Effect of acupuncture sensation on body sway during one legged stance / 全日本鍼灸学会雑誌

[Objectives]The purpose of this study is to clarify the effect of acupuncture sensation on the body sway during a one-legged stance.[Methods] The study participants were 16 healthy adults (mean age 21.8±1.6 years). The study design was a crossover method, wherein the same individuals participated in the acupuncture stimulation condition and the control condition at intervals of more than one week. Evaluation was performed before and after each intervention by holding a one-legged stance for 40 seconds on a force plate. A total of six items of body sway were measured, including: circumferential area, rectangular area, effective value area, total trajectory length, unit trajectory length, and unit area trajectory length. In addition, Visual analog scale (VAS) was used to evaluate the ease with which the lower leg was subjected to force during measurement. In the acupuncture stimulation condition, single acupuncture was performed on the lower limb muscle group of the measuring leg, and the VAS of the acupuncture sensation was evaluated at the time of stimulation and at the end of measurement. Stainless steel disposable acupuncture needles (length: 50 mm, diameter: 0.20 mm.) were used for stimulation. The stimulation sites were the ST32, ST37, BL37, BL57, and GB37 of the test leg, and acupuncture needles were inserted to the desired depth and removed when sensation was felt. The control condition was the supine position for five minutes. Comparisons were made between the pre- and post-acupuncture stimulation conditions and the pre- and post-control conditions(body sway, lower leg VAS, acupuncture sensation VAS). [Results] There was no significant difference between the two conditions in terms of body sway. However, the VAS of lower limb effort was significantly lower, from 78.0±14.9 mm to 63.1±17.0 mm before and after the intervention (p<0.05). On the other hand, in the control condition, there was no significant difference from 79.5±12.3 mm to 75.2±12.7 mm before and after rest. The VAS of acupuncture sensation was 50.4±14.3 mm during stimulation and 9.8±9.0 mm at the end of measurement, which was significantly lower (p<0.05). [Conclusion] Acupuncture sensation did not affect the body sway before and after acupuncture stimulation. However, the subjective sensation of weakness appeared, suggesting that acupuncture stimulation may cause a transient sensation of weakness.

Survey research on the perceptions and issues of ordinary women regarding cosmetic acupuncture / 全日本鍼灸学会雑誌

[Objective] This study aimed to investigate the awareness and perceptions of cosmetic acupuncture among ordinary women.[Method] A questionnaire method was adopted, with a target population of 1,000 ordinary women living in Shizuoka prefecture, which is considered a suitable location for test marketing in Japan.Questionnaires were distributed through the Chambers of Commerce in the prefecture by age group, according to the population ratio, and responses were obtained. The items included (1) basic information; (2) presence and type of facial cosmetic concerns; (3) experience of acupuncture, awareness of cosmetic acupuncture, the medium through which they learned of it, perception of effects, and experience of cosmetic acupuncture; (4) effects and types of cosmetic acupuncture, presence or absence of adverse effects, current treatment status, desired treatment outcomes and reasons for seeking treatment, wishes from treatment clinics, and wishes from practitioners; and (5) 1 month's investment in beauty.[Result] The response rate was 56.2%, and 91.8% of the participants perceived that they had facial cosmetic concerns; 28.8% had experience with acupuncture, whereas 42.0% had knowledge regarding cosmetic acupuncture. Television (45.3%) was the primary source of information regarding this. The most prevalent perception of the effects of cosmetic acupuncture was lifting (44.8%), and 43.2% of the 521 participants inexperienced with cosmetic acupuncture consented to treatment. Participants mostly reported being somewhat interested in the procedure as their reason for wanting to receive treatment (45.3%). The most common reason for opting out of treatment was due to pain (52.6%). Of those who experienced cosmetic acupuncture, 60.0% said they experienced positive effects, and lifting (62.5%) is the most frequently perceived outcome, which matched the commonly held perception. However, among the participants, 45.0% reported negative effects, while 47.5% received the treatment two or more times in the past but did not continue. Participants mainly wanted clean treatment centers and skilled practitioners. The most common monthly investment in beauty was between 3,000 yen and 5,000 yen (28.5%).[Discussion/Conclusion] The results suggest that many women have cosmetic concerns regarding their faces and expect lifting from cosmetic acupuncture. The low treatment rate among women and their reasons for not seeking re-treatment were elucidated in this study, despite their degree of awareness. Further, the problems associated with the development of cosmetic acupuncture were clarified.

Comparison between conventional acupuncture and press tuck needle acupuncture for physical and psychological fatigue in office workers / 全日本鍼灸学会雑誌

[Aim] We compared the effects of acupuncture and press tuck needle (PTN) acupuncture in office workers with physical and psychological fatigue.[Design] A randomized, open-label, parallel-group, comparison study.[Setting] An acupuncture room in the A Clinic within the Kanto Metropolitan Area.[Patients] Clinic workers. The inclusion criteria were 20-45 years of age and awareness of physical and psychological fatigue. The exclusion criteria were fatigue-related diseases and symptoms, medical abnormalities, and history.[Intervention] The subjects were randomly allocated to either the acupuncture treatment group (ACP group) or PTN acupuncture treatment group (PTN group). The interventions were based on acupoints for fatigue symptoms as per previous reports and individualized treatment for physical symptoms, including neck and lower back pain, among others, and were performed twice a week for one month.[Evaluation methods] The visual analog scale (VAS) scores were the primary method for evaluating for physical and psychological fatigue at four weeks post-treatment. Other forms of measurement used were the VAS scores within groups immediately after treatment and to evaluate physical health, the Health Perceptions Questionnaire, General Health Questionnaire-12, and Short Form-36 responses; and salivary amylase levels were used.[Results] Thirteen of 14 subjects in the ACP group and 13 of 15 in the PTN group were included in the analysis. There was no significant difference between the groups for VAS scores. Evaluation, immediately before and after the intervention showed a significant decrease in VAS scores for physical fatigue in both groups. The ACP group showed a greater immediate change than the PTN group. In a comparison within each group, the VAS of psychological fatigue in the PTN group showed significant decrease after the eighth treatment.[Conclusions] Acupuncture may immediately improve physical fatigue in office workers. Moreover, the frequency of using PTN acupuncture may eventually decrease physical fatigue. Therefore, acupuncture and PTN acupuncture can help office workers' health.

A questionnaire survey for orthopedists on the clinical experience of patients who suffered adverse events associated with acupuncture and moxibustion / 全日本鍼灸学会雑誌

[Objective]The purpose of this study was to gain a clear understanding of adverse events associated with acupuncture (Acp) and moxibustion (Mox) therapies. Thus, we administered questionnaires to orthopedists in order to understand the clinical experience of patients who suffered adverse events.<BR>[Materials and Methods]For this study, 6,000 orthopedic hospitals and clinics were randomly selected from 13,225 hospitals and clinics listed in the telephone directory iTown Page (http://itp.ne.jp). In October 2011 and July 2012, 3,500 and 2,500 questionnaires, respectively, were sent by mail. The questions addressed the following:(1) the respondent's profile (e.g., years of experience as a licensed orthopedist);(2) adverse events associated with Acp, including electroacupuncture;(3) adverse events associated with Mox;(4) use of Acp and Mox therapies in the orthopedist's hospital or clinic;(5) comments on the safety of Acp and Mox therapies. The identity of respondents remained secret.<BR>[Results]The questionnaire response rate was 10.7%. The respondents were licensed orthopedists for 30 ± 11 years (mean ±standard deviation). Adverse events associated with Acp included retained needles and needle breakage (n ≥148), hemorrhages (n ≥ 64), infections (n ≥ 40), organ injuries (n = 28), and so on. Retained needles (≥ 145 out of 148), subcutaneous hemorrhages (63out of 64), arthritis (17 out of 40), and pneumothorax injuries (27 out of 28) occurred most frequently. The adverse events associated with Mox were burn injuries (n ≥ 121), infections (n ≥ 16), and other adverse events (n = 2). Second-degree burn injuries (n ≥ 48 out of 121) and suppuration infections (11 out of 16) occurred most frequently. These were the most common adverse events associated with Acp and Mox. The usage rate of Acp and Mox therapies in the orthopaedist's hospital or clinic was 18.6%. There were many comments on infection control by acupuncturists (n = 27), education and technical levels of Acp and Mox (n = 13), and retained needles and needle breakages (n = 13). <BR>[Conclusion]These survey results reveal that the occurrence of severe adverse events associated with Acp and Mox was higher than our expectation. In order to improve the safety of Acp and Mox therapies, various educational activities to disseminate information about existing safety measures to acupuncturists are needed. Further studies on new preventive measures, continuous surveys, and feedback to acupuncturists are also required.

Core temperature of a burning moxa ball and temperature when dropped from a moxa needle / 全日本鍼灸学会雑誌

[Objective]The aim of this study was to prevent accidental burns caused by touching a heated needle shaft or by a burning moxa ball falling from a moxa needle. Therefore, we measured the central temperature (Tc) of a burning moxa ball and the temperature at the landing point (Td) of a falling moxa ball.<BR>[Methods]Stainless steel acupuncture needles and unrefined moxa for moxa needles were used. The moxa balls weighed 0.15 g (diameter, 13± 1mm), 0.30 g (diameter, 16 ± 1mm), and 0.60 g (diameter, 24 ± 1mm). To measure the Tc of a moxa ball, a K-type thermocouple temperature probe was inserted into the centre of the ball. The Td of a moxa ball was measured by placing the probe 2 mm directly below the moxa ball. At each point in time, the moxa ball was forced to drop after ignition. Each measurement was repeated 5 times. The data were expressed as mean ±standard deviation.<BR>[Results]The maximum Tc of the 0.15, 0.30, and 0.60 g moxa balls was 569 ± 26°C at 72 ± 8s after ignition, 606 ± 26°C at 109 ± 4s, and 624 ± 48°C at 167 ± 14 s, respectively. Tc of each ball decreased to less than 45°C at 180 ± 8s, 225 ± 4s, and 345 ± 13s after ignition, respectively. When a 0.15 g moxa ball was dropped 30 s after ignition, Td measured 1, 5, and 10 s after the drop was 60 ± 6°C, 97 ± 7°C, and 137 ± 31°C, respectively. Td was less than 45 degrees 120 seconds after ignition. When a 0.30 g moxa ball was dropped 120 s after ignition, Td measured 1, 5, and 10 s after the drop was 66 ± 7°C, 96 ± 6°C, and 129 ± 2°C, respectively. Td was less than 40 degrees 120 seconds after ignition. Td was less than 45 degrees 180 seconds after ignition. When a 0.60 g moxa ball was dropped 180 s after ignition, Td measured 1, 5, and 10 s after the drop was 69 ± 3°C, 96 ± 14°C, and 135 ± 20°C, respectively. Td was less than 45 degrees 270 seconds after ignition.<BR>[Conclusion]For 0.15, 0.30, and 0.60 g moxa balls, if Tc, that is the temperature of the probe, is considered to be the temperature of the needle shaft, burns may be caused by touching the heated shaft up until about 180, 240, and 360 s after ignition, respectively. Furthermore, there is a risk of burns caused by dropping a burning 0.15, 0.30, or 0.60 g moxa ball before 120, 180, or 270 s after ignition, respectively.

A survey of adverse events at acupuncture clinics in Japan / 全日本鍼灸学会雑誌

[Objective]The aim of this study was to survey the current status of adverse events (malpractice and side-effects) in clinical practices of acupuncture (Acp) and moxibustion (Mox), to discuss the problems, and to suggest corrective strategies.<BR>[Methods]The survey was sent by mail in October 2009 to 6,000 Acp clinics (including Mox) selected at random from the i-Town-Page telephone directory. The questions addressed the following issues:(1) respondent profile;(2) Acp adverse events;(3) Mox adverse events;(4) complaints and litigation;(5) informed consent regarding these adverse events;(6) subscriptions to publications that address the safety issues of Acp and Mox;and (7) access to free safety resources. Note that we inquired about the experiences of adverse events but did not inquire about their frequency.<BR>[Results]The response rate was 21.6%. The top three adverse events for Acp were subcutaneous hemorrhage (65.8%), micro-hemorrhage (62.0%), and needle pain (52.9%). The top malpractice event was forgotten needles (32.7%). Needle breakage and pneumothorax, which are severe malpractice events, were reported by 2.2%and 2.0%of the clinics, respectively. The top three adverse events for Mox were accidental and unintentional burn injury (24.0%), singed hair (15.5%), and singed clothes (15.0%). The most severe malpractice event was suppuration of the Mox point (10.8%). The top adverse events associated with complaints and litigation were symptom exacerbation (21.8%) and pneumothorax (36.4%). Only 74.8%of respondents obtained informed consent, but of those, 61.0%reported providing adverse affect warnings orally. Subscriptions to books and periodicals on the safety of Acp and Mox were reported by less than 30.0%of the respondents.<BR>[Conclusion]The most common adverse events associated with Acp were side effects caused by excessive stimulation. With Mox adverse events were more commonly attributable to negligence. The low subscription rate to safety periodicals suggests that safety information is not presently widely distributed. It is necessary to transmit safety information via the Internet as well as in books and other periodicals.

Effects of manual acupuncture on motor evoked potentials induced by transcranial magnetic stimulation in human / 全日本鍼灸学会雑誌

[Objective]The purpose of this study was to investigate the effects of manual acupuncture stimulation (MA) on motor evoked potential (MEP) induced by transcranial magnetic stimulation (TMS).<BR>[Methods]The subjects were 10 healthy volunteers who gave oral and written informed consent. Experiment 1. MEPs were induced from the right abductor digiti minimi muscle (rADM) by TMS with a circular coil to the left cortex motor area and were measured before and after MA to the right LI4 (right Hoku point), left LI4 (left Hoku point), right LR3(right Taichong point) or left LR3(left Taichong point). A sparrow pecking technique (1 Hz for 1 minute) with a stainless steel needle (40 mm long, 0.18 mm in diameter, Seirin co., Inc, Shizuoka) was used for MA. The subjects received the same experiments four times with MA to different acupoints on a different day. Experiment 2. MEPs were measured during imaging of rADM and lADM contraction and immediately after noxious pinch stimulation to the skin on the right LI4 and left LI4 and right LR3and left LR3respectively. Repeated measure two-way ANOVA was used for statistical analysis to compare between all groups. Repeated measure one-way ANOVA and multiple comparison (Dunnett's test) were applied to time point data in each group.<BR>[Results]MA to the left LI4 or right LR3was significantly decreased MEP (P < 0.01, respectively). In the right LI4, there was a tendency to decrease of MEP, but not significantly (P = 0.26). Most subjects answered feeling severe or strong acupuncture needle sensation. MEPs were significantly increased by imaging of contraction and noxious stimulation (P < 0.001 and P < 0.01, respectively).<BR>[Conclusion]These results suggested a possibility that distant acupuncture stimulation would suppress motor activity via several roots and that an acupuncture inhibited effect was compensated by facilitation arising from the concentration to the stimulated hand.

Present state of infection control in acupuncture and moxibustionpart 2-Questionnaire survey for practicing acupuncturists in the Chubu region- / 全日本鍼灸学会雑誌

[Objective]To survey the current situation of infection control in clinical practice of acupuncture and to discuss the problems and strategy.<BR>[Methods]The subjects were 1,000 acupuncture clinics enrolled in iTownPage in the Chubu region. The questionnaire was sent to them by mail in November 2008. The questions were the following; 1) Profile of respondent, 2) Hand hygiene, 3) Preparation of needling sites, 4) Sterilization and storage of needles and equipment and disposable products, 5) Disposable needle, 6) Hand-pressing (Oshi-de), 7) Infectious waste, 8) Awareness, efforts and self-evaluation of practitioner for infection control, and 9) Comments of this survey.<BR>[Results]The collection rate was 22.2%. Washing time for less than 30 sec was 31.1%, Usage rate of a cloth towel was 67.7%, Hand antisepsis by the basin method was 18.9%, Usage rate of 50 %isopropyl alcohol was 19.8%, etc. 26.6%of all respondents answered that the possibility of infection in acupuncture and moxibustion therapy was very low and 50.9%of those responded that it was low. However, only 27.0%of the responders answered that infection control in their own clinics was appropriate. In addition, 72.5%of the responders belonged to the Japan Acupuncture and Moxibustion Association (JAMA) or the Japan Society of Acupuncture and Moxibustion (JSAM).<BR>[Conclusion]Although some infection controls have been improved, many problems became clear. These problems are suggested to be caused by poor acknowledge, previous experience and wishful thinking of practitioners. It is necessary to continue activities to raise practitioner's awareness for infection control.

Present state of infection control in acupuncture and moxibustion -A questionnaire survey for practicing acupuncturists in the Kinki region- / 全日本鍼灸学会雑誌

We have been utilized acupuncture and moxibustion in our department of internal medicine at Meiji University of Integrative Medicine since its investment in 1987. In the department, various kinds of symptoms in the field of internal medicine have been managed with acupuncture and moxibustion. In this article, I would like to introduce our activities regarding acupuncture treatment in the department of internal medicine and some remarkable results of our clinical studies which evaluated effects of acupuncture and moxibustion as well as relationship between acupuncture therapists and the staff of our department. In the field of respiratory disorders such as COPD or bronchial asthma, usefulness of acupuncture have been proved through a controlled clinical trial which involved COPD patients who had not been able to control with standard care. Also, acupuncture was found to be useful in the management of bronchial asthma in a case series study in which acupuncture treatment was repeatedly applied with intervals without acupuncture. We have also demonstrated that acupuncture was useful for gastrointestinal disorders such as irritable bowel syndrome (IBS). Results of a case series with n-of-1 study design showed significant reduction in the symptoms during acupuncture treatment, while those in the period without acupuncture had been aggravated. Data from studies on diabetic complications such as peripheral neuropathy or gastropathy also showed usefulness of acupuncture. We considered that it is valuable to explore unknown usefulness of acupuncture in the field of internal medicine and prove effectiveness of acupuncture with appropriate scientific manner.