Medical Acupuncture

Chronic nonspecific low back pain (cNLBP) can be effectively treated by electroacupuncture (EA) at traditional acupoints (TAPs) and myofascial trigger points (MTrPs). However, the optimal type and frequency of stimulation (alternated frequency [AF] and high frequency [HF]) remain unclear. This study aimed to explore this.

A double-blinded randomized controlled trial was conducted with four treatment groups: EA using AF at MTrPs (MTP-AF group), HF at MTrPs (MTP-HF group), AF at TAPs (TAP-AF group), and HF at TAPs (TAP-HF), each with 40 middle-aged cNLBP patients. The AF was 2/100 Hz and HF was 100 Hz. Pain-visual analog scale (pain-VAS), paracetamol requirement, Oswestry disability index (ODI) score, global improvement, and adverse effects (AEs) were monitored.

After 4 weeks, groups of EA targeting MTrPs and TAPs with the same frequency showed no significant differences. Groups using AF demonstrated significantly superior pain-VAS and ODI percentage score reductions compared with HF groups, extending at least 4 weeks post-EA. All groups showed consistent results in paracetamol use, global improvement, and safety. Subgroup analysis indicated that EA with AF at MTrPs provided better results in patients aged ≥60–65 years.

EA at MTrPs and TAPs demonstrated similar effects on cNLBP. However, an AF proves more effective than an HF, potentially maintaining this trend in the short term. Older patients may respond better to EA at MTrPs with AF. Future studies may explore combined MTrPs and TAPs for cNBLP treatment with a broader age range and more diverse demographic groups.

Lay midwives attend most births at home in Guatemala facing many challenges with limited resources. Current research demonstrates that acupressure can reduce preterm contractions and encourage post-term labor. Sharing acupressure techniques with lay midwives could improve birth outcomes in Guatemala. The purpose of this study was to deliver an educational session for lay midwives to assess their learning and satisfaction with acupressure, and its feasibility and usefulness in their work.

Two acupressure protocols were designed based on the clinical expertise of University of Utah College of Nursing faculty and extant literature. Demographic data and a pretest were conducted, followed by a focus group and various educational activities. A post-test was administered, and participants were given Spanish-language, laminated Reminder Cards with acupressure point illustrations to reinforce knowledge retention as the group had a low literacy rate. This study was IRB approved.

Eleven lay midwives participated (all female, average age 52 with an average of 21 years of lay midwifery experience). Lay midwives lacked knowledge about acupressure before the educational session and were eager to learn. Afterward, most participants recalled six points to discourage preterm labor and six points to encourage post-term labor on a post-test, and expressed an intent to use their new acupressure knowledge with patients.

This sample of lay midwives eagerly embraced new acupressure information and demonstrated increased knowledge after this educational intervention. Next steps would be to continue to expand lay midwife knowledge and skills in response to their request for acupressure interventions for retained placenta.

Spasticity is a common complication in patients with multiple sclerosis (pwMS). The present study aimed to evaluate the clinical, biomechanical, and functional effects of dry needling (DN) in treating gastrocnemius muscle spasticity in pwMS.

A pilot single-blinded randomized controlled trial was carried out. Eleven patients were randomly allocated to the DN group, and 10 to the waiting list control group. A single session of DN for 2 minutes was performed for the gastrocnemius muscle. Primary outcome measures were the modified Modified Ashworth Scale (MMAS), the passive resistive torque (PRT), and the foot pressure distribution of podography. The secondary outcome measures were the active and passive ankle dorsiflexion range of motion (ROM) and timed up-and-go (TUG) test. Outcomes were measured at baseline, immediately after the intervention, and at one-week follow-up.

Twenty-one pwMS with a mean age of 39.52 ± 7.24 years and MS duration of 166.86 ± 5.66 months participated in the study. There were no significant changes in all outcomes for pwMS in the control group. In the DN group, the median gastrocnemius MMAS spasticity significantly decreased after the intervention, and the improvement remained at 1-week follow-up (median decrease from “3” to “2”, p = 0.004). The analysis of covariance between-group analysis showed that the PRT (effect size = 0.65) and ankle active (effect size = 0.62) and passive ROM (effect size = 0.8) improved significantly after DN. There were no significant improvements in contact area, but small effect sizes were observed for the maximum plantar force (0.28) and maximum peak pressure at follow-up. The effect size for the TUG test was moderate (0.49).

These findings show that a single session of DN applied for 2 min was effective in improving gastrocnemius spasticity, PRT, active and passive ankle ROM, and dynamic balance, but walking did not improve meaningfully.

This study investigated the effects of electroacupuncture (EA) on muscle hardness changes induced by exercise, using ultrasound real-time tissue elastography (RTE).

Healthy men were included in 2 experiments. Experiment 1 had 11, and Experiment 2 had 10. In Experiment 1, after resting in a prone position for 5 minutes, RTE of the gastrocnemius muscle was measured and subjective muscle fatigue was evaluated with a visual analogue scale (VAS). After RTE and VAS measurements, calf raises were performed, and measurements were made 15 and 30 minutes later. In Experiment 2, after measuring RTE and VAS after calf raises, EA was applied to BL-56 and BL-57 of the gastrocnemius muscle for 15 minutes, and measurements were made right after EA and 15 minutes later.

Experiment 1: Strain ratio (SR) increased significantly right after exercise, compared to no significant difference after 15 and 30 minutes. Experiment 2: SR was significantly lower after EA than right after exercise and stayed lower after 15 minutes of EA.

EA to the gastrocnemius muscle may promote recovery of gastrocnemius muscle hardness induced by calf-raise exercise.

Stiff person syndrome (SPS) is a rare neurological disorder. Treatments are limited, and non-pharmacologic therapies are recommended based on symptomatology. A G2P2002 post-menopausal 60-year-old female with hypertension, obesity, and type II diabetes, and SPS secondary to a paraneoplastic process cause by endometrioid ovarian adenocarcinoma who presented to acupuncture clinic seeking treatment for SPS and its sequela. Her main complaints upon presentation included muscles spasticity causing low back pain, hip flexor pain, insomnia and chemotherapy induced peripheral neuropathy. Her mood and quality of life were also noted to be poor at presentation.

A case report of implementation and customization of acupuncture treatment protocol for the sequelae of SPS including painful spasticity, insomnia, and reduced quality of life is discussed. Outcomes included measures of stiffness (degree of stiffness, distribution of stiffness, heightened sensitivity score) at each visit and health-related quality of life 14 item index at baseline. These outcomes were measured at the initiation of the acupuncture intervention (baseline) and after 9 weeks of weekly acupuncture treatments. These treatments included body acupuncture, electro acupuncture and auricular acupuncture. Acupuncture was performed in addition to her ongoing IVIG therapy.

Forward bending increased with maximal benefit observed by treatment 3. Lateral bending showed significant improvement with maximal effect by treatment 4. Timed activity testing (walk and stair climb) initially did not improve but showed a significant and sustained improvement following acupuncture protocol change following week 5. The self-rated quality of life outcome measure of overall health was unchanged (“good” at baseline and at follow-up), but all other quality of life outcome measures showed improvements.

SPS is a rare disorder causing substantial impairment for patients affected. The evidence supporting the use of acupuncture specifically for SPS is at most limited, however, the evidence supports the use of acupuncture for many of the symptoms experienced by those with SPS. This case illustrates how acupuncture can be considered as an adjunct therapy to improve the quality of life and function of these patients. More studies are needed to further investigate and optimize acupuncture treatment protocols for this rare disease.