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Effects of Acupuncture Stimulation on Recovery Ability of Male Elite Basketball Athletes

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Effects of Acupuncture Stimulation on Recovery Ability of Male Elite Basketball Athletes

Abstract

Developing effective methods for helping athletes recover from muscle fatigue is deemed essential, particularly on the eves' important competitions. This study aimed to investigate the effects of acupuncture stimulation on athletes' recovery abilities. Subjects were selected from 30 male elite university basketball players who were randomly assigned to 3 groups: acupuncture group, sham group, and normal (control) group, each containing 10 subjects. Acupuncture was carried out on each athlete in acupuncture group at the Neiguan (PC6) and Zusanli (ST36) acupoints, beginning at 15 min prior to exercise and continuing until exhaustion of the subject. Similar acupuncture was also carried out on each athlete in the sham group but the positions were 1 cm away from the PC6 and ST36 acupoints. No acupuncture was conducted on the athletes in the normal group. During the experiments, each subject performed separate runs on the treadmill. The data of heart rate (HR(max)), oxygen consumption (VO(2max)), and blood lactic acid were measured during the rest period and at 3 recovery points of time (5th, 30th and 60th min) post-exercise. The results showed that the acupuncture group (PC6 and ST36) has significantly lower HR(max), VO(2max) and blood lactic acid than both the sham and normal groups at the 30th min post-exercise. Blood lactic acid of the acupuncture group was also significantly lower than that of the other two groups in the 60th min post-exercise. Our findings have shed some light on the development of effective acupuncture schemes to enhance the recovery ability for elite basketball athletes.
May 15, 2009 10:52 WSPC WS-AJCM SPI-J000 00698
The American Journal of Chinese Medicine, Vol. 37, No. 3, 471–481
© 2009 World Scientific Publishing Company
Institute for Advanced Research in Asian Science and Medicine
Effects of Acupuncture Stimulation
on Recovery Ability of Male
Elite Basketball Athletes
Zen-Pin Lin,,Lawrence W. Lan,Tsung-Ying He,§Shi-Pin Lin,Jang-Geng Lin,//
Tsong-Rong Jang†† and Tsung-Jung Ho,∗∗
Department of Holistic Wellness
Department of Global Marketing and Logistics, MingDao University, Taiwan
College of Acupuncture, Moxibustion and Tuina
Nanjing University of Chinese Medicine, China
§
Institute of Medical and Molecular Toxicology, Chung Shan Medical University, Taiwan
Chinese Medicine Department, China Medical University Beigang Hospital, Taiwan
//
Graduate Institute of Acupuncture Science
∗∗
School of Chinese Medicine, College of Chinese Medicine
China Medical University, Taichung, Taiwan
††Athletics Department and Graduate School
National Taiwan Sport University, Taichung, Taiwan
Abstract: Developing effective methods for helping athletes recover from muscle fatigue
is deemed essential, particularly on the eves’ important competitions. This study aimed to
investigate the effects of acupuncture stimulation on athletes’ recovery abilities. Subjects
were selected from 30 male elite university basketball players who were randomly assigned
to 3 groups: acupuncture group, sham group, and normal (control) group, each containing 10
subjects. Acupuncture was carried out on each athlete in acupuncture group at the Neiguan
(PC6) and Zusanli (ST36) acupoints, beginning at 15 min prior to exercise and continuing
until exhaustion of the subject. Similar acupuncture was also carried out on each athlete in
the sham group but the positions were 1 cm away from the PC6 and ST36 acupoints. No
acupuncture was conducted on the athletes in the normal group. During the experiments, each
subject performed separate runs on the treadmill. The data of heart rate (HRmax), oxygen
consumption (VO2max), and blood lactic acid were measured during the rest period and at 3
recovery points of time (5th, 30th and 60th min) post-exercise. The results showed that the
acupuncture group (PC6 and ST36) has significantly lower HRmax,VO
2max and blood lactic
Correspondence to: Dr. Tsung-Jung Ho, School of Chinese Medicine, College of Chinese Medicine, China
Medical University, 91 Hsueh-Shih Road, Taichung 404, Taiwan. Tel: (+886) 4-2205-3366 (ext. 3120), Fax: (+886)
4-2201-3703, E-mail: tjho@mail.cmu.edu.tw
The last three authors contributed equally to this work.
471
May 15, 2009 10:52 WSPC WS-AJCM SPI-J000 00698
472 Z.-P. LIN et al.
acid than both the sham and normal groups at the 30th min post-exercise. Blood lactic acid
of the acupuncture group was also significantly lower than that of the other two groups in the
60th min post-exercise. Our findings have shed some light on the development of effective
acupuncture schemes to enhance the recovery ability for elite basketball athletes.
Keywords: Acupuncture; Basketball; Heart Rate; VO2max; Blood Lactic Acid; Neiguan (PC6);
Zusanli (ST36).
Introduction
In the athletic world, many nations have long strived for developing competitive advantages
in sports by employing various scientific methods to improve the athletes’ peak perfor-
mance in hope of winning competitions. Developing effective methods to help the athletes
quickly recover from muscle fatigue after exercise training or fierce competitions and to
help them achieve the best physiological situations is deemed essential, especially prior to
international competitions. Acupuncture, one of the traditional Chinese medicine (TCM)
techniques, has long been used in clinic to treat illnesses or release pains for thousands
of years; it was also known to help in recovering from muscle fatigue after exercise. For
instance, the World Health Organization (WTO) has acknowledged that acupuncture can
treat more than 50 illnesses (Lin et al., 1996). Liang et al. (2003) found that acupuncture can
enhance the rate of recovery in terms of both subjective feeling (rate of perceived exertion
and self-report emotional state) and objective evidence (isokinetic muscle power output).
Itoh et al. (2008) reported that acupuncture can reduce inflammation and decrease pain in
delayed onset muscle soreness (DOMS). Moreover, Knardahl et al. (1998) demonstrated
that electroacupuncture (applying electric stimulation on the needles during acupuncture)
can increase pain threshold. Ulett et al. (1998) also showed that electroacupuncture appears
to be more effectivethan manual acupuncture in producing analgesic effects. Recently, tran-
scutaneous electrical acupoint stimulation (TEAS) has been used to treat various clinical
conditions and the reports indicated that TEAS appears to be effective in reducing post-
operative nausea and vomiting (Coloma et al., 2002; White et al., 2002; 2005). On the other
hand, Qu et al. (1993) found that acupuncture treatment to a fatigued muscle immediately
after 3 hours of continuous contraction can result in a 5% improvement in muscle tension
output. Lin et al. (1995) demonstrated that ear acupressure is effective in increasing oxygen
uptake and lowering lactic acid following exercise. Wang et al. (1999) also reported that
acupuncture can enhance the recovery of muscle force capacity after exercise.
From the scientific perspective, athletic ability can be a combination of various elements,
including muscular strength, speed, power, muscular and cardiopulmonary endurance, flex-
ibility, agility, and balance and coordination, among others. Cardiopulmonary endurance is
perhaps the most essential element for all types of sports. VO2max is a fundamental indica-
tor for measuring the cardiovascular endurance. The level of VO2max is one of the critical
elements for succeeding in endurance sports because an upper limit of oxygen consumption
does exist for each person. In choosing the athletes, however, each element of the proceed-
ing developments of competitive exercise is closely related and is as equally important as
May 15, 2009 10:52 WSPC WS-AJCM SPI-J000 00698
EFFECTS OF ACUPUNCTURE ON RECOVERY ABILITY OF MALE ATHLETES 473
any other element. Thus, researchers of physical science tried to find out all kinds of bio-
characteristics of athletes in distinct ways to reach the most effective training. During the
normal exercise training, it is important to properly adjust the quantity of exercise, according
to the regularity of dynamic changes in athletes, to prevent them from excessive exercise train-
ing or unbearable load. Prior to competitions, however, designing effective methods to help
the athletes achieve the best situation so as to outperform others is immediately necessary.
Since muscle fatigue was reported to closely relate to human performance (Bigland-Ritchie
and Woods, 1984; So et al., 2007) and acupuncture has been regarded as an effective method
to improve the rate of muscle recovery after exercise (Ehrlich and Haber, 1992; Qu et al.,
1993; Lin et al., 1995; Wang et al., 1999),this study aimed to conduct scientific experiments
on selected athletes to investigate in-depth the effects of acupuncturestimulation on recovery
abilities.
Methods
Participants
Thirty elite basketball athletes (all male, aged =21.1±0.6 years, height =182.3±2.1cm,
and weight =82.1±4.0 kg) from the University of Physical Education in Taiwan were
selected to participate in this study (Table 1). These athletes were randomly divided into 3
groups: acupuncture group (n =10), sham group (n =10), and normal group (n =10).
Procedure
In the first phase, all subjects were to conduct the experiment without laboratory control. In
the second phase, subjects were randomly divided into 3 groups: acupuncture group (AG),
sham group (SG), and normal group (NG), each group containing 10 athletes. Acupuncture
was carried out for each athlete in the AG at the PC6 and ST36 acupoints beginning 15 min
prior to exercise and continuing until exhaustion, which was determined by the subject.
Similar acupuncture was also carried out on each athlete in the SG, but the positions were
1 cm away from the PC6 and ST36 acupoints. No acupuncture was conducted on the NG
athletes.
The following equipment and instruments were used: (1) SENSOR MEDICS Vmax29
Gas Meter; (2) YSI2300 PLUS Lactate Analyzer; (3) 586 PIII Computer and Laser Printer;
(4) POLAR Mobile Heart Rate Recorder; (5) Stopwatch; (6) Hygrometer. Each subject was
required to wear a mask and a breathing collector. All participants warmed up their muscles
Table 1. The Basic Characteristics of Study Subjects
Height (cm) Weight (kg) Age (Year) Training Duration (Year)
Mean ±SD Mean ±SD Mean ±SD Mean ±SD
182.3±2.182.1±4.021.1±0.67.5±0.8
(n =30).
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474 Z.-P. LIN et al.
on the bicycle till the RQ indicator reached 0.70.8 on the Vmax29c before the experiment
took place. There was a time lag of 24 hours between the pre-experiment and post-experiment
graded exercise tests so as to wash out time to reduce the cross-over effects. It potentially
provided better comparisonof the effects of stimulation. During the experiment, each subject
rode the bicycle until completely exhausted. Initially, the speed was set 60 RPM with power
120 W and it was increased by 30 W every 2 min.
The investigation was mainly on the variations during the rest period and the 3 recovery
periods (5th, 30th and 60th min post-exercise). Wireless heart recorder (POLAR), Vmax29
gas analyzer, and YSI2300 lactic acid analyzer were to analyze the heart rate, oxygen con-
sumption, and blood lactic acid, respectively. In addition, we drew their blood and measured
their serum biochemistry data in resting state, 5th, 30th, and 60th min post-exercise, and
then observed the differences. All the serum biochemical data for each subject, including
heart rate, oxygen consumption, and blood lactate acid were measured on each stage.
Data Analysis
SPSS 12.0 for Windows was used for the data analyses. First, a descriptive analysis on the
age, height and weight of the participants was conducted. Then the one-way ANOVA and
repeated Schfee’ way methods were used to test the differences of VO2max,HR
max,and
blood lactic acid among different groups, prior to and after the exercise at 3 different points
of time. The level of statistical significance was set at p <0.05.
Results
The one-way ANOVA and r epeated Schfee’ way test results showed that the HRmax,VO
2max,
and blood lactic acid in the AG athletes were significantly lower than those of the SG and
NG athletes in the 30th min post-exercise (Table 2). Blood lactic acid in AG was also found
significantly lower than those in the other 2 groups in the 60th min post-exercise. However,
there is no significant difference of HRmax,VO
2max, and blood lactic acid between SG and NG
athletes in the 5th, 30th, and 60th min post-exercise. These results indicated that acupuncture
at Neiguan (PC6) and Zusanli (ST36) could significantly stimulate the post-exercise recovery
of heart rate, oxygen consumption, and blood lactic acid for the elite basketball athletes. Our
findings indicate that it is beneficial to carry out acupuncture at PC6 and ST36 acupoints,
particularly on the eves of competitions, as to enhance the recovery ability for elite basketball
athletes. This study has made an inspiring attempt to understand in-depth of the recovery
system and physiological profile of basketball athletes by acupuncture. It would facilitate
the coaches to provide more appropriate training schemes and recovery plans for the elite
basketball athletes.
Discussion
The following factors have been considered to influence the effectiveness of acupuncture:
acupoint selection, matching compatibility, timing of acupuncture, skill of supplement of
the insufficiency of acupuncture, depth of acupuncture needling, and length of time and
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EFFECTS OF ACUPUNCTURE ON RECOVERY ABILITY OF MALE ATHLETES 475
Table 2. A Comparison of Cardiopulmonary Endurance Among Acupuncture Group (AG), Sham Group
(SG) and Normal Group (NG)
Variables Acupuncture Group (AG) Sham Group (SG) Normal Group (NG)
Mean ±SD Mean ±SD Mean ±SD
HR (bpm)
Rest 68.3±1.31 69.4±1.77 68.3±1.05
P5 118.9±2.84 119.0±2.40 117.8±1.39
P30 80.0±1.24a82.3±1.25 83.4±1.89
P60 75.2±2.69 75.6±1.64 75.8±1.68
VO2max (ml/kg/min)
Rest 4.4±0.54.3±0.10 4.3±1.6
P5 23.4±1.31 23.7±1.15 22.8±1.31
P30 7.37 ±0.35a7.86 ±0.45 7.9±0.39
P60 4.19 ±0.01 4.23 ±0.15 4.29 ±0.14
Blood lactic acid (mmol/l)
Rest 0.83 ±0.01 0.82 ±0.01 0.8±0.01
P5 8.65 ±0.17 8.45 ±0.10 8.54 ±0.28
P30 3.89 ±0.29a4.78 ±0.16 4.74 ±0.12
P60 1.20 ±0.11a1.62 ±0.11 1.67 ±0.14
aStatistically significant (p <0.05) when compared with SG and NG.
connection between non-acupoints and acupoints, among others (Chen et al., 1990; Ernst
et al., 2007). This is the reason acupuncture deserves further exploration today despite that
its use in clinical treatment for thousands of years. In our recent work, we have attempted
to control a similar experimental condition, yet we were still unable to avoid the influences
of some of the factors mentioned above. We found that acupuncture is effective in lowering
the resting heart rate and carbon dioxide production and that there is a significant differ-
ence between the acupuncture group and the control group (Lin et al., 1996). Following
nonparametric testing, Hübscher et al. (2008) observed that there were no significant differ-
ences between various groups in outcome measures at baseline and after 72 hours, however
pain perception (VAS) was significantly lower in the acupuncture subjects than in the sham
acupuncture and control subjects. Although acupuncture seemed to have no effects on the
mechanical pain threshold or muscle function, it has been proven to reduce perceived pain
raised from exercise-induced muscle soreness. Similarly, Itoh et al. (2008) also found that
there were significant differences in visual analog scores for pain between the control group
and tender point group immediately after treatment and 3 days after exercise (p <0.05,
Dunnetts multiple test) and that tender point acupuncture relieves muscle pain of DOMS.
A few studies have discussed acupuncture for VO2max changes in the national elite bas-
ketball athletes. Bentley et al. (2001) found that the determination of physiological variables,
such as the anaerobic threshold (AT), maximal oxygen uptake (VO2max)through incremen-
tal exercise testing, and relevance of these variables to endurance performance, is a major
requirement for coaches and athletes. Many medical institutions recognized the importance
of this traditional method and were devoted to research on acupuncture theory and clinical
experimentation (Lin et al., 1996). Niu et al. (2000) investigated that when acupuncture
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476 Z.-P. LIN et al.
was applied on the superficial personal nerve after strenuous running exercise, blood lactate
removal rate was significantly faster than that of the control group. Xiang et al. (1998) demon-
strated an increase in the rate of lactate removal. Richardson and Vincent (1986) found that
there is good evidence from controlled studies on the short-term effectiveness of acupunc-
ture in relieving clinical pain in each of the areas they reviewed. This pain control effect of
acupuncture might also contribute to the enhanced recovery rate after strenuous exercise.
Koo et al. (2002) demonstrated that an analgesic effect could be induced by electroacupunc-
ture points located at a remote site on the body in a stimulus point-specific manner. The
suggestion that pain relief or analgesic effect will mediate the adverse feeling after strenu-
ous exercise is echoed by Craig et al. (1999) who indicated that acupuncture therapy might
represent a beneficial treatment for the reduction of the muscle damage and soreness asso-
ciated with intense exercise. Such phenomenon is also in line with the models proposed by
Noakes et al. (2005) and St Clair Gibson et al. (2006).
Acupuncture stimulation has also been an internationally recognized alternative ther-
apy proven to have substantial improvement on the cardiopulmonary functions (Samuels,
2000; Asamoto and Takeshige, 1992; Matthees, 2001). In these studies, auricular stimula-
tion enhanced the physical capabilities of athletes. The results showed that aerobic function
indicators such as VO2max and VEmax improved significantly with stimulation. Based on
these findings, auricular stimulation could be used to improve the performance results for
marathons, 400 meter sprints, and 800 meter long distance runs. Furthermore, significant
differences were observed between participants’ body temperatures prior to stimulation and
following auricular stimulation. Previous research reported that rising body temperature
could not only increase the enzyme activities, muscular blood volume, and oxygen intake
level but also increase the time between contraction and relaxation of muscles, thus enhanc-
ing performance and avoiding injuries (Mohr et al., 1998; McNair and Stanley, 1996). These
findings demonstrated that in addition to improved functioning of elements necessary for
athletic performance, stimulation on the auricular acupuncture points before exercising can
also decrease the warm-up time, which can prevent injuries due to insufficient warm-ups
and essentially enhance the athletes’ overall performance.
Furthermore, auricular acupuncture is both a diagnostic and treatment system, based on
normalizing the body’s dysfunction through stimulation of definite points on the ear and its
reflex systems, which does not correlate with modern knowledgeof anatomy and physiology.
Auricular acupuncture stimulation significantly improved oxygen intake in athletes. The
VO2max per min was higher in athletes with auricular acupuncture stimulation than in those
without. Similar results were found by Sa and Lin (1990) who gave stimulations to subjects
using auricular acupuncture patches on the related points to the lung, kidney, spleen, Sen-
joug, adrenal cortex and endocrine with an aim of improving the VO2max during aggressive
exercise. Their results showed that VO2max was only significantly different between the
pre-experiment and post-experiment measurements in the acupuncture group but not in the
control group. Moreover, many other researchers have also used VO2max as an important
indicator for evaluating aerobic ability and sporting performances (Adams et al., 1975; Atomi
et al., 1986; Hill and Rowell, 1996; Helgerud et al., 2001). Based on the discussion above, it
was concluded that auricular acupuncture stimulation could potentially enhance the aerobic
ability of athletes, thus improving sport performance.
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EFFECTS OF ACUPUNCTURE ON RECOVERY ABILITY OF MALE ATHLETES 477
Muscle fatigue has been defined as any exercise-induced loss of ability to produce force
with a muscle or muscle group and it involves processes at all levels of the motor pathway
between the brain and the muscle (Taylor et al., 2006). Søgaard et al. (2006) regarded human
muscle fatigue as a loss of force-generating capacity in voluntary contractions. According
to the Chinese medicine theory, fatigue is caused by deficiency or imbalance in life energy
(also known as “Qi”) and recovery is promoted through the mechanism of “tonifcation” of
Qi, which focuses on boosting the “lung” and “spleen” functions (Li et al., 2004). Notice-
able progress has been made in biochemistry, hematological changes, neurophysiology,and
clinical treatment and acupuncture has an adjusting and controlling effect on some body
functions, allowing the physiological activity of the human body to reach a constant state
(Lin et al., 1996). Research in acupuncture analgesia and anesthesia indicated that acupunc-
ture cannot only modify the heart rate and blood flow of coronary arteries, but also lower fat
and cholesterol levels (Lin et al., 1996). Acupuncturecan be used to improve gas metabolism
and pulmonary respiratory function (Plummer, 1981; Chang, 1982; Wang and Wang, 1989;
Liu, 1990; Wang and Jin, 1990). In particular, evidence showed that electroacupuncture at
PC6 and ST36 acupoints after vigorous exercise, can increase the clearance rate of sarco-
lactic acid, thus leaving a perception of improved results (Lin, 1991). Moreover, Lin et al.
(1996) also reported that acupuncture at both PC6 and ST36 acupoints can decrease resting
heart rate and carbon dioxide production.
Generally,performing low-intensity aerobic exercise (active recovery)during the imme-
diate post-exercise period is more effective in accelerating lactate clearance than that in
inactive rest (passive recovery). Hagberg (1984) pointed out that blood lactic acid, while
still important from the exercise physiologist’s viewpoint, now is known to contribute much
less than originally believed to the regulation of human’s physiological responses to exercise.
Martin et al. (1998) showed that lactate metabolism and its rate of elimination from blood
and muscle are important components of recovery following maximal exercise. It is well
known that impairment of performance resulting from muscle fatigue differs according to the
types of contraction involved,the muscular groups tested, and the exercise duration/intensity.
For instance, Millet and Leoers (2004) focused on the origin of muscle fatigue after a pro-
longed exercise, lasting 30 min to several hours, and found that strength loss with fatigue
can originate from different sites: from the motor cortex to the contractile elements, and
this was termed “task dependency of muscle fatigue.” They found that electrically-evoked
contractions and associated electromyostimulation (EMS) can help characterize peripheral
fatigue. Søgaard et al. (2006) indicated that recovery from fatigue caused by weak con-
tractions differs from that caused by maximal contractions. Many others also found that,
after fatiguing maximal efforts, changes in the responses to stimulation of the motor cortex
during contraction would recoverto control levels and voluntary activation would recoverin
1–2 min (Gandevia et al., 1996; Taylor et al., 1996; Todd et al., 2005; Søgaard et al., 2006).
More recently, Pallard (2008) indicated that both EMS and voluntary muscle contraction
(VC) constitute different modes of muscle activation, which induce different acute physio-
logical effects on the neuromuscular system. Long-term application of each mode of muscle
activation can produce different muscle adaptations.
There are some potential limitations of this study. First, this experiment was designed for
a relatively small group of athletes (only 30) since the experiment required that participants
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478 Z.-P. LIN et al.
exercise on the treadmill training machines till exhausted. It required a high degree of will-
ingness of subjects to volunteerand cooperate. The participantsof this research were primar-
ily competitive elite athletes who desired eagerly to improve the competition performance
through acupuncture stimulation. Enriching the subjects to draw more robust conclusions is
necessary for future studies. Secondly, the lifestyle of participants could potentially impact
the athletic performance. Therefore, in future studies, the athletes’ lifestyle may need to
be closely monitored to decrease the external variations that could affect the experimental
results. Thirdly, this study was conducted in a laboratory environment to eliminate inter-
ference variables, and therefore it might yield different results from otherwise observed in
an uncontrolled environment under competition circumstances. Design of a future study to
test the findings of this research in the context of athletic competition is suggested. Lastly,
this study did not intend to provide the validation of the direct relation between acupuncture
stimulation and sporting performance. Future studies can explore this issue in more depth.
In conclusion, it was believed that if the quality and quantity of training intensity, cardio-
respiratory function, energy consumption, and blood lactate system during training as well
as the body weight and physical ability can be well controlled, the athletes should be able to
elaborate their potential and maintain their peak performance. To recover the physiological
characteristics during training and competition periods, acupuncture stimulation could be
used for all kinds of sports training and for obtaining desirable competition results. To keep
the athletes in the best situations, it is important to design effective schemes to help them
achieve their peak performance and to recover quickly in the competition phase. This study
demonstrated that the acupuncture group (PC6 and ST36) had significantly lower HRmax,
VO2max and blood lactic acid than both the sham group and the normal group in the 30th
min post-exercise. Blood lactic acid of the acupuncture group was also significantly lower
than that of the other 2 groups in the 60th min post-exercise. Our findings have shed some
light on the development of effective acupuncture schemes to enhance the recovery ability
for elite basketball athletes. It can be used to improve subjects in future sport performance.
Acknowledgments
The authors are indebted to anonymous referees for their insightful and constructive com-
ments to level up the quality of the original work. This stud y has been supported/sponsored by
the Chinese Taipei Olympic Committee, MingDao University and China Medical University
VS Beigang Hospital.
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... Our previous review [1] found that there is strong evidence in support of the use of acupuncture with regards to enhancing HR recovery following intense exercise [15][16][17][18]. However, there was conflicting evidence to support the use of acupuncture to enhance removal of blood lactate [7,16,19] and to enhance VO 2 max [15][16][17] postexercise. ...
... Our previous review [1] found that there is strong evidence in support of the use of acupuncture with regards to enhancing HR recovery following intense exercise [15][16][17][18]. However, there was conflicting evidence to support the use of acupuncture to enhance removal of blood lactate [7,16,19] and to enhance VO 2 max [15][16][17] postexercise. The majority of the RCTs in our previous review scored low formethodological quality and the quality of the acupuncture interventionwas poor. ...
... Our previous review [1] found that there is strong evidence in support of the use of acupuncture with regards to enhancing HR recovery following intense exercise [15][16][17][18]. However, there was conflicting evidence to support the use of acupuncture to enhance removal of blood lactate [7,16,19] and to enhance VO 2 max [15][16][17] postexercise. The majority of the RCTs in our previous review scored low formethodological quality and the quality of the acupuncture interventionwas poor. ...
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Objective: To update the current evidence of the effect of acupuncture on recovery heart rate (HR), blood lactate and maximum volume of oxygen consumption (VO2 max) following intense exercise through a systematic review of published randomised controlled trials. Methods: A systematic literature search was performed on electronic databases from inception to 2020. The Cochrane Handbook guidelines for Systematic Reviews of Interventions were used to assess the methodological quality and exclude studies with fatal flaws. The risk of bias was assessed using the Cochrane grading system by two reviewers (SB and BL). Acupuncture intervention was assessed using the Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA). This review is reported according to the PRISMA guidelines. Results: A total of 16 RCTs were included in this review. 8 of the 10 studies that assessed the effect of acupuncture on HR recovery found acupuncture to be significantly more effective than no treatment or sham acupuncture at enhancing recovery HR following exercise. 7 of the 10 studies that assessed the effect of acupuncture on reducing blood lactate found that acupuncture was significantly more effective than no treatment or sham acupuncture at reducing blood lactate following exercise. 4 of the 7 studies that assessed the effect of acupuncture on VO2 max found that there was no significant difference between groups with regards to VO2 max. Conclusion: Our results indicate that there is strong evidence that acupuncture is significantly more effective than sham and control in enhancing recovery HR and blood lactate following intense exercise. However, there is conflicting evidence with regards to the effect of acupuncture on enhancing VO2 max in athletes. Future studies are required that follow the STRICTA guidelines to help determine the effect of acupuncture on enhancing VO2 max in athletes.
... They suggested that the improvement of exercise performance is associated with decrease in the heart rate resulting from modulation of the autonomic nervous system by acupuncture treatment. Lin et al. [6] reported that acupuncture beginning 15 min prior to exercise induced the rapid recovery of heart rate and blood lactic acid after exercise. White and Raven [7] reported that the increase in heart rate elicited by dynamic exercise depended on the balance between the influences of the parasympathetic and sympathetic branches of the autonomic nervous system. ...
... Then, the heart rate was recorded during the last 2 min of the pre-experimental period (baseline value). Perceived exertion (RPE, scale [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] was also rated immediately after all high-and low-intensity exercise tasks. ...
... The bradycardic effects induced by pre-exercise acupuncture remained during low-intensity exercise and the beginning of high-intensity exercise performed immediately after the cessation of acupuncture stimulation. Previous studies suggested that acupuncture improves exercise performance and expedites post-exercise recovery [5,6]. Cheung and Jones [16] reported that transcutaneous electrical nerve acupuncture stimulation at the PC6 acupoint both before and immediately after exercise facilitates heart rate recovery after high-intensity exercise. ...
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Background The purpose of the present study was to investigate the effects of bradycardia induced by pre-exercise acupuncture on heart rate responses during short-duration exercise. Methods A total of 29 healthy subjects underwent two protocols: protocol 1 assessed the effects of manual acupuncture on heart rate response during rest, and protocol 2 tested the hypothesis that the bradycardic effects induced by pre-exercise acupuncture continue during low- and high-intensity exercise. Their average age, height, weight, and body mass index were 21.2 ± 2.0 years, 167.2 ± 8.8 cm, 63.8 ± 12.8 kg, and 22.7 ± 3.5 kg/m ² , respectively. In acupuncture stimulations for protocols 1 and 2, an acupuncture needle was inserted into the lower leg and manual acupuncture stimulation was performed at 1 Hz. Results In protocol 1 (resting condition), acupuncture stimulation induced a bradycardic response, which continued for 4 min after the cessation of acupuncture stimulation (p < 0.05). In protocol 2, the bradycardic response induced by pre-exercise acupuncture stimulation remained during low-intensity exercise and in the beginning of high-intensity exercise performed immediately after the cessation of acupuncture stimulation (p < 0.05). However, the effects disappeared when post-acupuncture exercise was performed when the heart rate was approximately 140 beats/min during high-intensity exercise. The rating of perceived exertion after exercise differed significantly between the acupuncture stimulation task (7.9 ± 1.6) and no-stimulation task (8.5 ± 2.0) (p = 0.03) only in the low intensity group. Conclusion This study may provide new insights into the effect of acupuncture stimulation on psycho-physiological conditions during exercise.
... ST36 was also found to lower the levels of interleukin-17 (IL-17) and tumor necrosis factor (TNF)-alpha in rat serum [38]. Another recent study found that acupuncture at ST36 dramatically reduced the heart-rate and oxygen-consumption statistics, which indicate fatigue reduction [39]. Acupoint ST36 may also upregulate the level of skeletal-muscle adenosine triphosphate (ATP) synthase and enhance the integration of mitochondrial ATP when the body is afflicted by tiredness or excessive weariness [40]. ...
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Although acupuncture (AT) is used in the treatment of CRF, the evidence from different systematic reviews (SRs) of AT has not yet been comprehensively evaluated. Moxibustion, which is a treatment method that is well established within Traditional East Asian Medicine, applies the heat of burning herbs towards or onto special points on the skin. Commonly, the herb Artemisia vulgaris, is used. It has been used for palliative cancer care, as well as for CRF. The aim of this overview was to evaluate the efficacy of AT and moxibustion in the management of CRF. Eleven databases were searched through for studies that were published from their dates of inception to February 2022. The study selection, the data extraction, and the assessment were performed independently by two researchers. The methodological and report quality were assessed by using the Assessment of Multiple Systematic Reviews-2 (AMSTAR-2) tool. The evidence quality was evaluated by using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. Fifteen SRs on AT (n = 10) and moxibustion (n = 5) treatments for CRF were included, and they include 169 randomized controlled trials and 14,392 participants. All of the SRs that were evaluated by the AMASTAR-2 had more than one deficiency, and so all of the SRs were rated as either low or critically low. For the GRADE, 18 outcomes were rated as very-low-quality evidence, 13 as low-quality evidence, 3 as moderate-quality evidence, and 0 as high-quality evidence. Most of the SRs reached the potential benefits of AT for CRF. No serious adverse effects were identified. In conclusion, the evidence suggests that, despite the advantages of AT in terms of the improvement in and the safety of the treatment of CRF, the methodological quality of most of these studies is low, which limits our ability to draw definitive meanings. Further research of high quality is needed in order to confirm these findings.
... ese points, though sometimes located on the extremities rather than the organs, may regulate some symptoms of the whole body via the action of meridian circulation [32]. For instance, the stimulation of the acupoints on the wrist, such as Nei Guan (PC6), sends afferent discharges to the neurons, inhibits sympathetic output, and decreases the cardiac demand for oxygen [33]. From Figure 2, selecting acupoints from the kidney meridian of the foot-shaoyin, the ren meridian, and back-shu points is commonly used for treating ED. e most frequent acupuncture point used in this review was Guan Yuan (CV4), which is located on the abdomen. ...
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Erectile dysfunction (ED) is one of the most common sexual dysfunctions in men. The prevalence of ED has been increasing in recent years, which has critically affected male reproductive health and quality of life. According to various guidelines, phosphodiesterase-5 inhibitors are the most commonly recommended drugs for treating ED. However, many patients turn to alternative therapies because of adverse reactions, such as headache, and the poor efficacy of these drugs. Acupuncture is a long-established treatment in traditional Chinese medicine (TCM) and has been approved by the World Health Organization for improving penile erection as well as other discomforts in patients. However, previous systematic reviews have not discussed the characteristics and the related mechanisms of acupuncture treatment. Therefore, this study focuses on summarizing the characteristics and advantages of TCM in acupuncture treatment for ED based on relevant literature and on predicting and analyzing the related mechanisms.
... Similar rates (22%) were found by other authors (Venter et al. 2009). Some studies show lower HR max , VO 2max, and blood lactic acid in male elite basketball compared to control and sham acupuncture groups (Lin et al. 2009). Additionally, beneficial effects on cardiac parasympathetic reactivity and sympathovagal balance in collegiate football players using reflexology after a repeated sprint ability test have been reported (Chen et al. 2019). ...
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This study aimed to describe the recovery strategies used by the Spanish professional basketball teams playing in the “Liga ACB.” Data from all teams during the 2019-2020 season (n = 18), and the team promoted for the season 2020-2021 were collected using a six-section online survey. Protocols, timings, and recovery strategies employed differed among teams. However, natural and physical recovery strategies such as sleep/nap, food/fluid replacement, active field, or gym-based cool-downs, use of supplementation, active or passive stretching, cold/ice bath/shower/immersion, massage, and foam-rolling were the most used among seventeen teams (>89%). Food and fluid replacement, showed a higher presence in the recovery protocols after competition and practice, always used by thirteen or more teams (~70%). The design and supervision of recovery are multidisciplinary tasks in 74% of the teams. Only two teams (11%) acknowledged not periodizing or individualizing recovery, while the other seventeen used these procedures regularly, considering different parameters, being previous injuries a factor always present. Teams not reaching the playoffs used a higher number of recovery strategies on average. This study provides a real vision of how the “Liga ACB” teams use recovery protocols, and pertinent contextual information that may be used for coaches and practitioners to tailor them.
... Additionally, acupuncture-induced motoneuron recruitment may increase the fast-twitch fiber contribution and thus enhance performance in subsequent explosive activities [7,8]. Acupuncture has long been used in the clinic to help individuals recover from muscle fatigue after exercise and can improve speed abilities and lower extremity explosive strength [9,10]. A recent study showed that acupuncture at specific areas of the shoulder joint can increase muscle excitability, thereby delaying muscle fatigue and increasing muscle endurance [11]. ...
Article
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Athletes aim to improve muscle strength to optimize sports performance and gain a competitive edge. Although modern sports medicine includes rehabilitation treatment methods for improving the explosive force of athletes, including acupuncture, a common alternative therapy, research on the effectiveness of acupuncture in improving the timeliness of explosive forces is limited. There is uncertainty regarding how long the effects of acupuncture treatment persist after treatment. Therefore, the purpose of this study was to explore the effect of acupuncture on the timeliness of explosive forces generated by the male shoulder joint. Eighteen healthy men underwent tests of shoulder adduction/abduction (Add/Abd) and flexion/extension (Flex/Ext) through an isokinetic measurement system. Acupuncture was used to stimulate LU1 (Zhongfu), LU3 (Tianfu), LU4 (Xiabai), LI14 (Binao), SJ13 (Naohui), SJ14 (Jianliao), and SJ12 (Xiaoluo), and the isokinetic parameters were recorded before and after acupuncture. After acupuncture, isokinetic muscle force parameters including the maximum (Max) torque, the average power, the average peak power, the average work, and the total work increased significantly (P
... Ma, (2017), who reported that participants exhibited less perceived pain, allowing them to exercise with greater intensity, which may help explain our findings in the CrossFit group. Applying needles at points PC6 and E36, the latter also used in the present study, was shown to reduce heart rate and lactate levels after 60 minutes (Lin et al., 2009), suggesting that the technique accelerated the recovery of athletes, similarly to that demonstrated here, where the physiological variables under study recovered in less time than those of the group submitted to acupuncture before exercise. Applying one acupuncture session seems to maximize athletic exertion by decreasing pain perception, as previously reported by Hübscher, Vogt, Ziebart, & Banzer, (2010). ...
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Studies have demonstrated the positive effects of acupuncture on athletic performance. The aim of this study was to determine the acute effects of acupuncture on heart rate, the perceived exertion scale and lactate levels in recreational athletes. Seven competitive male engaged in HIIT. The characteristic was 31.61+7.02 years old, heart rate reserve 59.71+4.10, lactate 3.31+0.63 mM/DL. The subjects were submitted to two exercise sessions. Both training sessions consisted of 10 burpees, 12 thrusters and 14 box jumps (75 cm high) for 12 minutes. Activity intensity was between 85 and 95% of maximum heart rate. Acupuncture points: ST36, L3, LI11. The student’s t-test was adopted, Shapiro-Wilk test was applied for normality, and Pearson correlation. There was a positive correlation of r = 0.69 between lactate levels and heart rate. Lactate: P2 15.00±1.18 - P3 19.59±1.46 p= 0.0004; Heart rate: P2 163.71±7.27 - P3 177.60±6.99 p=0.0007; Blood pressure: P2 174.86±1.57 - P3 180.86±1.77 p= 0.0001. Acupuncture increased lactate accumulation, heart rate and blood pressure, suggesting that the exertion reached after acupuncture is higher than without acupuncture. The acupuncture technics will improve the athlete performance. On this case, we suggest use this practice thirty minutes before the work out or race. It will allow the effects of acupuncture during the activity.
... A prevenção das lesões no basquete se concretizaria com a interrelação entre a implementação de um programa preventivo multicomponente nos aquecimentos, um controle sistemático das cargas de treinamento e, com a adoção de estratégias regenerativas após os treinos e competições, como discutido nos capítulos sobre controle das cargas de treinamento e lesões no basquete (Montgomer et al, 2008;Lin et al, 2009;Eils et al, 2010;LaBella et al, 2011;Bompa & Haff, 2012;Longo et al, 2012;Bridgett et al, 2018;Escobar et al, 2019;Brunner et al, 2019;Gabbett, 2020;Gabbett, 2020a;Huyghe et al, 2020;Watson et al, 2020). ...
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RESUMO O basquete é um esporte dinâmico que possui características intermitentes durante a realização das suas diversas tarefas motoras. A natureza das ações motoras executadas pelos jogadores acabam exigindo em variados graus da força e potência musculares. Isto pode ser observado nos movimentos multiplanares acelerativos, desacelerativos, mudanças bruscas de direção, saltos, aterrisagens, entre outras situações técnico-táticas que envolvem o ataque ou a defesa nas partidas. Treinar a força motora é uma condição básica elementar para o aprimoramento de outras capacidades biomotoras. Entre os recursos pedagógicos para o desenvolvimento da força, temos o uso da metodologia funcional. Sendo assim, neste manuscrito discutimos alguns aspectos relacionados ao treinamento da força funcional direcionada especificamente aos basquetebolistas. Palavras-chave: Basquete, Treinamento da Força, Treinamento Funcional, Treinamento Esportivo, Basketball, Sports Training, Strength Training, Functional Training
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Chinese herbs have been used as dietary supplements to improve exercise performance. However, evidence-based studies for the use of Chinese herbs in sports remain scarce. Traditional Chinese therapy (TCT), a form of traditional Chinese non-pharmacological intervention, has remained in use for thousands of years in sports medicine. TCT is beneficial for sports injuries and in enhancing skill development, and is becoming increasingly popular among athletes, fitness enthusiasts, and individuals who regularly exercise. The therapeutic effects of TCT have been demonstrated by clinical and experimental studies, but using these modalities still is associate with potential adverse effects. Further well-designed studies are necessary to confirm the efficacy of TCT in sports medicine. This review aims to summarize the application of TCT, discuss the issues surrounding TCT clinical research, and provide suggestions for applying traditional Chinese methods in the field of sports medicine.
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This article examines how pacing strategies during exercise are controlled by information processing between the brain and peripheral physiological systems. It is suggested that, although several different pacing strategies can be used by athletes for events of different distance or duration, the underlying principle of how these different overall pacing strategies are controlled is similar. Perhaps the most important factor allowing the establishment of a pacing strategy is knowledge of the endpoint of a particular event. The brain centre controlling pace incorporates knowledge of the endpoint into an algorithm, together with memory of prior events of similar distance or duration, and knowledge of external (environmental) and internal (metabolic) conditions to set a particular optimal pacing strategy for a particular exercise bout. It is proposed that an internal clock, which appears to use scalar rather than absolute time scales, is used by the brain to generate knowledge of the duration or distance still to be covered, so that power output and metabolic rate can be altered appropriately throughout an event of a particular duration or distance. Although the initial pace is set at the beginning of an event in a feedforward manner, no event or internal physiological state will be identical to what has occurred previously. Therefore, continuous adjustments to the power output in the context of the overall pacing strategy occur throughout the exercise bout using feedback information from internal and external receptors. These continuous adjustments in power output require a specific length of time for afferent information to be assessed by the brain's pace control algorithm, and for efferent neural commands to be generated, and we suggest that it is this time lag that crates the fluctuations in power output that occur during an exercise bout. These non-monotonic changes in power output during exercise, associated with information processing between the brain and peripheral physiological systems, are crucial to maintain the overall pacing strategy chosen by the brain algorithm of each athlete at the start of the exercise bout.
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Acupuncture is used to reduce inflammation and decrease pain in delayed onset muscle soreness (DOMS). This study investigates the efficacy of acupuncture on the symptoms of DOMS. Thirty subjects were assigned randomly to there groups, namely the control, non-tender point and tender point groups. Measurement of pain with full elbow flexion was used as indices of efficacy. Measurements were taken before and after exercise, immediately after treatment and seven days after treatment. Significant differences in visual analog scores for pain were found between the control group and tender point group immediately after treatment and three days after exercise (P < 0.05, Dunnetts multiple test). The results show that tender point acupuncture relieves muscle pain of DOMS.
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This study was done to investigate the effects of a standardized acupuncture treatment on symptoms and muscle function in exercise-induced delayed-onset muscle soreness (DOMS). A prospective, randomized, controlled, observer and subject-blinded trial was undertaken. Twenty-two (22) healthy subjects (22-30 years; 10 males and 12 females) were randomly assigned to three treatment groups: real acupuncture (deep needling at classic acupuncture points and tender points; n = 7), sham-acupuncture (superficial needling at nonacupuncture points; n = 8), and control (no needling; n = 7). DOMS of the nondominant elbow-flexors was experimentally induced through eccentric contractions until exhaustion. The outcome measures were pain perception (visual analogue scale; VAS; range: 0-10 cm), mechanical pain threshold (MPT; pressure algometer), and maximum isometric voluntary force (MIVF; force transducer). Treatment was applied immediately, 24 and 48 hours after DOMS induction. Measurements of MPT and MIVF were made prior to DOMS induction as well as before and after every treatment session. VAS data were acquired after DOMS induction as well as pre- and post-treatment. Final pain, MPT, and MIVF measurements were performed 72 hours after DOMS induction. Following nonparametric testing, there were no significant differences between groups in outcome measures at baseline. After 72 hours, pain perception (VAS) was significantly lower in the acupuncture group compared to the sham acupuncture and control subjects. However, the mean MPT and MIVF scores were not significantly different between groups. Although acupuncture seemed to have no effects on mechanical pain threshold and muscle function, it proved to reduce perceived pain arising from exercise-induced muscle soreness.
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The purpose of this study was to investigate the physical activity levels in eleven 9–10 year old boys with reference to aerobic power or lactate threshold (LT). Daily physical activity levels were evaluated from a HR monitoring system for 12 h on three different days.\(\dot V_{O_{2max} } \),\(\dot V_{O_2 }\)-HR relationship and LT were determined by the progressive treadmill test. LT was 36.7±3.1 ml · kg−1 · min−1 and 71.0±6.6%\(\dot V_{O_{2max} } \). Mean total time of activities with HR above the level corresponding to 60%\(\dot V_{O_{2max} } \) (T-60%) and that above LT (T-LT) were 34±7 and 18±7 min, respectively.\(\dot V_{O_{2max} } \) (ml · kg−1 · min−1) correlated significantly with T-60% (p<0.01), while no significant relationship was found with LT in ml · kg−1 · min−1. In conclusion, longer daily physical activities at moderate to higher intensity for preadolescent children seem to increase\(\dot V_{O_{2max} } \) rather than LT.
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Twelve middle-distance runners, each having recently completed a competitive track season, were divided into two groups matched for maximal oxygen uptake (VO2max), 2-mile run time and age. Group 1 trained for 3 wk at Davis, PB = 760 mmHg, running 19.3 km/day at 75% of sea-level (SL) VO2max, while group 2 trained an equivalent distance at the same relative intensity at the US Air Force Academy (AFA), PB = 586 mmHg. The groups then exchanged sites and followed a training program of similar intensity to the group preceding it for an additional 3 wk. Periodic near exhaustive VO2max treadmill tests and 2-mile competitive time trials were completed. Initial 2-mile times at the AFA were 7.2% slower than SL control. Both groups demonstrated improved performance in the second trial at the AFA (chi = 2.0%), but mean postaltitude performance was unchanged from SL control. VO2max at the AFA was reduced initially 17.4% from SL control, but increased 2.6% after 20 days. However, postaltitude VO2max was 2.8% below SL control. It is concluded that there is no potentiating effect of hard endurance training at 2,300-m over equivalently severe SL training on SL VO2max or 2-mile performance time in already well conditioned middle-distance runners.