Effect of Muscle Energy Technique on Hamstring Flexibility: Systematic Review and Meta-Analysis.

Since 2005, there have been no systematic reviews on the effects of multiple manual therapies, including muscle energy technique (MET), on the hamstrings. Therefore, this systematic review aimed to provide clinical evidence for the effectiveness of the MET on hamstring flexibility. We queried 10 electronic databases (PubMed, EMBASE, The Cochrane Library, KISS, NDSL, KMBASE, KISTI, RISS, Dbpia, and OASIS) up to the end of March 2022. This study only included randomized controlled trials (RCTs) investigating the use of MET for the hamstring. The literature was organized using Endnote. Literature screening and data extraction were conducted by two researchers independently. The methodological quality of the included RCTs was evaluated using the Cochrane risk-of-bias tool 1.0, and the meta-analysis was performed using RevMan 5.4. In total, 949 patients from 19 RCTs were selected according to the inclusion criteria. During active knee extension tests, the efficacy between MET and other manipulations did not significantly differ. For sit and reach tests, MET groups had higher flexibility compared to stretching (MD = 1.69, 95% CI: 0.66 to 2.73, p = 0.001) and no treatment (MD = 2.02, 95% CI: 0.70 to 3.33, p = 0.003) groups. No significant differences were observed in the occurrence of adverse reactions. Overall, we found that MET is more efficacious for improving hamstring flexibility compared to stretching and having no treatment during sit and reach tests because it combines isometric contraction with stretching. Owing to clinical heterogeneity, uncertain risk of bias, and the small number of included studies, further high-quality studies should assess the effectiveness of MET.

Improving the quality of life in a breast cancer patient and caregiver: Protocol for the application of the integrative medical service model.

BACKGROUND: Patients with chronic diseases require ongoing treatment, and caregivers face financial burdens as well as psychological and physical difficulties. However, the current healthcare system does not provide adequate systems or services to address the difficulties that patients and caregivers face. PURPOSE: The purpose of this study was to conduct an observational case study in order to evaluate and improve the application of an integrative healthcare service model developed for distress management and improved quality of life in breast cancer (BC) patients and caregivers. METHOD: The integrative healthcare service model was intensively applied to a patient-caregiver pair in this observational study. This was followed by gathering feedback from participants and experts, as well as reflecting on the content of the feedback in order to improve the model further. RESULTS: This study will then modify and improve the program with feedback and provide integrative medical services to a BC patient and caregiver. CONCLUSION: This study used the BC patients' pain management and quality of life enhancement model, aiming to provide basic data for the establishment of a healthcare service system for patients suffering from chronic pain due to diseases such as BC by systematically integrating previously applied interventions into the current healthcare system and soliciting feedback from patients and caregivers.

The efficacy, effectiveness, and safety of Kyung-ok-ko: A narrative review.

Kyung-ok-ko (KOK), a traditional medicinal formula in East Asia, has been recently studied across various fields. However, comprehensive reviews of clinical applications of KOK targeting clinical and experimental studies are lacking. Therefore, the application of KOK is being limited to the range of tonic medicines. To overcome this limitation, we aim to investigate the effectiveness, mechanism, and safety of KOK to obtain evidence regarding its effects in clinical applications. We searched for clinical and experimental articles in 11 databases (PubMed, Cochrane Library, Excerpta Medica dataBASE, China National Knowledge Infrastructure, Google Scholar, Research Information Sharing Service, Oriental Medicine Advanced Searching Integrated System, Koreanstudies Information Service System, Korean Medical Database, DBpia, and ScienceON). We selected 54 studies based on the inclusion criteria. Three clinical studies used KOK for a consumptive disease and health promotion. Fifty-one experimental studies reported the antioxidant activity, neuroprotective activity, anticancer effect, anti-inflammatory activity, immunological activity, growth promotion, impacts on cardiovascular system diseases, gastrointestinal system diseases, respiratory system diseases, and metabolic bone disease, hepatoprotective function, and antifatigue function of KOK, which were considered effective and safe in consumptive, chronic, metabolic, inflammatory, and immune diseases. We identified the effectiveness of KOK in the treatment of a wide range of diseases. However, further clinical studies are warranted in the future.

An Observational Study Using Ultrasound to Assess Allowable Needle Insertion Range of Acupoint CV12.

BACKGROUND: Abdominal organ injuries are a rarely reported complication when deep acupuncture needling is applied to the abdomen. In order to ascertain the allowable needle insertion range (ANIR) of the abdomen region, we selected acupoint CV12, which is commonly used for treating gastric disease, and ANIR was measured with an ultrasound device. METHOD: Eighty-five healthy volunteers were recruited, of which 83 cases of ultrasound images were obtained. To investigate the prediction factor of ANIR, we also measured several anthropometric factors. RESULTS: The average ANIR was 25.3 ± 10.2; generally, the ANIRs of females were thicker than those of males; and the liver was observed in 62.7% subjects' ultrasound images. The non-observed group showed thicker ANIR and higher BMI than the liver-observed group. CONCLUSION: There are reliable variables that make it possible to predict the ANIR. It is advised to refer to anthropometric factors in needling acupoint CV12 to avoid complications with the acupuncture treatment. However, individual differences are not negligible when applying deep needling. Thus, if the risk is not judged before or during the procedure, practitioners could consider the patient's ANIR on CV12 when applying acupuncture by examining the individual anatomical structures using ultrasound and considering internal organ positions to prevent adverse events due to acupuncture.

Change of Safe Needling Depth at Acupoint GB21 according to Posture and Breathing.

Acupoint GB21 (Jianjing) is used for treating back and shoulder pain but is associated with a risk of pneumothorax. We aimed to determine the SND (safe needling depth) at GB21 according to posture and breathing in real time. Ultrasonographic images of GB21 during normal breathing, inspiration, and expiration in a SP (sitting position) were acquired for 52 healthy volunteers. Images were also acquired during normal respiration in the PP (prone position) with arms raised and lowered. The average SND was greater for men than for women (p < 0.05). Analysis of variance revealed that the SND was greater for the PP than for the SP (p = 0.01 and p < 0.05, resp.). Although the SND tended to change according to posture, the average depth tended to deviate widely in some subjects. During breathing, the differences between inspiration and expiration were less than 1 mm in most subjects, but some showed differences more than 4.5 mm. The SND at GB21 was greater in overweight subjects and significantly greater in the PP and during maximal expiration. However, intragroup differences were greater than the intergroup differences. Therefore, it is dangerous to simply apply needling depth on a gender or BMI basis. The practitioner would adjust the SND by examining the individual anatomical structures.

Development of an ultrasound-imaging procedure and acquisition of ultrasound images of acupuncture points for safety and accuracy of needle insertion.

BACKGROUND: Acupuncture is a relatively safe, commonly used "alternative" medical treatment for various symptoms. However, adverse effects can occur, including trauma, pneumothorax, and central-nervous-system injury. Our objective was to develop a reliable and practical procedure for ultrasound imaging of acupuncture points to improve safety during needling, and to acquire ultrasound images of several (44) acupuncture points, especially those in high-risk areas, according to an in-house standard operating procedure. METHODS: We created the standard operating procedure for ultrasound imaging for acupuncture, and collected ultrasound images of acupuncture points in clinical trials. RESULTS: Ultrasound images for 44 acupuncture points considered as high-risk points were collected from 85 healthy people who were classified by body-mass index, and high-quality, clear representative images of all 44 points were obtained. CONCLUSION: These baseline images could be helpful for understanding the anatomy under the skin at acupuncture points, which would allow for an enhanced safety and more accurate needling.