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  • Clinical Study Protocol2021-12-31

    Abstract : Background: Spasticity is a common motor disorder in adult stroke patients. Injury to the corticospinal tract (CST) is associated with spasticity. Dry needling (DN) has positive impacts on spasticity reduction and improvement in the range of motion (ROM) in stroke patients. This study aims to investigate the effectiveness of DN on the connectivity of the CST and the level of spasticity in adult stroke patients. Methods: This double-blind randomized controlled trial will enroll and randomly assign stroke patients to either the experimental group, for receiving three sessions of DN for the spastic wrist flexors, or the control group, for sham needling. The primary outcome measures will be diffusion tensor imaging and the Modified Modified Ashworth Scale score to assess CST connectivity and wrist flexor spasticity, respectively. The Box and Block Test and standard goniometry are the secondary outcome measures to assess hand dexterity and active and passive wrist ROM, respectively. Measurements will be taken both before and after the intervention. Discussion: The results of this study will provide important evidence of the effects of DN on CST connectivity, spasticity, and arm function in adult stroke patients. Trial registration: This trial is registered in the Iranian Registry of Clinical Trials (IRCT) (https://www.irct.ir; IRCT20191208045649N1).

  • Research Article2022-04-30

    Trigger Point Acupuncture and Exercise for Chronic Low Back Pain in Older Adult: a Preliminary Randomized Clinical Trial

    Yoichi Minakawa1,2,*, Shogo Miyazaki1,2, Hideaki Waki1,2, Naruto Yoshida1,2, Kaori Iimura3, Kazunori Itoh4
    J Acupunct Meridian Stud 2022; 15(2): 143-151 https://doi.org/10.51507/j.jams.2022.15.2.143

    Abstract : Background: Exercise therapy is the first choice non-pharmacotherapeutic approach for musculoskeletal pain; however, it often interferes with the implementation and continuation of exercise due to fear-avoidance behaviors. Trigger point acupuncture (TrPAcp) has been reported to reduce musculoskeletal pain.Objectives: To examine the efficacy of exercise combined with TrPAcp compared to exercise alone for older patients with chronic low back pain (CLBP), the most common subjective symptom reported by old people of both sexes in Japan.Methods: In this single-center randomized controlled trial conducted at Teikyo Heisei University, 15 men and women aged ≥ 65 years with low back pain for at least 3 months who met the eligibility criteria were included. The Ex+TrPAcp group received exercise and trigger point acupuncture, while the Ex group received only exercise for 3 months. The main outcome, pain intensity, was measured using the numerical rating scale (NRS). Improvement was defined as a decrease in NRS of ≥ 2 or less than moderate (NRS < 4).Results: The analysis included 7 of 8 cases in the Ex+TrPAcp group and 7 of 7 cases in the Ex group. NRS improved in 6 of 7 and 1 of 7 patients in the intervention and control groups, respectively, with a significant difference between groups (p = 0.03, φ = 0.71). Regarding adverse events due to acupuncture, one patient (14.3%) complained of heaviness after acupuncture. Nothing specific was reported with exercise.Conclusion: Compared with Ex alone, Ex+TrPAcp may be more effective therapy for older people with CLBP who do not have an exercise habit.

  • Brief Report2022-12-31

    Abstract : 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.


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December, 2022
Vol.15 No.6

pISSN 2005-2901
eISSN 2093-8152

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  • Case Report2021-10-31

    Abstract : Hypothyroidism is one of the most common endocrine disorders linked to various systemic diseases ranging from obesity to cancers. The present line of management is insufficient as reports suggest that there is persistence of symptoms and poor adherence that makes the management of said disease challenging. Acupuncture and other Traditional Chinese Medicine (TCM) therapies are proven to alleviate endocrine dysfunctions. However, reports on acupuncture and cupping therapy on hypothyroidism are very scarce. Here, we report 5 cases of hypothyroid patients aged between 38-44 yrs who were treated with acupuncture and fire cupping for a period of three months. At the baseline, the patients presented with either a weak, wiry or vacuum pulse which represents spleen Qi deficiency. Further, they presented with elevated levels of Thyroid Stimulating Hormone (TSH), and higher Body Mass Index (BMI). Acupuncture treatment at ST36, LI4, SP6, and BL20 was given bilaterally whilst CV4, LR3, LR4, SP9, ST40, SP10, GV4, KI3, ST12, and SI17 were punctured unilaterally. At the end of the time period of three months, patients progressed to normal levels of TSH, reduction in BMI and had succeeded in tapering their medication doses. Supplementing this, the patients reported marked improvement in other symptoms like fatigue, hair loss, and cold feet post-treatment. The effects were consistent even during the three month follow-up period post-interventions. The results encourage the utilization of acupuncture and fire cupping in the management of hypothyroidism. However, large scale studies are warranted to strengthen this recommendation.

  • Research Article2021-02-28

    Effect of Remote and Local Acupuncture Points on Periarthritis of Shoulder: A Comparative Study

    Kumaresan Poorna Chandran1,*, Prabu Poorna Chandran2, Naveena Arumugam3, Sendhilkumar Muthappan4

    Abstract : Background: Periarthritis of shoulder is a painful condition of the shoulder, affecting 2-3% of the general population and 20% of diabetic patients. Acupuncture is a widely practiced traditional Chinese medicine. Recent evidence shows that it alleviates shoulder pain with different needling techniques. Objectives: The present study is to compare the efficacy of remote and local points on PAS. Methods: 60 subjects were randomly assigned into two groups, remote acupuncture group (n = 30) and local acupuncture group (n = 30). Both groups were assessed at baseline and at the end of 12 sessions. Shoulder pain and its disability index (SPADI) and (ROM) were measured using goniometer. The intervention was given weekly thrice on alternate days for four weeks with 20 min for each session. Results: The result shows that both remote and local acupuncture points were beneficial in the pain management and rage of motion when compared within the group. The effects of acupuncture at remote acupoints were better than those at local acupoints in SPADI and ROM when compared between two groups. Conclusion: In treatment of periarthritis of shoulder remote acupuncture points may have higher therapeutic value when compared to local points.

  • Case Report2021-02-28

    Abstract : The present case study illustrates the case of a 47-year-old female (Ms X) with primary progressive Multiple Sclerosis (MS) who presented with central post-stroke pain (CPSP) over her left shoulder and underwent acupuncture treatment (AT) since she appeared irresponsive to conventional treatment. The aim of this case study is to explore the effectiveness of acupuncture as a complimentary treatment in improving central neurogenic pain in MS patients affected by CPSP. AT lasted six weeks, some modification of the conventional AT points was required to ensure continuity and safety of the treatment plan. In fact, Ms X suffered from gingivitis that led to hypersensitivity of her left upper limb (UL) to acupuncture needling; moreover, she experienced sensation loss in her legs as a result of post-stroke complications. The outcome showed that the subject’s shoulder range of motion (ROM), Disabilities of the Arm, Shoulder and Hand (DASH) score and pain improved remarkably, enabling Ms X to resume post-stroke rehabilitation and reduce her analgesic intake.

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  • Research Article2021-12-31

    Effect of Dry Cupping Therapy on Pain and Functional Disability in Persistent Non-Specific Low Back Pain: A Randomized Controlled Clinical Trial

    Marianna de Melo Salemi1,*, Vanessa Maria da Silva Alves Gomes1, Laylla Marjorye Rebouças Bezerra1, Thania Maion de Souza Melo1, Geisa Guimarães de Alencar1, Iracema Hermes Pires de Mélo Montenegro2, Alessandra Paula de Melo Calado3, Eduardo José Nepomuceno Montenegro1, Gisela Rocha de Siqueira1
    J Acupunct Meridian Stud 2021; 14(6): 219-230 https://doi.org/10.51507/j.jams.2021.14.6.219

    Abstract : Background: Cupping therapy is used to treat musculoskeletal conditions, including low back pain.Objectives: The study assessed the effects of dry cupping on pain and functional disability from persistent nonspecific low back pain. Methods: This was a randomized controlled trial, where participants were allocated to a cupping therapy (n = 19) or sham (n = 18) group, for five 10-minute sessions of cupping therapy, twice a week, to stimulate the acupoints related to low back pain (GV4, BL23, BL24, BL25, and BL30, BL40 and BL58) and emotional aspects (HT3 and ST36). All participants were assessed at baseline, post-treatment and follow up (a finalization period of four weeks) using a visual analogue scale (VAS) and the Oswestry Disability Index (ODI). Groups were compared using the analysis of covariance (ANCOVA) and the effect size was calculated using Cohen̓s d. Results: The cupping therapy group presented a lower mean VAS when compared to the sham, at post-treatment (mean difference: –2.36; standard error [SE]: 0.58; p < 0.001; “large” effect size: –0.94) and follow up (mean difference: –1.71; SE: 0.81; p < 0.042; ‘large’ effect size: –0.83). The cupping therapy group presented a lower mean ODI when compared to the sham post-treatment (mean difference: –4.68; SE: 1.85; p: 0.017; ‘large’ effect size: –0.87), although in follow-up, there was no difference between the groups (mean difference: 4.16; SE: 2.97; p: 0.17; “medium” effect size: –0.70). Conclusion: Dry cupping was more effective in improving pain and functional disability in people with persistent nonspecific low back pain when compared to the sham.

  • Research Article2021-04-30

    Abstract : Background: Diabetes mellitus (DM) is a chronic metabolic disease characterized by increased blood sugar levels. The current management of DM to date has a target of controlling blood glucose, but the therapy cannot be separated from long-term drug side effects. Acupuncture can be an option as an adjunct therapy for DM. Objectives: The purpose of this study was to compare the effectiveness between manual acupuncture and laser acupuncture. Methods: This study was a randomized control experimental study with a pretest and posttest design using 24 male Sprague-Dawley rats divided into 4 groups: a normal group, a diabetes group, an acupuncture group, and a laser group. Manual acupuncture and laser acupuncture were performed 6 times in two weeks. Fasting blood glucose (FBG) levels, the cell density of Langerhans islets, and side effects were assessed and compared among the 4 groups. Results: The highest mean cell density of Langerhans islets was found in the laser and acupuncture group, and the lowest was found in the diabetes group. In the post hoc analysis, the normal, acupuncture, and the laser groups had a significantly higher mean cell density than the diabetes group. The lowest mean FBG level was in the laser group, followed by the acupuncture group, and the highest was in the diabetes group, but this difference was not significant. There were no serious side effects from the use of manual acupuncture or laser acupuncture. Conclusion: Both manual acupuncture and laser acupuncture can improve the histological findings of Langerhans islets in type 2 diabetic rats, and both are safe to use.

  • Research Article2021-02-28

    Abstract : Background: Pain is a major complaint in cancer patients and a global problem that requires medical attention, including pain in cervical cancer. Although pharmacotherapy has been used for the treatment of cancer pain, there are still around 40% cannot be treated only with pharmacotherapy. Objectives: To determine the effects of electroacupuncture (EA) on pain in stage III cervical cancer patients. Methods: Twenty-eight stage III cervical cancer patients were divided into two groups (14 treatments and 14 controls) with randomized control trial design. The treatment group received EA with a frequency of 2/20-25 Hz at points of ST36, SP6, LI4 and LR3 for 30 minutes, while the control group did not receive EA. Both groups were given paracetamol and codeine at the same dose. Assessment was carried out by measuring pain scale (VAS), plasma β-endorphin levels, and quality of life/QoL (EORTC QLQ-C30) before and after therapy. Results: The average reduction in VAS in the treatment group (2.71 ± 1.14) compared to the control group (0.71 ± 1.33; p < 0.001), average increase in plasma β-endorphin levels in the treatment group (88.57 ± 52.46 pg/ml) compared to the control group (12.86 ± 56.76 pg/ml; p = 0.001), and in QoL, there were significant differences in symptom improvement between the treatment and control groups in the domain of fatigue, pain, insomnia and overall QoL (p < 0.05). Conclusion: Medical therapy combined with EA decreased pain scale, increased plasma β-endorphin levels, and improved the QoL for stage III cervical cancer patients.

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