Acupuncture at "Zusanli" (St.36) and "Sanyinjiao" (SP.6) Points on the Gastrointestinal Tract: A Study of the Bioavailability of (99m)Tc-Sodium Pertechnetate in Rats.

The objective of this study is to investigate the differences of acupuncture effect between the Zusanli (St.36) and Sanyinjiao (SP.6) points on the gastrointestinal-tract (GIT) segment performed by the bioavailability of (99m)Tc-sodium-pertechnetate (Na(99m)TcO(4)) in rats. Male Wistar rats (n = 21) were allocated into three groups of seven each. Group 1 was treated by acupuncture bilaterally at St.36; Group 2 at SP.6; and Group 3 was untreated (control). After 10 min of needle insertion in anesthetized rats, 0.3 mL of Na(99m)TcO(4) (7.4 MBq) was injected via ocular-plexus. After 20 min, the exitus of animals was induced by cervical-dislocation and GIT organs isolated. However, immediately before the exitus procedure, blood was collected by cardiac-puncture for blood radio-labeling (BRL). The radioactivity uptake of the blood constituents was calculated together with the GIT organs by a well gamma counter. The percentage of injected dose per gram of tissue (%ID/g) of Na(99m)TcO(4) was calculated for each GIT organs, while BRL was calculated in %ID. According to the one-way ANOVA, the stomach, jejunum, ileum from the treated groups (Group 1 and Group 2) had significant differences compared to the controls (Group 3). However, between the treated groups (Group 1 and Group 2), there were significant differences (P < .05) in the stomach, jejunum, ileum, cecum, transverse and rectum. In BRL analysis, Group 2 showed significant increase and decrease of the insoluble and soluble fractions of the blood cells, respectively (P < .0001). The authors suggest that St.36 may have a tendency of up-regulation effect on GIT, whereas SP.6, down-regulation effect. However, further rigorous experimental studies to examine the effectiveness of acupuncture in either acupuncture points need to be carried out.

Afecções álgicas da coluna vertebral tratadas pela acupuntura cinética associada à manobra Hualong / Kinetic acupuncture using Hualong maneuver on the treatment of pain disorders of the vertebral column

O presente trabalho é um estudo observacional que tem o objetivo de avaliar os efeitos da inclusão da manobra Hualong (MH) com a Acupuntura Cinética (AC) para tratamento de afecções álgicas da coluna vertebral (AACV) decorrentes de desalinhamento/subluxação vertebral (DSV). Em trabalhos anteriores já demonstramos o efeito potencial da AC para modular a dor crônica associada à tensão muscular e tratar distúrbios musculoesqueléticos. A MH foi desenvolvida por nós desde 2000, visando a sua aplicação no início da “fase per-cinética” da AC. É uma manobra anti-thrust que consiste de mobilização realizada através de movimentos ondulatórios passivos e suaves, em um ritmo lento e sem resistências, para viabilizar a mobilidade da coluna vertebral e das articulações do membro superior e inferior, evitando transtornos como o DSV. Esse procedimento pode ser executado em um único movimento ou em sequência, dependendo da capacidade de adaptação, isto é, o “momento cinético” de cada paciente. Foram tratados 108 pacientes portadores de AACV, sendo 81 mulheres e 27 homens (81:27), com idade entre 25-61 anos, e classificados em três categorias: cervicalgia (total de 36, 31:5); dorsalgia (total de 27, 21:6); e lombalgia (total de 45, 29:16). Todos pacientes foram submetidos ao protocolo de tratamento da AC associado à MH. Os parâmetros de estudo para esse trabalho incluíram: dor, tensão muscular, mobilidade funcional, satisfação terapêutica e evolução clínica; os quais foram avaliados através de escalas de mensuração verbal, visual e numérica, além de outros questionários específicos. Os nossos resultados sugerem que a inclusão da MH na AC pode potencializar os efeitos terapêuticos de reabilitação física em pacientes com afecções álgicas e outros distúrbios musculoesqueléticos da coluna vertebral.

The present work is an observational study that aimed to evaluate the effect of Kinetic Acupuncture (KA) using Hualong maneuver (HM) on the treatment of pain disorders of the vertebral column (PDVC) associated with vertebral misalignment/subluxation (VMS). In previous work we demonstrated the potential effect of KA on the treatment of chronic pain associated to muscular tension and musculoskeletal disorders. HM was developed by us, since 2000, to be used in the “kinetic phase” of KA. It is an anti-thrust maneuver that consists of a mobilization technique performed with soft, passive and waving movements in slow rhythm and without resistance, which can promote mobility of the vertebral column and joints of the upper and lower limbs, avoiding complications as VMS. This procedure can be carried out by only one movement or in sequence, depending on the adaptability of each patient, in other words, the “kinetic moment” of each patient. A hundred and eight patients with PDVC have been treated, being 81 women and 27 men, 25-61 years of age. They were classified in three categories: 36 with neck pain (31 women and 5 men, 31:5); 27, upper back pain (21:6); and 45, low back pain (29:16). All patients were submitted to the KA treatment protocol associated with HM. The parameters for evaluation included: pain, muscle tension, functional mobility, therapeutic satisfaction and clinical resolution; which were assessed by verbal, visual and numerical measurement scales, and other specific questionnaires. This study suggests that inclusion of HM in KA treatment may enhance therapeutic effects on the physical rehabilitation of patients with pain and others musculoskeletal disorders of the vertebral column.

Effect of Zusanli (ST.36) electroacupuncture at two frequencies on the bioavailability of (99m)Tc-sodium pertechnetate and on labeling of blood constituents in rats.

OBJECTIVES: A study was performed on the effects of stimulation at Zusanli-point (ST.36) by electroacupuncture (EA) at two frequencies on the bioavailability of (99m)Tc-sodium pertechnetate (Na(99m)TcO(4)) in rats. METHODS: Forty Wistar rats were divided into four groups: untreated control, treated by manual acupuncture at ST.36 bilaterally, treated by EA at 2 Hz at ST.36 bilaterally, and the same site at 100 Hz bilaterally. Na(99m)TcO(4) (7.4 MBq) was administrated via the ocular-plexus and, 20 minutes before sacrifice, blood was withdrawn for radiolabeling assay (BRL). In the bioavailability analysis, organs and tissues were isolated, their radioactivity determined, and the percentage of injected dose per gram of organ or tissue (%ID/g) and the %ID were calculated for each organ or tissue (%ID/ot). For BRL, the plasma and blood cells isolated, and the fractions also precipitated with 5% trichloroacetic acid to separate the soluble and insoluble fractions; these were assessed as percentage of injected dose (%ID) in blood (%ID/b). RESULTS: The results showed significant differences in the %ID/g in some organs and tissues in comparison with controls; lung (p = 0.0013), spleen (p = 0.0085), pancreas (p = 0.0167), liver (p = 0.0003), stomach (p < 0.0001), small-intestine (p = 0.0181), large-intestine (p = 0.04099), urinary-bladder (p = 0.0271), thyroid (p < 0.0001), muscle (p = 0.0187); %ID/ot in spleen (p = 0.0349); and %ID/b in blood sample (p = 0.0235). In the blood labeling analyses, EA in either frequency significantly increased insoluble fraction/blood cells (p < 0.0001). CONCLUSIONS: These findings suggested that acupuncture procedures at ST.36 could modulate responses in some organs, tissues, and blood in rats. Further rigorous experimental studies to examine the effectiveness in either acupuncture therapy need to be pursued.

Tension neck syndrome treated by acupuncture combined with physiotherapy: a comparative clinical trial (pilot study).

OBJECTIVE: To evaluate the effect of acupuncture combined with physiotherapy in comparison with acupuncture and physiotherapy performed alone in different parameters; pain intensity, muscle tension, functional disability and muscle strength in the treatment of tension neck syndrome (TNS). DESIGN: A prospective, comparative clinical trial. SETTING: Acupuncture and Rehabilitation Department. BACKGROUND: TNS can occur in computer users. Acupuncture has been one alternative treatment in physiotherapeutic rehabilitation of musculoskeletal disorders. SUBJECTS: Forty-six patients with TNS. INTERVENTIONS: Patients were allocated into three groups: Group-1 received physiotherapy (therapeutic exercises) combined with acupuncture; Group-2, acupuncture alone, and Group-3, physiotherapy alone; over a period of 10 weeks, with one or two sessions weekly. OUTCOME ASSESSMENT: All patients had completed the protocols and were assessed using a visual analogue scale for pain intensity (VASpain) and muscle tension (VASmt), the Neck Disability Index: Brazilian Portuguese version for functional disability, and the cranio-cervical Flexion Test for isometric neck muscle strength (INMS); in the periods before treatment (baseline), after 10 weeks of treatment, and after 6 months of follow-up. RESULTS: All groups showed significant improvement (p < 0.001) in these parameters after 10 weeks of treatment and after 6 months of follow-up. Group-1 was superior to Group-3 in pain and functional disability improvements (p<0.05); and Group-1 was superior to both Group-2 (p < 0.01) and Group-3 (p < 0.05) in INMS. After 6 months of follow-up, the improvements of all groups were maintained (p < 0.05). CONCLUSION: The data suggested that acupuncture effect may facilitate and/or enhance physiotherapy performance in musculoskeletal rehabilitation for tension neck syndrome.

Acupuncture stimulation at Sanyinjiao: effect on the sodium pertechnetate bioavailability in rats.

In clinical acupuncture, when acupuncture points are stimulated, several types of reflex responses can be evoked. Consequently, different categories of physiological responses are induced, which include changes in the activities of internal organs and tissues. The acupuncture point Sanyinjiao (SP6) has been used successfully to treat different human gastrointestinal conditions. The aim of this work was to investigate the effects of end-organ response induced by acupuncture point SP6 on the bioavailability of the radiopharmaceutical sodium pertechnetate (Na99mTcO4) in Wistar rats. Healthy rats were allocated into 2 groups, control-CG and treated-TG. TG was bilaterally stimulated at acupuncture point SP6 with stainless steel needles. Ocular plexus administration of Na99mTcO4 (3.7MBq) was carried out 10 min after every needle insertion in all animals. Ten minutes later, the animals were killed, the organs were isolated, the radioactivity was determined in a well gamma counter, and the percentage of injected dose per gram of tissue (%ID/g) was determined for each organ. The %ID/g was significantly altered (p < 0.05) in the small intestine of TG (0.56 +/- 0.09) when compared to CG (0.82 +/- 0.18). These results may suggest that this stimulation might induce physiological responses capable of altering the bioavailability of the radiopharmaceutical sodium pertechnetate. These findings aid in providing a better understanding of acupuncture and its effects on various organs and tissues.

Acupuntura na reabilitação da terceira idade / Acupuncture for rehabilitation of old people

O envelhecimento constitui num processo de mudanças progressivas que vai desde o declínio fisiológico gradual ao aumento de doenças que acomete o organismo paralelamente. Este processo é acompanhado por déficit funcional progressivo de vários sistemas orgânicos no qual inclui o sistema musculoesquelético (SME). O objetivo deste estudo é apresentar um método terapêutico combinado que associa a Acupuntura à Cinesioterapia simultaneamente durante a reabilitação, conhecida como Acupuntura Cinética (AC) (ou Cinesioacupuntura). Neste estudo foram incluídos 37 indivíduos acima de 65 anos, sendo 9 homens e 28 mulheres com faixa etária compreendida entre 65 anos a 90 anos. Os distúrbios musculoesqueléticos envolvidos foram 7 casos de cervicalgia, 5 de dorsalgia, 11 de lombalgia, 5 de gonalgia, 9 de ombralgia acometidos de osteoartroses, hérnias discais, contraturas crônicas. Os parâmetros de avaliação foram: Escala Visual Analógica (EVA) da intensidade da dor; Escala de Avaliação Numérica (EAN) em percentual de ganho da mobilidade funcional e de satisfação terapêutica em relação às atividades físicas. A média geral da melhora de intensidade da dor foi 11,43mm ± 15,40 (p < 0,001); o ganho da mobilidade funcional 75,16% ± 13,87 (p < 0,001), e a satisfação terapêutica 88,68% ± 18,33. Os resultados mostraram que a Acupuntura Cinética foi eficiente na reabilitação do idoso dando uma qualidade no seu movimento e a qualidade de vida. Isso estaria ser justificado devido a Acupuntura ter a capacidade de melhora da oxigenação, aumento do aporte sanguíneo e inibição o ciclo espasmo-dor. Quando a Acupuntura é associada simultaneamente a Cinesioterapia potencializa a higidez da estrutura anatômica e mecanismo do movimento.

Aging consists of a progressive changing process that leads to a gradual decline of physiological activities. Functional deficit of organic systems in which includes the musculoskeletal system (SME) are observed due to the aging. The aim of this study is to present a therapeutic approach that associates the Acupuncture to Kinesiotherapy, known as Kinetic-acupuncture (KA). KA is a multidisciplinary therapeutic approach offering the advantage of synchronizing two treatments simultaneously. Older patients (38) were included, 9 men and 29 women (age, from 65 up to 90 years). The involved musculoskeletal disorders were cervical pain (7 cases), upper back pain (5), low back pain (11) and knee pain, due to osteoarthritis, hernial disk and chronic contracture. Visual Analogue Scale (VAS) method for pain intensity and Numeric Rating Scale (NRS) for the improvement of functional mobility and for therapeutic satisfaction were used in the evaluations. The over all mean of the pain intensity improvement was 11.43 mm ± 15.40 (p < 0.001); the functional mobility improvement was 75.16% ± 13.87 (p < 0.001), and therapeutic satisfaction in relation to occupational activities was 88.68% ± 18.33. The results showed that the KA was efficient and suitable for elderly patients by giving them better functional mobility life quality. The KA could improve the SME disorders due to acupuncture has the capability to improve of the oxygenation, to increase the blood circulation and to inhibit the pain-spasm cycle. When Acupuncture is associated to Kinesiotherapy, simultaneously, it can improve the health of the anatomical structures and the mechanism of the movement.

The effect of "Zusanli" (ST. 36) acupuncture on the bio-availability of sodium pertechnetate in Wistar rats.

The effect of acupuncture stimulation at Zusanli point (ST.36) on the bioavailability of radio-pharmaceutical 99mTc-sodium pertechnetate (Na99mTcO4) in Wistar rats was investigated. Ten healthy rats were allocated into two groups of five. Group 1 (n=5) was treated by acupuncture by inserting stainless steel needles bilaterally at ST.36; Group 2 was the untreated control. Ocular plexus administration of 0.3ml of Na99mTcO4 (3.7MBq) was carried out 10 minutes after every needle insertion. The rats were killed 25 minutes later. The organs were isolated, the radioactivity determined in a well gamma counter, and the percentage of injected radio-pharmaceutical dose per gram of tissue (%ID/g) was assessed for each organ. The %ID/g varied significantly (p<0.05) between Group 1 and Group 2 in pancreas (0.91 +/- 0.17 vs 0.15 +/- 0.03), stomach (7.97 +/- 0.68 vs 3.51 +/- 0.22), spleen (0.97 +/- 0.11 vs 0.41 +/- 0.14), brain (0.19 +/- 0.09 vs 0.09 +/- 0.04), kidneys (0.91 +/- 0.17 vs 0.15 +/- 0.03), heart (0.81 +/- 0.17 vs 0.31 +/- 0.02) and testis (0.46 +/- 0.04 vs 0.14 +/- 0.03). These findings suggest that the effect of acupuncture at ST.36 modulated organs and tissues responses in rats. Using Chinese theories of Zang-Fu and Five Phases, we suggest that the relationship between acupoints and organs may be related to neuromodulation mechanisms such as somatovisceral reflex responses, which play an important role in the autonomic nervous system. These results also suggest that the effect of acupuncture on the bio-availability of radio-pharmaceuticals may help our understanding of the action of acupuncture points on various organs and tissues.

Tendinite do tendão de Aquiles tratado por eletroacupuntura associado a cinesioterapia / Achilles tendonitis treated by electroacupuncture associated to kinesiotherapy

Este trabalho foi baseado em um caso clínico de uma paciente do sexo feminino de 12 anos de idade e tenista profissional, a qual apresentava dor crônica e flogose na região distal do tendão calcâneo (tendinite do tendão de Aquiles - TTA) do lado esquerdo e com dificuldade de completar o ciclo da marcha. Estava com 28 dias sem treinar devido à dor. A paciente foi submetida ao tratamento combinado de eletroacupuntura (EAP) associado a cinesioterapia, segundo os princípios da Acupuntura Cinética (AC). Os parâmetros de avaliação foram: 1) a intensidade da dor por Escala Visual Analógica (Visual Analogue Scale - VAS); 2) a qualidade da marcha através da Análise da Marcha (AM). A paciente chegou ao atendimento sem apoiar o pé direito no chão devido ao intenso quadro álgico (VAS = 100) nas fases do toque do calcâneo e do apoio médio do pé que apresentava em pé esquerdo (VAS = 100 mm). Após a primeira sessão do tratamento de EAP com exercícios cinesioterápêuticos apresentou melhora da dor nas fases de toque do calcâneo (VAS = 20 mm) e apoio médio (VAS = 40 mm). Ao término de cinco sessões todos os movimentos já estavam completos e já não havia mais dor (VAS = 0). Este estudo sugere que a aplicação da EAP de acordo com os princípios da AC, pode ser um procedimento eficaz no combate da dor durante a reabilitação fisioterapêutica em atletas com TTA. Assim como, pode favorecer a recuperação precoce dos distúrbios agudos do sistema musculoesquelético sem comprometer a rotina de treinamento.

This work is based on a case report of a 12 years old female professional tennis player who presented a chronic pain and phlogosis at the distal region of the calcaneus tendon (Achilles Tendonitis – AT) with difficulty to complete the gait cycle. The patient was 28 days without training because of the pain. The patient underwent to a combined treatment of electroacupuncture (EAP) and kinesiotherapy, according to the principles of the Kinetic Acupuncture (KA). The evaluation assessments were: 1) the pain intensity by Visual Analogue Scale (VAS); and 2) the quality of the gait according to the Gait Analysis (GA). The patient showed up for the first presentation without any support of the right foot on the floor. Since there was an intense pain (VAS = 100) in the step of the touch of the calcaneous (TC) and in the step of the support around the middle of the foot (SAMF) of the left foot. After the first session of treatment, the patient showed pain improvement in the steps of TC (VAS = 20mm) and SAMF (VAS = 40mm). After five sessions of treatment, patient was totally free from pain (VAS = 0) and all movements of the left foot were completed. This study suggests that the use of the EAP can be an efficient procedure to relieve pain during the physical therapy rehabilitation under the principles of KA in athlete with AT. Although, it is suggested this therapeutic approach can favour precocious recuperation of the acute disorders of the musculoskeletal system without compromising the training routine.

Acupuntura cinetica como efeito potencializador dos elementos moduladores do movimento no tratamento de lesoes desportivas / Kinetic acupunture as ´potential effect of movement modulation elements in treatment of sport injuries

Este trabalho se baseia no estudo do tratamento de lesoes desportivas atraves da Acupuntura Cinetica, que é um metodo sistematico o qual associa a Acupuntura á Cinesioterapia durante a reabilitaçao do sistema musculo-esqueletico, potencializando os elementos moduladores do movimento, atraves da propriocepçao. Tal associaçao visa preparar a estrutura lesada para receber o estimulo fisioterapico, considerando que a Acupuntura é capaz de :inibir o ciclo espasmo-dor, melhorando as valencias fisicas e a performance do fuso muscular e tendinoso durante os movimentos. Alem disso, a Acupuntura promove sinergismo com a Cinesioterapia na recuperaçao do movimento, pois o estimulo acupuntural pode ser de açao prolongada atraves da manutençao da inserçao de agulhas pou sementes em postos especificos, durante o tratamento. Neste estudo, foram incluidos 31 casos de atletas de diversas modalidades(tenis, futebol, voleibol, ginastica olimpica, capoeira, balé e jiu-jitsu) portadores de disturbios locomotores, tais como: tendinite de tendao de Aquiles, lombalgia, dorsalgia, torcicolo, tenossinovite, Sindrome de Tunel do Carpo, Sindrome do Pronador, contusao muscular, Tennis elbow e gonalgia por lesao de minisco; sendo 13 homens e 18 mulheres, com faixa etaria compreendida entre 11 e 40 anos. Todos apresentavam dificuldade na realizaçao de atividade fisica por presença da dor, que prejudicavam o seu desempenho geral. Os parametros de avaliaçao dos resultados foram: Escala Visual Analogiva(EVA) da intensidade da dor(0-10 mm,sendo ) sem dor e 10 pior dor); Escala de Avaliaçao Numerica(EAN) de melhora clinica em relaço a dor(MCRD) (0-100 por cento, sendo 0 sem melhora e 100 por cento a melhora total; e o numero de sessoes (NS) que influenciam indiretamente a performance geral do atleta. A taxa media de reduçao da intensidade da dor calculada com dados da EVA...

Acupuntura cinetica: tratamento sistematico do aparelho locomotor e neuromuscular da face por acupuntura associada á cinesioterapia / Kinetic acupunture: Systematic therapy of face neuromuscular and locomotor system by acupunture associated to kinesitherapy

Este trabalho visa á apresentaçao do conceito Acupuntura Cinetica ou ( Cinesioacupuntura)como um metodo terapeutico que associa a aplicaçao da Acupuntura à Cinesioterapia duarante a reabilitaçao. È uma conduta multidisciplinar que tem, como vantagem, a aplicaçao sincronizada de dois procedimentos terapeuticos em uma só sessao, sendo dividida em tres fases respeitando o momento cinetico do paciente. A inserçao das agulhas é feita em pontos sistemicos, microssistemicos e locomotores(sejam eles loco-regionais, segmentares á distancia, ou somatotopicos)e tem como principios: a preparaçao pre-cinetica, adaptando a estrutura para o recebimento do estimulo fisioterapico pela inibiçao do ciclo espasmo-dor; a promoçao per-cinetica, promovendo com sinergismo a recuperaçao do movimento;e a manutençao pos-cinetica, mantendo o estimulo acupuntural de açao prolongada atravez de inserçao de agulhas ou sementes em pontos especificos que pode durar dias ou semanas; que visa a melhora do complexo musculo-esqueletico e neuromusculares da face mediante a debelaçao do quadro algico, do bloqueio fibrotico e a reintegraçao do sistema neuromotor. Foram tratados 305 pacientes portadores de disturbios locomotores sendo 122 homens e 183 mulheres, sendo a faixa etaria comprendida entre 7 a 80 anos. Os parametros de avaliaçao foram: dor, amplitude articular, tônus, marcha, coordenaçao motora e equilibrio. O percentual de melhora dos quadros ficou em torno de 50 a 100 por cento para um tempo de recuperaçao muito abaixo da media de um tratamento convencional de reabilitaçao. Foi observado que a acupuntura é um excelente recurso pre-cinetico na fisioterapia por apresentar quesitos favoraveis á inibiçao do ciclo espasmo-dor. Assim, a acupuntura potencializa a açao da cinesioterapia levando a uma reabilitaçao mais eficaz.