.16.1.11

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Background: Blood lipid levels have been reported as novel biomarkers for chronic subjective tinnitus (CST), with their levels being higher in patients with CST.Objectives: This trial aimed to determine the change in lipid profile and tinnitus-related quality of life (TR-QoL) responses to 8-week acupuncture treatment in patients with CST.Methods: Sixty obese patients with CST were randomly assigned to group A (treatment group; n = 30; mean age = 44.10 ± 3.69 years) or group B (sham group; n = 30; mean age = 45.53 ± 3.62 years). Patients in group A (n = 30) received manual stimulation at the TE3, TE5, TE17, TE18, TE19, TE20, TE21, TE22, GB2, GB8, GB20, LI4, LI11, KI3, SP6, ST36, CV4, CV9, and CV12 acupoints through in-site acupuncture needles thrice weekly. Furthermore, the bilateral abdominal ST25 and GB28 acupoints were electrically stimulated through in-site acupuncture needles. Group B (n = 30) received the same acupuncture protocol as group A but the insertion of needles was a sham insertion. Anthropometrics such as body mass index (BMI) and waist circumference (WC), TR-QoL (assessed via tinnitus handicap inventory), blood lipid levels such as high-density lipoprotein (HDL_s), low-density lipoprotein (LDL_s), cholesterol (C), and triglycerides (TG_s), and the visual analogue scale (VAS) score for tinnitus severity, were assessed prospectively.Results: Only group A showed significant within-group improvements. Except for HDL_s, BMI, and WC, unpaired between-group comparisons showed significantly greater improvements in other outcome measures of all patients with tinnitus (TR-QoL, LDL_s, TG_s, C, and VAS) in group A than in group B.Conclusion: Safe acupuncture treatment not only improves anthropometrics and TR-QoL, but also helps resolve hyperlipidemia and reduces the severity of tinnitus in obese patients with CST.

Research Article2023-04-30

The Effects of Manual Acupuncture on Mitochondrial Fusion and Fission Gene Expression in Rat Spleen

Yu-Mi Lee^1,†, Dong-Hee Choi^2,†, Jeong-Hye Park², Min-Woo Cheon³, Jae Gwan Kim¹, Jeong-Sang Kim², Taejin Choi⁴, Hye-Ran Kim², Daehwan Youn^2,*

J Acupunct Meridian Stud 2023; 16(2): 49-55 https://doi.org/10.51507/j.jams.2023.16.2.49

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Background: A significant amount of research has been conducted to establish the validity of acupuncture, and it has been demonstrated through animal disease model studies that acupuncture influences mitochondrial changes. However, to more accurately examine the mechanisms of acupuncture treatment effectiveness in pathological models, it is crucial to investigate changes in disease-free animals. Among various hypotheses regarding the effects of acupuncture on the body, we focused on the result that acupuncture stimulation is related to mitochondria.Objectives: We examined the effects of acupuncture mitochondrial fission and fusionrelated mediators in disease-free Sprague Dawley (SD) rats' spleen meridian acupoints.Methods: SD rats were divided into control, SP1, SP2, SP3, SP5, and SP9 acupuncture groups. Acupuncture was performed at each point for 10 minutes daily for four days. Peroxisome proliferator-activated receptor-gamma coactivator 1-α (PGC-1α) and fission protein 1 (Fis1) levels were evaluated using quantitative real-time polymerase chain reaction (qRT-PCR), while dynamin-related protein 1 (DRP1), optic atrophy-1 (OPA1), mitofusin-1 (MFN1), and mitofusin-2 (MFN2) levels were assessed via western blotting. Mitochondria protein concentrations and NADH dehydrogenase activity in spleen tissues were measured using enzyme-linked immunosorbent assay (ELISA).Results: PGC-1α expression decreased in the SP1 (p < 0.01), SP5 (p < 0.05), and SP9 (p < 0.05) groups, while Fis1 expression increased in the SP1 (p < 0.01), SP5 (p < 0.01), and SP9 (p < 0.05) groups. DRP1, OPA1, MFN1, and MFN2 levels exhibited no significant changes. Mitochondrial protein concentrations decreased in the SP2 (p < 0.01), SP3 (p < 0.01), SP5 (p < 0.01), and SP9 (p < 0.01) groups, while NADH dehydrogenase activity decreased in the SP2 (p < 0.05) and SP9 (p < 0.05) groups.Conclusion: Acupuncture at the SP9 acupoint influenced the mitochondrial fission pathway by modulating PGC-1α and Fis1 mediators in the rat spleen under non-disease conditions.