ACUPUNCTURE IN MANUAL THERAPY PDF
COMBINATION OF MANUAL THERAPY AND ACUPUNCTURE FOR PAIN MANAGEMENT OF PATIENTS WITH KNEE OSTEOARTHRITIS. Acupuncture in Manual Therapy is a comprehensive overview of manual therapy interventions combined with acupuncture management of musculoskeletal. Two acupuncture points were selected by the manual technique, together Keywords: Acupuncture, Amitriptyline, Earache, Therapy with acupuncture, Touch.
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This retrospective study investigated the effects of combining manual therapy and acupuncture on the pain and maximal mouth opening (MMO), which were. value of acupuncture and electroacupuncture as a treatment for 1Department of Physical Therapy, Communication Science & Disorders. International Association of Acupuncture of Physical Therapists (IAAPT). Standards of media/cms/File/resourceone.info>; [Accessed 1 Jul ]. Brady S.
However, dry needling not based on traditional Chinese medicine TCM theory was excluded. Acupoint injections, laser acupuncture, moxibustion, cupping, herbal medicine, and any combination of the above were excluded. In addition, studies that compared different acupuncture therapies were also excluded.
Types of control groups: Sham acupuncture or conventional pharmacological therapies will be included.
Conventional pharmacological therapies do not contain herbal medicine. Types of outcome measures: The primary outcome measures include a change in pain intensity and quality of life. Quality of life was evaluated using the fibromyalgia impact questionnaire FIQ. The secondary outcome was an adverse event of acupuncture therapy to assess acupuncture safety. Study selection and data extraction According to the search strategy, one author XCZ performed the searches. Two investigators XCZ and HC reviewed the titles and abstracts of the references and screened eligible studies according to inclusion and exclusion criteria.
Then, we downloaded the full text of the eligible studies to determine the final selection. The information extracted included study design, patient characteristics, sample size, diagnostic criteria, interventions, treatment sessions, clinical outcome results, follow-up period, and adverse events. If there were any unclear or missed data, we attempted to contact authors for the details by phone or email. If we could not obtain access to the data by contacting the authors, then we would exclude the studies.
Any disagreements were resolved by rechecking the primary papers and further consultation with the third author WTX. This tool contains seven items of ROB: random sequence generation selection bias , allocation concealment selection bias , blinding of participants and personnel performance bias , blinding of outcome assessment detection bias , incomplete outcome data attrition bias , selective reporting reporting bias , and other bias.
Discrepancies were resolved by further discussion with the third author WTX. Statistical analyses The meta-analysis was performed using RevMan 5. Considering the clinical heterogeneity of different acupuncture therapies, we performed subgroup analysis based on EA and manual acupuncture MA. Statistical heterogeneity between studies was quantified by the I2 statistic.
Publication bias was estimated by funnel plot analysis if sufficient studies were included.
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Results Study selection A total of studies were identified from all the initial searches; studies were retained after screening and removing duplications, and studies were excluded according to the title and abstract.
Then, 48 full-text studies were further assessed for eligibility. Of these, 36 studies were excluded because of not RCTs, inappropriate intervention, data duplication, or data unusable Table S1. Finally, 12 RCTs 14 , 18 — 20 , 26 — 33 were eligible and included in the systematic review. The flow chart of the study selection process is shown in Figure 1.
Figure 1 Review flow diagram. Description of the included studies In 12 studies, all FM patients were diagnosed by the American College of Rheumatology criteria.
The sample size ranged from 20 to participants. Nine articles were published in English, 14 , 18 — 20 , 27 , 29 , 30 , 32 , 33 two in Chinese, 28 , 31 and one in Portuguese. Risk of bias within studies Most of the studies were rated as low ROB, except for four studies. Nine studies performed blinding of participants and outcome assessment. Figure 2 Risk of bias summary.
Effects of interventions Real acupuncture vs sham acupuncture Pain changes after treatment The data regarding pain changes were reported in all studies.
The quality of evidence was downgraded because of inconsistency and evaluated as moderate Table 2.
Figure 3 Forest plot comparing real acupuncture vs sham acupuncture. C Outcome: FIQ changes after treatment.
D Outcome: long-term effect of pain changes VAS, 0—10 cm scale. E Outcome: long-term effect of FIQ changes. The quality of evidence was evaluated as low downgraded because of imprecision and publication bias, Table 2 Quality of life: FIQ changes after treatment Four studies evaluated quality of life by using the FIQ score. The quality of evidence was evaluated as low downgraded because of inconsistency and imprecision, Table 2.
Long-term effect of acupuncture There were three studies that followed-up long-term more than three months after treatment to assess the effect of acupuncture, and the data can be obtained.
Eligible patients who signed informed consent provided initial demographic data and were scheduled for 12 combined EPT and acupuncture sessions. At the initial treatment visit the patient underwent EPT therapy and was randomized and administered either real needle acupuncture or non-penetrating needle acupuncture.
The same treatment was given during this and all subsequent EPT visits targeting 12 combined treatments. Inclusion criteria required that patients be age 40 years or older to focus on classic knee OA. Between the enrollment and first treatment visit, the degree of knee OA was radiologically confirmed as Kellgren—Lawrence score 2 or 3[ 17 ], in 1 or both knees on a radiograph obtained within the last year or on an X-ray performed as part of the study.
Patients were excluded if they had other diseases known to affect the knee including gout, rheumatoid arthritis and significant trauma; neurologic, cardiac or psychiatric disease that would interfere with a standard EPT program; pregnancy; significant coagulopathy or taking anti-coagulants that would interfere with the safe administration of acupuncture; or previous acupuncture treatment within the last 12 months.
Resistance was increased as appropriate beginning with a minute program of aerobic activity progressing as tolerated to a goal of 20—30 minutes over the course of therapy. Acupuncture protocol In keeping with the STRICTA checklist [ 18 ], acupuncture sessions with the puncturing and non-puncturing needles were administered following every EPT session once or twice a week by fully trained and licensed acupuncturists, without electrical stimulation or co-intervention.
Nine acupuncture points for each knee were chosen to be consistent with the traditional Chinese Bi syndrome therapy for knee pain and to be consistent with a previously positive acupuncture study[ 19 ].
The same points were used for each affected leg.
The insertion depth for standard needles was between 0. The needles were left in place for 20 minutes, with a brief manipulation at the beginning and end of the treatment. The de qi sensation, a local sensation of achy, distension, and tingling[ 20 ], was not required and not specifically recorded. Non-penetrating acupuncture The Streitberger non-penetrating needle was used in the control group. The needle appears identical to the real needle except that it is blunt and retracts into the handle when it is pressed against the skin, giving the appearance, and sensation of needle insertion[ 21 ].
Both real and non-puncturing needles were placed at exactly the same acupuncture points and held in place by being inserted through a single-layer gauze-retaining mechanism held on by a small doughnut-shaped bandage. Acupuncturists were instructed to not to attempt to stimulate with the Streitberger needle and did not ask about the achievement of de qi to minimize the interaction between the acupuncturist and the patient.
Lane once the research was completed, and the call for research participants did provide a form of free advertising for Dr. Abstract Despite the rise in popularity of both acupuncture and manual therapy in veterinary medicine, and the increasing number of Canadian veterinarians practising these techniques, there is little research demonstrating their effectiveness.
In this repeated measures, therapeutic trial, 47 client-owned dogs with naturally occurring lameness were assessed for clinical response to treatment. Mood and attitude also improved, but did not attain statistical significance.
The recently established specialty of veterinary sports medicine and rehabilitation routinely employs both these techniques to address musculoskeletal disorders.
There are veterinarians who perform manual therapy concurrently with acupuncture as part of their regular practice when treating musculoskeletal pain.
Many, including the primary author of this paper, do so because they believe that the combination of these 2 modalities yields better results than they see with either therapy alone. Despite this rise in popularity and common acceptance of these techniques, the effectiveness of acupuncture in addressing musculoskeletal pain in dogs has only been superficially examined 1 — 6. The authors could find no research publications regarding the effectiveness of manual therapy in dogs, and only few papers examining the effectiveness of combined acupuncture and manual therapy CAMT , all of which were from human medicine 7 — It can be divided into the broad categories of manipulations, mobilizations, and stretching or massage.Therefore, this review concluded that acupuncture cannot be recommended for the management of FM.
Butterworth-Heinemann, Acupuncture protocol In keeping with the STRICTA checklist [ 18 ], acupuncture sessions with the puncturing and non-puncturing needles were administered following every EPT session once or twice a week by fully trained and licensed acupuncturists, without electrical stimulation or co-intervention. Conventional pharmacological therapies do not contain herbal medicine.
Nichols HW. Figure 1 Review flow diagram. Increased trapezius pain sensitivity is not associated with increased tissue hardness. This latter technique is known as myofascial trigger point dry needling or intramuscular stimulation