[Quantitative research on operation behavior of acupuncture manipulation].

OBJECTIVE: To explore a method of quantitative evaluation on operation behavior of acupuncture manipulation and further analyze behavior features of professional acupuncture manipulation. METHODS: According to acupuncture basic manipulations, Scales for Operation Behavior of Acupuncture Basic Manipulation was made and Delphi method was adopted to test its validity. Two independent estimators utilized this scale to assess operation behavior of acupuncture manipulate among 12 acupuncturists and 12 acupuncture-novices and calculate interrater reliability, also the differences of total score of operation behavior in the two groups as well as single-step score, including sterilization, needle insertion, needle manipulation and needle withdrawal, were compared. RESULTS: The validity of this scale was satisfied. The inter-rater reliability was 0. 768. The total score of operation behavior in acupuncturist group was significantly higher than that in the acupuncture-novice group (13.80 +/- 1.05 vs 11.03 +/- 2.14, P < 0.01). The scores of needle insertion and needle manipulation in the acupuncturist group were significantly higher than those in the acupuncture-novice group (4.28 +/- 0.91 vs 2.54 +/- 1.51, P < 0.01; 2.56 +/- 0.65 vs 1.88 +/- 0.88, P < 0.05); however, the scores of sterilization and needle withdrawal in the acupuncturist group were not different from those in the acupuncture-novice group. CONCLUSION: This scale is suitable for quantitative evaluation on operation behavior of acupuncture manipulation. The behavior features of professional acupuncture manipulation are mainly presented with needle insertion and needle manipulation which has superior difficulty, high coordination and accuracy.

[Research on action features of acupuncturist experts' acupuncture needle twirling skills].

OBJECTIVE: To observe the features of acupuncture needle twirling manipulations in order to promote the development of objective and quantitative performance standards of acupuncture manipulation. METHODS: Twelve expert acupuncturists and 12 novices were enrolled in this study. Everyone of them was instructed to perform 10 trials of the uniform reinforcing and reducing technique of acupuncture on an artificial skin-pad that was mounted to a six-axis force transducer and each subject had his or her dominant hand index finger affixed with an infrared light emitting diode for acquiring parameters of acupuncture needle manipulation. The force transducer was used to measure the force the participant applied as they held an acupuncture needle to stimulate the skin-pad, and at the mean time, an optoelectric camera was employed to measure the position of the diode. RESULTS: In comparison with the expert acupuncturist group, the straggling coefficient of needle-twirling frequency was significantly bigger in the novice group (P < 0.01), suggesting a higher consistency in the trial-by-trial needle-twirling operation of the expert acupuncturists. Comparison of the needle-twirling force showed that the force values of the Z-axis in both expert group and novice group were considerably higher than those of the X-axis and Y-axis in the same one group (P < 0.01). The time of pre-needle-twirling of the novice group was markedly longer than that of the expert group (P < 0.01), suggesting a skilled operation technique of the expert acupuncturists. No significant differences were found between the expert acupuncturist group and novice group in the needle-twirling amplitude, frequency, force and total operation time (P > 0.05). CONCLUSION: Movement frequency consistency and temporal efficiency are the action features of expert acupuncturists in performing the uniform reducing-reinforcing twirling skill, which differentiates the performances of experts from novices. The assessment and training of this acupuncture skill should focus on these kinematic features.

Perceptual motor features of expert acupuncture lifting-thrusting skills.

BACKGROUND: Little is known with regard to how acupuncture skills are optimally taught, learnt and evaluated despite clear evidence that technical skill acquisition is important to trainee success in health professions. OBJECTIVES: This study reports an investigation of the sensorimotor aspects of the acupuncture lifting-thrusting skill in order to highlight the important kinematic and kinetic features of the action. The study also explores the role of perceptual acuity in accurate acupuncture performance. METHODS: Twelve novice and 12 expert acupuncturists watched a standardised video demonstrating the mild reinforcing and reducing technique of lifting-thrusting on an acupuncture point and then performed 10 trials of the technique on an artificial skin pad mounted on a six-axis force transducer with an infrared light-emitting diode affixed to the index finger of their dominant hand. The force transducer measured the force applied by participants as they needled the acupuncture point while an optoelectric camera measured the position of the diode. Subsequently, the participants engaged in two tests of general perceptual acuity. RESULTS: Repeated measures analyses of variance indicated that experts are more consistent in their trial-by-trial amplitude (p=0.03) and lifting-thrusting velocity (p=0.029) than novices. Measures of perceptual acuity revealed no differences between novices and experts. CONCLUSIONS: Movement amplitude and velocity consistency are the action features of the mild reinforcing and reducing lifting-thrusting skill that differentiate the performances of experts from novices. The acquisition of acupuncture expertise is a function of extended practice rather than any inherent perceptual ability.