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Could Cupping Therapy Be Used to Improve Sports Performance?

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Abstract

Cupping Therapy " is the topic chosen for the fourth editorial of this newly launched journal. The aim of this editorial is to deepen this interesting topic, little analyzed in the present literature, in order to explain the technique and deal with the evidence of the effects of cupping therapy in musculoskeletal disorders, and some possible relation to sports performance.

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... However, it was recently argued that the technique is beneficial because it promotes the elimination of oxidants from the blood (Mehta and Dhapte, 2015). Overall, the possible mechanisms of wet cupping may be classified as neurological/psychological and hematological/immunological (Michalsen et al., 2009;Musumeci, 2016). One published theory about the possible mechanism of lowering blood pressure of hijamah named the "Taibah Theory", stated that hijamah helps to remove the interstitial fluids, extra intravascular fluid, and destructive or harmful substances from the body. ...
... This theory also postulates that hijama lead to elimination of free radicals and vasoactive fluids. In addition, stimulation of production of nitric oxide which will help to keep the balance between antioxidants and free radicals (Niasari et al., 2007;Musumeci, 2016). ...
... Different types wet cupping therapy have been used to treat different diseases and for different purposes which include the improvement of sport performance. In the 1996 Olympic games in Brazil, many athletes including the 23-time Olympic gold-medal winner Michael Phelps, the greatest swimmer of all time, were noticed with wetcupping impressures on their skin (Nimrouzi et al., 2014;Musumeci, 2016). These athletes might have gone through wetcupping treatment for other healtreasons as well as for performance improvement. ...
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Özet Bu çalışmanın amacı, sporcularda hacamat uygulamasının sporcuların bazı performans ve kan parametreleri üzerine etkisinin araştırılmasıdır. Çalışmaya katılan sporcular (n=23), rastgele örneklem yöntemi ile yaş ortalaması 20,36±1,286 yıl, antrenman yaşı ortalaması 7,45±4,132 yıl, boy uzunlukları ortalaması 177,82±6,585 cm, vücut ağırlıkları ortalaması 74,09±11,476 kg olan kontrol grubu (KG) (n=11) ve yaş ortalaması 21,17±2,290 yıl, antrenman yaşı ortalaması 9,08±3,825 yıl, boy uzunlukları ortalaması 179,67±8,553 cm, vücut ağırlıkları ortalaması 71,25±10,314 kg olan deney grubu (DG) (n=12) olmak üzere iki farklı gruba ayrıldı. Katılımcıların bacak kuvveti, ivmelenme, sürat, dikey sıçrama ve durarak uzun atlama değerleri, kan parametrelerinde ise WBC, RBC, HGB, PLT ve HCT düzeyleri ölçüldü. Çalışmanın istatistiksel analizlerinde tanımlayıcı olarak aritmetik ortalama ve standart sapma değerleri kullanıldı ve dağılımların normalliği için Shapiro-Wilks testi uygulandı. Gruplar arası farkın belirlenmesinde Independent-Sample T testi, grup içi farkın belirlenmesinde ise, Paried-Sample T testi yapıldı. Anlamlılık düzeyi p<0.05 olarak alındı. Sonuç olarak hacamat uygulamasının sporcuların bacak kuvveti, ivmelenme, dikey sıçrama ve Yoyo-1 değerleri üzerinde olumlu etkisinin olduğu ifade edilebilir. Abstract The aim of this study was to investigate how wet cupping effects performance and certain blood parameters of athletes. The athletes participating in the study (n=23) were divided into control group (CG, n=11) and experimental group (EG, n=12) by using random sample method. The athletes in sample group were selected in accordance with following criteria; age average: 20,36±1,286 year, average training age: 7,45±4,132 year, average stature: 177,82±6,585 cm, average body weight: 74,09±11,476 kg. The same criteria for the athletes in experimental group (EG) (n=11) were as follows; age average: 21,17±2,290 year, average training age: 9,08±3,825 year, average stature: 179,67±8,553 cm, average body weight: 71,25±10,314 kg. Leg force, acceleration, speed, vertical jump and standing long jump values of the participants were measured along with their blood parameters such as WBC, RBC, HGB, PLT and HCT levels. In statistical analyses of the study, arithmetic mean and standard deviation values were used as descriptive statistics, and Shapiro-Wilks was made in order to analyze the normality of distributions. Independent-Sample t-Test was made to determine the difference between the groups and Paired Sample t-Test to determine the difference within each group. Significance level was taken as p<0.05. Consequently, it can be said that wet cupping has a positive effect on leg force, acceleration, vertical jump and Yoyo-1 values of athletes.
... [69] In a recent report from Harvard Medical School about pediatric patients with chronic pain, authors reported that cupping and acupuncture treatments were pleasant and helpful for pain conditions. [70] Cupping treatment is used to reduce musculoskeletal inflammation and pain, and may consequently increase physical performance during sport activity. [71] The value of CT as a prophylactic method and its promotion of health and energy was implied during the 2016 Olympic Games held in Rio de Janeiro, Brazil, when an outstanding swimmer used it prior to a swimming event and broke the world record. ...
... [5,10,44,52,58] With time, definitions of CT evolved, its medical use was expanded, cupping instruments were developed, medical research was conducted, its contraindications were identified and its mechanisms of action were suggested. [4,5,27,52,64,70] Finally, CT is a promising therapy, as many studies are providing evidence-based data in favor of its effectiveness and safety. [21,32,66] CT is reported to have some side effects, including scars, burn, abscess and infections, especially when it is used by unqualified and untrained practitioners, who fail to apply infection control measures. ...
... [40] Beliefs that CT extracts toxic or poisonous substances (detoxification) in the blood were promoted in ancient times and continue to be part of our understanding of the technique. [4,5,27,64,70] Sucking contaminated blood from the affected, inflamed area reduces congestion, increases fresh blood supply and may speed up recovery. CT also corrects imbalance in the internal bio-field through restoring the flow of Qi. [81] Its other suggested mechanisms of action include boosting immunity and promoting anti-inflammatory process through the removal of oxidants and reduction of oxidative stress. ...
Article
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Cupping (Hijama in Arabic) is an ancient, holistic method for the treatment of a variety of diseases. Though the exact origin of cupping therapy is a matter of controversy, its use has been documented in early Egyptian and Chinese medical practices. Diverse human civilizations have contributed to the historical development and continuation of cupping therapy. This narrative review describes the history of cupping, historical definitions, cupping instruments and uses of cupping therapy. Electronic searches of relevant databases (PubMed, Google Scholar and OvidSP) were conducted using keywords and Boolean operators. Manual searches and references of published articles and books were also conducted. A number of articles (N = 625) were retained for extensive review, and finally 83 articles were included in this paper. The historical descriptions of cupping therapy were found in ancient human civilizations of the Eastern and Western world. There were inconsistent data concerning the origin of cupping, definitions, instruments, procedures, definite advancements and research in Hijama over centuries. Cupping therapy fell out of favor in 17th and mid-18th centuries but recovered popularity in modern medicine. Currently, cupping therapy is used for health promotion, prophylaxis and treatment of a variety of diseases around the world. Cupping therapy with a good safety profile has a checkered history and is a well-recognized traditional method for managing medical conditions. Currently, the scope of cupping therapy is expanding, and a growing body of research is providing additional evidence-based data for the further advancement of cupping therapy in the treatment of a variety of diseases.
... [69] In a recent report from Harvard Medical School about pediatric patients with chronic pain, authors reported that cupping and acupuncture treatments were pleasant and helpful for pain conditions. [70] Cupping treatment is used to reduce musculoskeletal inflammation and pain, and may consequently increase physical performance during sport activity. [71] The value of CT as a prophylactic method and its promotion of health and energy was implied during the 2016 Olympic Games held in Rio de Janeiro, Brazil, when an outstanding swimmer used it prior to a swimming event and broke the world record. ...
... [5,10,44,52,58] With time, definitions of CT evolved, its medical use was expanded, cupping instruments were developed, medical research was conducted, its contraindications were identified and its mechanisms of action were suggested. [4,5,27,52,64,70] Finally, CT is a promising therapy, as many studies are providing evidence-based data in favor of its effectiveness and safety. [21,32,66] CT is reported to have some side effects, including scars, burn, abscess and infections, especially when it is used by unqualified and untrained practitioners, who fail to apply infection control measures. ...
... [40] Beliefs that CT extracts toxic or poisonous substances (detoxification) in the blood were promoted in ancient times and continue to be part of our understanding of the technique. [4,5,27,64,70] Sucking contaminated blood from the affected, inflamed area reduces congestion, increases fresh blood supply and may speed up recovery. CT also corrects imbalance in the internal bio-field through restoring the flow of Qi. [81] Its other suggested mechanisms of action include boosting immunity and promoting anti-inflammatory process through the removal of oxidants and reduction of oxidative stress. ...
Article
Full-text available
Abstract Cupping (Hijama in Arabic) is an ancient, holistic method for the treatment of a variety of diseases. Though the exact origin of cupping therapy is a matter of controversy, its use has been documented in early Egyptian and Chinese medical practices. Diverse human civilizations have contributed to the historical development and continuation of cupping therapy. This narrative review describes the history of cupping, historical definitions, cupping instruments and uses of cupping therapy. Electronic searches of relevant databases (PubMed, Google Scholar and OvidSP) were conducted using keywords and Boolean operators. Manual searches and references of published articles and books were also conducted. A number of articles (N = 625) were retained for extensive review, and finally 83 articles were included in this paper. The historical descriptions of cupping therapy were found in ancient human civilizations of the Eastern and Western world. There were inconsistent data concerning the origin of cupping, definitions, instruments, procedures, definite advancements and research in Hijama over centuries. Cupping therapy fell out of favor in 17th and mid-18th centuries but recovered popularity in modern medicine. Currently, cupping therapy is used for health promotion, prophylaxis and treatment of a variety of diseases around the world. Cupping therapy with a good safety profile has a checkered history and is a well-recognized traditional method for managing medical conditions. Currently, the scope of cupping therapy is expanding, and a growing body of research is providing additional evidence-based data for the further advancement of cupping therapy in the treatment of a variety of diseases.
... It is beyond this paper to include a full spectrum of diseases, adverse effects, efficacy and outcome studies and all cupping points system in the given Table 1 and for more details see these sources [3,24,26,28,31]. Notably cupping therapy has evident role in promotion of health and prevention of diseases [1,24,32] and notably cups are applied on healthy skin surface. With special reference to interscapular region points including Kahel (Fig. 2) which are used frequently in most systemic diseases but not all, this area is characterized by five features; brown adipose tissue, direct proximity to sympathetic ganglia, passage of the thoracic duct, two important acupuncture meridians, and closeness to the main vessel divisions carrying blood from the heart and the brain. ...
... This area and Sunnah days for cupping were also recommended by Prophet Mohammad (PBUH) for cupping (Al-Hijamah) therapy [24,28]. This Kahel area together with other cupping points on the back and dorsum of legs is also used for promotion of health in sports medicine, and for enhancing athletes' performance [32]. It is better to use the largest cup on Kahel area/point because of multiple reasons such as large area. ...
... Cupping has been purported to enhance exercise performance through facilitating myofascial decompression, increased vascular function and tissue oxygenation, and reduced inflammatory response and oxidative stress (Antush, et al., 2020;Becerra, et al., 2021;Ekrami, et al., 2021;Stephens, et al., 2020;Stoner, et al., 2017;Tagil, et al., 2014). Accordingly, despite the increasing use of cupping therapy prior to sports events (Bridgett, et al., 2018;Musumeci, 2016), there is limited research examining of the efficacy of this modality on anaerobic exercise performance. The present study demonstrates no performance or physiological benefit when dry or wet cupping therapy is performed prior to a WAnT effort. ...
Article
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The use of cupping therapy prior to sports events has increased in popularity, with limited evidence to support its efficacy. The purpose of this study was to evaluate the efficacy of dry and wet cupping therapy on subsequent Wingate anaerobic test (WAnT) performance. Twelve trained men participated in this repeated-measures randomized crossover study (age 24.9 ± 4.8 years; body mass index 27.6 ± 14.3 kg.m-2). Participants were familiarized with the ergometer and the Wingate anaerobic test on three separate occasions. They then randomly performed three experimental Wingate tests separated by 48-72 h after either dry cupping (DRY), wet cupping (WET), or no treatment (CON). Repeated measures ANOVA and Pearson’s correlation coefficient were used to analyze data and determine the relationships between WAnT and peak lactate and heart rate (HR). Peak power (PP), mean power (MP), and fatigue index (FI) were similar in all treatments (p=.47-.72). Heart rate (HR) and lactate increased similarly at all time points in all treatments (p<.001 for all comparisons). Post-WAnT peak HR was moderately, negatively correlated with PP in all treatments and MP in CON only (p<.05 for all correlations). No other significant correlations were detected. The present findings demonstrate no beneficial effects of wet and dry cupping therapy, and hence do not support its use prior to high-intensity anaerobic sports events.
... Bunun sebebi yine medyayla ilintili olarak Michael Phelps, Justin Bieber gibi dünyaca ünlü ikonların deneyimleri olabilir. [19,20] Birçok çalışmada kayropraktik en az bilinen GETAT yöntemi olarak saptanmıştır. [7,9,10,15,18] Bu çalışmada da kayropraktik, proloterapi ve sülük tedavisi ile birlikte bilinirliği en son sırada yer alan uygulamadır ve literatürle uyumludur. ...
... Buna karşın 21 sporcuda tek doz yapılan hareketli kupa uygulamasının kalça ve diz ROM'unda artış yaparken, izokinetik diz fleksiyon kuvvetinde artış yapmadığı belirtilmiştir (34). Kupa uygulamasının kas-eklem ağrısı ve enflamasyonda azalma sonucunda performans artışı yaptığı ileri sürülmektedir (35). ...
... Studies regarding cupping therapy in sports medicine are insufficient, but the use of cupping has increased recently in elite athletes worldwide. [14]. The study showed that cupping was the second most used and satisfactory treatment. ...
... It is common for athletes to try new treatments that can relieve pain and improve performance, whether or not they are supported by scientific evidence [1]. At the last Olympic Games in Rio de Janeiro, Brazil in 2016, we noticed many athletes with big red circles all over the skin, including Olympic gold medalist Michael Phelps, 23 times the best swimmer of all time. ...
... Today, there is an increased interest in integrating complementary and alternative medicine (CAM) with current modern medical practices. Cupping has recently become evident in modern culture, especially after the 2016 Olympics in Rio de Janeiro, Brazil (11). Prominent athletes were seen competing with the dark circu-lar marks evident on their backs (12). ...
Article
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Cupping is an ancient procedure that has been practiced for thousands of years. It has been used to treat a variety of medical conditions, including dermatological ones. Cupping has been described in the literature for the treatment of conditions such as acne and eczema. The procedure is fundamentally divided into dry cupping and wet cupping; however, there have been many modern adaptations. Adverse events related to the procedure have been reported in the literature and should be considered by patients. However, cupping has a promising role in helping manage dermatological conditions.
... Cupping therapy has been used for various illnesses to headache, low back pain, neck pain and carpal tunnel syndrome (Ahmadi et al., 2008;Farhadi et al., 2009;Michalsen et al., 2009;Lauche et al., 2011). Cupping therapy has been recommended for treatment of musculoskeletal disorders following publication of various studies (Ahmadi et al., 2008;Farhadi et al., 2009;Michalsen et al., 2009;Lauche et al., 2011), and is expected to become a new trend in sports medicine when applied in combination with use of movement patterns or functional exercises (Lacross, 2014;Musumeci, 2016;Ries, 2016). ...
... The clinical outcome for PFJ OA should be improved, increasing the study on conventional pharmacological and/or non-pharmacological treatment strategies oriented to the exclusive biomechanical functions of the PFJ and the specific impairments linked with disease in this compartment. Kinesio tape, bracing, cupping therapy, adapted physical activity, kinesiotherapy and physiotherapy are interventions that all offer possibilities in the improvement of symptoms and/or reduction of PFJ stress and pain in patients with PFJ OA [27][28][29]. There are few studies in literature that demonstrate these important differences in knee joint compartments. ...
Article
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Knee Joint Osteoarthritis " is the topic chosen for the first editorial of the second volume of this journal. The aim of this editorial is to discuss this interesting but little analyzed topic in the current literature, in order to explain and help readers to better understand the functional anatomical aspects of knee joints affected by Osteoarthritis (OA). As the knee joint is tri-compartmental, numerous radiographic patterns of disease are possible and the differences between the two main compartments of the knee (patellofemoral joint versus tibiofemoral joint) are explored in this editorial.
Article
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Cupping therapy is one of the traditional and complementary medicine applications that have survived for thousands of years with its history and knowledge. Today, cupping therapy is widely used in many different regions of the world. In some European countries, cupping therapy has been included in the conventional health system. Cupping therapy can be used for the treatment of many different indications such as rheumatoid arthritis, hypertension, headache, fibromyalgia, low back pain, osteoarthritis, myofascial pain syndrome, and infertility and also it can be used for strengthening the immune system in healthy individuals. Taibah theory, gate control theory, diffuse noxious inhibitory controls, reflex zone theory, the release of β-endorphin and adrenocortical hormones, immune system activation, nitric oxide theory, circulatory detoxification theory, oxidative stress reduction, myofascial decompression and placebo activity are suggested mechanisms. In the literature, the number of studies that discuss the experimental and clinical efficacy, safety, and mechanism of action of cupping therapy in depth is not sufficient. Based on this relationship, the underlying mechanisms of cupping therapy have not been fully elucidated, despite some theories. To summarize, in this review; history and current classification of cupping therapy, the proposed mechanisms of action and the diseases in which it is used are explained with the guidance of the current literature and the legal situation in our country related to this practice is expressed. To fully understand the scientific aspects of cupping therapy, it is well known that there is a need for well-designed, advanced clinical trials.
Article
Cupping therapy has become more popular in the sports setting because of its simplicity in application, minimal adverse effects, and reduction in pain and muscle tenderness, yet there is little research on its effectiveness for range of movement and power. Objectives: The primary aim of this study was to investigate if a single session of moving cupping to the posterior aspect of the lower limb effects hip and knee range of movement and knee flexion power. The secondary aim was to consider participants’ views and perceptions of moving cupping therapy. Methods: Twenty-one healthy participants (12 male and 9 female) aged between 19 and 31 years volunteered to take part in the study. All participants received 15 min of moving cupping therapy to their dominant posterior lower extremity. Hip and knee range of movement and knee flexion isokinetic power measurements were taken prior to and immediately after the moving cupping intervention. Participants also completed a questionnaire based on their experience and perceptions of cupping. Results: Results showed a significant increase (p = <.05) in hip and knee range of movement measurements by 7% in the straight leg raise and 4% in a popliteal angle test. However, no significant changes were seen in the knee flexion power measures. Data from the questionnaire suggest that despite moving cupping being reported as ‘uncomfortable’ it is considered acceptable. Discussion: Moving cupping therapy may have short-term changes to range of movement but not power, though the limitations of this study mean that rigorous studies are required before the effectiveness of moving cupping can be determined.
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Wet cupping therapy (WCT) is a simple and economic treatment that still needs scientific interpretation. It treated effectively diseases with different etiologies and pathogeneses e.g. rheumatoid arthritis (RA), hypertension, migraine, carpal tunnel syndrome (CTS), fibromyalgia, cellulitis and others. Here, we review medical and scientific bases underlying cupping therapy and introduce Taibah theory as a novel evidence-based scientific mechanism to explain it. Briefly, in Taibah theory, WCT is a minor surgical excretory procedure related scientifically to the principles of renal glomerular filtration and abscess evacuation, where a pressure-dependent excretion of causative pathological substances (CPS) occurs. CPS include disease-causing substances and disease-related substances (that result during disease pathogenesis). Negative pressure applied to skin surface causes local collection of filtered and interstitial fluids containing CPS at skin upliftings inside cups. Scarifying skin upliftings followed by cupping causes a pressure gradient and a traction force across the skin and capillaries to excrete collected fluids with CPS and cause bleeding at puncture sites. This increases filtration at both capillary ends and causes clearance of blood and interstitial spaces from CPS. WCT benefits from the suction pressure, phenomenon of reactive hyperemia, nitric oxide production and skin scarifications (openings in skin barrier) in enhancing natural excretory skin functions, improving lymphatic and capillary circulations and restoring homeostasis. Reported CPS of RA include autoantibodies, immune complexes, soluble interleukin-2 receptors, inflammatory mediators, certain cytokines, prostaglandins, toxic cellular products and rheumatoid factor, while CPS of CTS include malondialdehyde, interleukin 6, prostaglandin PGE- 2 and progressive edema (causing pain). WCT-induced filtration pressure may excrete those CPS in cupped blood. Prophetic medicine (related to Prophet Mohammad peace be upon him) recommends WCT: “The best among what you use in therapy is Al-hijamah (prophetic method of WCT)”. In conclusion, WCT has scientific bases in treating different diseases being the only treatment that clears blood and interstitial fluid from CPS.Therapeutic benefits of WCT is related to the amount of excreted CPS not the amount of letted blood.
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The aims of this study were to investigate whether there is a gap between evidence of traditional medicine (TM) interventions in East-Asian countries from the current Clinical Practice Guidelines (CPGs) and evidence from current systematic reviews and meta-analyses (SR-MAs) and to analyze the impact of this gap on present CPGs. We examined 5 representative TM interventions in the health care systems of East-Asian countries. We searched seven relevant databases for CPGs to identify whether core CPGs included evidence of TM interventions, and we searched 11 databases for SR-MAs to re-evaluate current evidence on TM interventions. We then compared the gap between the evidence from CPGs and SR-MAs. Thirteen CPGs and 22 SR-MAs met our inclusion criteria. Of the 13 CPGs, 7 CPGs (54%) mentioned TM interventions, and all were for acupuncture (only one was for both acupuncture and acupressure). However, the CPGs did not recommend acupuncture (or acupressure). Of 22 SR-MAs, 16 were for acupuncture, 5 for manual therapy, 1 for cupping, and none for moxibustion and herbal medicine. Comparing the evidence from CPGs and SR-MAs, an underestimation or omission of evidence for acupuncture, cupping, and manual therapy in current CPGs was detected. Thus, applying the results from the SR-MAs, we moderately recommend acupuncture for chronic LBP, but we inconclusively recommend acupuncture for (sub)acute LBP due to the limited current evidence. Furthermore, we weakly recommend cupping and manual therapy for both (sub)acute and chronic LBP. We cannot provide recommendations for moxibustion and herbal medicine due to a lack of evidence. The current CPGs did not fully reflect the evidence for TM interventions. As relevant studies such as SR-MAs are conducted and evidence increases, the current evidence on acupuncture, cupping, and manual therapy should be rigorously considered in the process of developing or updating the CPG system.
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Introduction. Cupping has been used since antiquity in the treatment of pain conditions. In this pilot study, we investigated the effect of traditional cupping therapy on chronic nonspecific neck pain (CNP) and mechanical sensory thresholds. Methods. Fifty CNP patients were randomly assigned to treatment (TG, n = 25) or waiting list control group (WL, n = 25). TG received a single cupping treatment. Pain at rest (PR), pain related to movement (PM), quality of life (SF-36), Neck Disability Index (NDI), mechanical detection (MDT), vibration detection (MDT), and pressure pain thresholds (PPT) were measured before and three days after a single cupping treatment. Patients also kept a pain and medication diary (PaDi, MeDi) during the study. Results. Baseline characteristics were similar in the two groups. After cupping TG reported significantly less pain (PR: -17.9 mm VAS, 95%CI -29.2 to -6.6; PM: -19.7, 95%CI -32.2 to -7.2; PaDi: -1.5 points on NRS, 95%CI -2.5 to -0.4; all P < 0.05) and higher quality of life than WL (SF-36, Physical Functioning: 7.5, 95%CI 1.4 to 13.5; Bodily Pain: 14.9, 95%CI 4.4 to 25.4; Physical Component Score: 5.0, 95%CI 1.4 to 8.5; all P < 0.05). No significant effect was found for NDI, MDT, or VDT, but TG showed significantly higher PPT at pain-areas than WL (in lg(kPa); pain-maximum: 0.088, 95%CI 0.029 to 0.148, pain-adjacent: 0.118, 95%CI 0.038 to 0.199; both P < 0.01). Conclusion. A single application of traditional cupping might be an effective treatment for improving pain, quality of life, and hyperalgesia in CNP.
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Kinesio tape (KT) is an elastic therapeutic tape used for treating sports injuries and a variety of other disorders. Chiropractor, Dr Kenso Kase, developed KT taping techniques in the 1970s. It is claimed that KT supports injured muscles and joints and helps relieve pain by lifting the skin and allowing improved blood and lymph flow. The profile of KT rose after the tape was donated to 58 countries for use during the 2008 Olympic Games, and was seen on high-profile athletes. Practitioners are asking whether they should use KT over other elastic adhesive tapes. The aim of this review was to evaluate, using meta-analysis, the effectiveness of KT in the treatment and prevention of sports injuries. Electronic databases including SPORTDiscus, Scopus, MEDLINE, ScienceDirect and sports medicine websites were searched using keywords 'kinesio taping/tape'. From 97 articles, ten met the inclusion criteria (article reported data for effect of KT on a musculoskeletal outcome and had a control group) and were retained for meta-analyses. Magnitude-based inferences were used to assess clinical worth of positive outcomes reported in studies. Only two studies investigated sports-related injuries (shoulder impingement), and just one of these involved injured athletes. Studies attending to musculoskeletal outcomes in healthy participants were included on the basis that these outcomes may have implications for the prevention of sporting injuries. The efficacy of KT in pain relief was trivial given there were no clinically important results. There were inconsistent range-of-motion outcome results, with at least small beneficial results seen in two studies, but trivial results in two other studies across numerous joint measurements. There was a likely beneficial effect for proprioception regarding grip force sense error, but no positive outcome for ankle proprioception. Seven outcomes relating to strength were beneficial, although there were numerous trivial findings for quadriceps and hamstrings peak torque, and grip strength measures. KT had some substantial effects on muscle activity, but it was unclear whether these changes were beneficial or harmful. In conclusion, there was little quality evidence to support the use of KT over other types of elastic taping in the management or prevention of sports injuries. KT may have a small beneficial role in improving strength, range of motion in certain injured cohorts and force sense error compared with other tapes, but further studies are needed to confirm these findings. The amount of case study and anecdotal support for KT warrants well designed experimental research, particularly pertaining to sporting injuries, so that practitioners can be confident that KT is beneficial for their athletes.
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Wet cupping is a traditional Chinese medicine therapy commonly used in treating herpes zoster in China, and clinical studies have shown that wet cupping may have beneficial effect on herpes zoster compared with Western medication. We included randomized controlled trials (RCTs) on wet cupping for herpes zoster. We searched PubMed, the Cochrane Library (Issue 3, 2008), China Network Knowledge Infrastructure (CNKI), Chinese Scientific Journals Fulltext Database VIP, and Wan Fang Database. All searches ended in February 2009. Two authors extracted data and assessed the trials' quality independently. RevMan 5.0.18 software (The Cochrane Collaboration, The Nordic Cochrane Centre, Copenhagen, Denmark) was used for data analysis with effect estimate presented as relative risk (RR) and mean difference (MD) with a 95% confidence interval (CI). Eight RCTs involving 651 patients were included, and the methodological quality of trials was generally fair in terms of randomization, blinding, and intention-to-treat analysis. Meta-analyses showed wet cupping was superior to medication in the number of cured patients (RR 2.49, 95% CI 1.91 to 3.24, P < .00001), the number of patients with improved symptoms (RR 1.15, 95% CI 1.05 to 1.26, P = .003), and reducing the incidence rate of postherpetic neuralgia (RR 0.06, 95% CI 0.02 to 0.25, P = .0001). Wet cupping plus medication was significantly better than medication alone on number of cured patients (RR 1.93, 95% CI 1.23 to 3.04, P = .005) but demonstrated no difference in symptom improvement (RR 1.00, 95% CI 0.92 to 1.08, P = .98). There were no serious adverse effects related to wet cupping therapy in the included trials. Wet cupping appears to be effective in the treatment of herpes zoster. However, further large, rigorously designed
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Though cupping therapy has been used in China for thousands of years, there has been no systematic summary of clinical research on it.This review is to evaluate the therapeutic effect of cupping therapy using evidence-based approach based on all available clinical studies. We included all clinical studies on cupping therapy for all kinds of diseases. We searched six electronic databases, all searches ended in December 2008. We extracted data on the type of cupping and type of diseases treated. 550 clinical studies were identified published between 1959 and 2008, including 73 randomized controlled trials (RCTs), 22 clinical controlled trials, 373 case series, and 82 case reports. Number of RCTs obviously increased during past decades, but the quality of the RCTs was generally poor according to the risk of bias of the Cochrane standard for important outcome within each trials. The diseases in which cupping was commonly employed included pain conditions, herpes zoster, cough or asthma, etc. Wet cupping was used in majority studies, followed by retained cupping, moving cupping, medicinal cupping, etc. 38 studies used combination of two types of cupping therapies. No serious adverse effects were reported in the studies. According to the above results, quality and quantity of RCTs on cupping therapy appears to be improved during the past 50 years in China, and majority of studies show potential benefit on pain conditions, herpes zoster and other diseases. However, further rigorous designed trials in relevant conditions are warranted to support their use in practice.
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Traditional Chinese Medicine (TCM) is popular for treatment of fibromyalgia (FM) although there is a lack of comprehensive evaluation of current clinical evidence for TCM's therapeutic effect and safety. Objective: To review systematically the beneficial and harmful effects of TCM therapies for FM. We searched six English and Chinese electronic databases for randomized clinical trials (RCTs) on TCM for treatment of FM. Two authors extracted data and assessed the trial quality independently. RevMan 5 software was used for data analyses with an effect estimate presented as mean difference (MD) with a 95% confidence interval (CI). Twenty-five RCTs were identified with 1516 participants for this review. Seven trials (28%) were evaluated as having a low risk of bias and the remaining trials were identified as being as unclear or having a high risk of bias. Overall, ten trials were eligible for the meta-analysis, and data from remaining 15 trials were synthesized qualitatively. Acupuncture reduced the number of tender points (MD, -3.21; 95% CI -4.23 to -2.11; p < 0.00001, I(2) = 0%), and pain scores compared with conventional medications (MD, -1.78; 95% CI, -2.24 to -1.32; p < 0.00001; I(2) = 0%). Acupuncture showed no significant effect, with a random-effect model, compared with sham acupuncture (MD, -0.55; 95% CI, -1.35-0.24; p = 0.17; I(2) = 69%), on pain reduction. A combination of acupuncture and cupping therapy was better than conventional medications for reducing pain (MD, -1.66; 95% CI, -2.14 to -1.19; p < 0.00001; I(2) = 0%), and for improving depression scores with related to FM (MD, -4.92; 95% CI, -6.49 to -3.34; p < 0.00001; I(2) = 32%). Other individual trials demonstrated positive effects of Chinese herbal medicine on pain reduction compared with conventional medications. There were no serious adverse effects reported that were related to TCM therapies in these trials. TCM therapies appear to be effective for treating FM. However, further large, rigorously designed trials are warranted because of insufficient methodological rigor in the included trials.
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The objective of this study was to assess the evidence for or against the effectiveness of cupping as a treatment option for pain. Fourteen databases were searched. Randomized clinical trials (RCTs) testing cupping in patients with pain of any origin were considered. Trials using cupping with or without drawing blood were included, while trials comparing cupping with other treatments of unproven efficacy were excluded. Trials with cupping as concomitant treatment together with other treatments of unproven efficacy were excluded. Trials were also excluded if pain was not a central symptom of the condition. The selection of studies, data extraction and validation were performed independently by three reviewers. Seven RCTs met all the inclusion criteria. Two RCTs suggested significant pain reduction for cupping in low back pain compared with usual care (P < .01) and analgesia (P < .001). Another two RCTs also showed positive effects of cupping in cancer pain (P < .05) and trigeminal neuralgia (P < .01) compared with anticancer drugs and analgesics, respectively. Two RCTs reported favorable effects of cupping on pain in brachialgia compared with usual care (P = .03) or heat pad (P < .001). The other RCT failed to show superior effects of cupping on pain in herpes zoster compared with anti-viral medication (P = .065). Currently there are few RCTs testing the effectiveness of cupping in the management of pain. Most of the existing trials are of poor quality. Therefore, more rigorous studies are required before the effectiveness of cupping for the treatment of pain can be determined.
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Many coaches, athletes and sports medicine personnel hold the belief, based on observations and experiences, that massage can provide several benefits to the body such as increased blood flow, reduced muscle tension and neurological excitability, and an increased sense of well-being. Massage can produce mechanical pressure, which is expected to increase muscle compliance resulting in increased range of joint motion, decreased passive stiffness and decreased active stiffness (biomechanical mechanisms). Mechanical pressure might help to increase blood flow by increasing the arteriolar pressure, as well as increasing muscle temperature from rubbing. Depending on the massage technique, mechanical pressure on the muscle is expected to increase or decrease neural excitability as measured by the Hoffman reflex (neurological mechanisms). Changes in parasympathetic activity (as measured by heart rate, blood pressure and heart rate variability) and hormonal levels (as measured by cortisol levels) following massage result in a relaxation response (physiological mechanisms). A reduction in anxiety and an improvement in mood state also cause relaxation (psychological mechanisms) after massage. Therefore, these benefits of massage are expected to help athletes by enhancing performance and reducing injury risk. However, limited research has investigated the effects of pre-exercise massage on performance and injury prevention. Massage between events is widely investigated because it is believed that massage might help to enhance recovery and prepare athletes for the next event. Unfortunately, very little scientific data has supported this claim. The majority of research on psychological effects of massage has concluded that massage produces positive effects on recovery (psychological mechanisms). Post-exercise massage has been shown to reduce the severity of muscle soreness but massage has no effects on muscle functional loss. Notwithstanding the belief that massage has benefits for athletes, the effects of different types of massage (e.g. petrissage, effleurage, friction) or the appropriate timing of massage (pre-exercise vs post-exercise) on performance, recovery from injury, or as an injury prevention method are not clear. Explanations are lacking, as the mechanisms of each massage technique have not been widely investigated. Therefore, this article discusses the possible mechanisms of massage and provides a discussion of the limited evidence of massage on performance, recovery and muscle injury prevention. The limitations of previous research are described and further research is recommended.
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Centuries ago cupping was one of the most used medical therapies worldwide but it is now regarded as an antiquated and unsafe treatment. Nevertheless it is widely used especially in Germany and China. To investigate the effectiveness of "wet cupping" of a defined connective tissue area (over the Musculus trapezius) in patients suffering from brachialgia paresthetica nocturna. Monocenter, randomised, controlled, sequential clinical trial. Section of pain management at the District Hospital of Rüdersdorf, Germany. Brachialgia-patients of both sexes without age restictions were eligible if they suffered from chronical tonsillar irritations and showed pathologic indurations of the connective tissue area. The active group was "wet cupped" once, i.e. the skin first was scarified and then blood was drawn by applying vacuum cupping glasses. The control group was left untreated. Pre- to post-treatment change of brachialgia severeness, calculated from 1-week averages of the means of three subscales (pain, tingling and numbness), each assessed on a 0-10 numeric analogue scale. N=20 patients were randomised (13 women, median age 47 years). Treatment effects can be found in the active (-2.3+/-1.9 score points) but not in the control group (+0.5+/-1.0 points; p=0.002; triangle test). The results are supported by secondary outcome criteria. Adverse events were not documented in any patient. This study suggests short-term effects of a single wet cupping therapy, which remain at least for 1 week. As the trial lacks of an adequate and blinded placebo therapy the findings are potentially biased.
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Wet-cupping is an ancient medical technique still used in several contemporary societies, but little empirical study has been devoted to test its efficacy to treat tension and migraine headache. Using a pre-post research design, 70 patients with chronic tension or migraine headache were treated with wet-cupping. Three primary outcome measures were considered at the baseline and 3 months following treatment: headache severity, days of headache per month, and use of medication. Results suggest that, compared to the baseline, mean headache severity decreased by 66% following wet-cupping treatment. Treated patients also experienced the equivalent of 12.6 fewer days of headache per month. We conclude that wet-cupping leads to clinical relevant benefits for primary care patients with headache. Possible mechanisms of wet-cupping's efficacy, as well as directions for future research are discussed.
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The aim of this study was to investigate the effects of kinesio taping (KT) in combination with moderate adapted exercise on the functional outcome of patients with knee osteoarthritis. We included 66 patients who presented pain and functional impairment with osteoarthritis. At the end of the treatment, only 57 patients remained because nine patients were excluded. Patients were randomly allocated to three treatment groups: (1) exercise group; (2) exercise KT with tension application (stabilizing effect) group; (3) exercise KT without tension application (draining effect) group. We used different methods of investigation: the Western Ontario and McMaster Universities Arthritis Index, the Visual Analogue Scaling Score for Pain, the Timed Up and Go test and analgesic consumption. Our results showed a reduction in knee pain, improvement in knee function and also less need for medication in patients with knee osteoarthritis treated with kinesio taping in combination with exercise for, at least, a period of three months. In conclusion, we can assert that therapeutic knee kinesio taping in association with a moderate adapted training is an effective method for the management of pain and disability limitations in patients with knee osteoarthritis.
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This new edition continues to offer readers a comprehensive exploration and description of techniques of cupping in the context of Traditional Chinese Medicine theory. Extensively updated throughout, and with a new website containing videos and a downloadable image bank, this volume will be ideal for students and practitioners of Traditional Chinese Medicine, and all other complementary health practitioners looking to expand their skill base.
Article
Objective: To assess the efficacy of Kinesio taping (KT) on venous symptoms, quality of life, severity, pain, edema, range of ankle motion (ROAM), and peripheral muscle myoelectrical activity in lower limbs of postmenopausal women with mild chronic venous insufficiency (CVI). Design: Double-blinded randomized controlled trial with concealed allocation. Setting: Clinical setting. Participants: Consecutive postmenopausal women (N=123; age range, 62-67y) with early-stage CVI. None of the participants withdrew because of adverse effects. Intervention: Participants were randomly assigned to an experimental group for standardized KT application for external gastrocnemius (EG) and internal gastrocnemius (IG) muscle enhancement and ankle function correction or a placebo control group for sham KT application. Both interventions were performed 3 times a week during a 4-week period. Main outcome measures: Venous symptoms, CVI severity, pain, leg volume, gastrocnemius electromyographic data, ROAM, and quality of life were recorded at baseline and after treatment. Results: The experimental group evidenced significant improvements in pain distribution, venous claudication, swelling, heaviness, muscle cramps, pruritus, and CVI severity score (P≤.042). Both groups reported significant reductions in pain (experimental group: 95% confidence interval [CI], 1.6 to 2.1; control group: 95% CI, -0.2 to 0.3). There were no significant changes in either group in quality of life, leg volume, or ROAM. The experimental group showed significant improvements in root mean square signals (right leg: EG 95% CI, 2.99-5.84; IG 95% CI, 1.02-3.42; left leg: EG 95% CI, 3.00-6.25; IG 95% CI, 3.29-5.3) and peak maximum contraction (right leg: EG 95% CI, 4.8-22.7; IG 95% CI, 2.67-24.62; left leg: EG 95% CI, 2.37-20.44; IG 95% CI, 2.55-25.53), which were not changed in controls. Conclusions: KT may reduce venous symptoms, pain, and their severity and enhance gastrocnemius muscle activity, but its effects on quality of life, edema, and ROAM remain uncertain. KT may have a placebo effect on venous pain.
Article
Unlabelled: We investigated the effectiveness of cupping, a traditional method of treating musculoskeletal pain, in patients with carpal tunnel syndrome (CTS) in an open randomized trial. n = 52 outpatients (58.5 +/- 8.0 years) with neurologically confirmed CTS were randomly assigned to either a verum (n = 26) or a control group (n = 26). Verum patients were treated with a single application of wet cupping, and control patients with a single local application of heat within the region overlying the trapezius muscle. Patients were followed up on day 7 after treatment. The primary outcome, severity of CTS symptoms (VAS), was reduced from 61.5 +/- 20.5 to 24.6 +/- 22.7 mm at day 7 in the cupping group and from 67.1 +/- 20.2 to 51.7 +/- 23.9 mm in the control group [group difference -24.5mm (95%CI -36.1; -2.9, P < .001)]. Significant treatment effects were also found for the Levine CTS-score (-.6 pts: 95%CI -.9; -.2, P = .002), neck pain (-12.6mm; 95%CI -18.8; -6.4, P < .001), functional disability (DASH-Score) (-11.1 pts; 95%CI -17.1; -5.1, P < .001), and physical quality of life (.3; 95%CI .0; .3, P = .048). The treatment was safe and well tolerated. We conclude that cupping therapy may be effective in relieving the pain and other symptoms related to CTS. The efficacy of cupping in the long-term management of CTS and related mechanisms remains to be clarified. Perspective: The results of a randomized trial on the clinical effects of traditional cupping therapy in patients with carpal tunnel syndrome are presented. Cupping of segmentally related shoulder zones appears to alleviate the symptoms of carpal tunnel syndrome.
Article
To determine the efficacy of wet-cupping for treating persistent nonspecific low back pain. Wet-cupping therapy is one of the oldest known medical techniques. It is still used in several contemporary societies. Very minimal empirical study has been conducted on its efficacy. Randomized controlled trial with two parallel groups. Patients in the experimental group were offered the option of referral to the wet-cupping service; all accepted that option. The control group received usual care. Medical clinic in Kermanshah, Iran. In total, 98 patients aged 17-68 years with nonspecific low back pain; 48 were randomly assigned to experimental group and 50 to the control group. Patients in the experimental group were prescribed a series of three staged wet-cupping treatments, placed at 3 days intervals (i.e., 0, 3, and 6 days). Patients in the control group received usual care from their general practitioner. Three outcomes assessed at baseline and again 3 months following intervention: the McGill Present Pain Index, Oswestry Pain Disability Index, and the Medication Quantification Scale. Wet-cupping care was associated with clinically significant improvement at 3-month follow-up. The experimental group who received wet-cupping care had significantly lower levels of pain intensity ([95% confidence interval (CI) 1.72-2.60] mean difference=2.17, p<0.01), pain-related disability (95% CI=11.18-18.82, means difference=14.99, p<0.01), and medication use (95% CI=3.60-9.50, mean difference=6.55, p<0.01) than the control group. The differences in all three measures were maintained after controlling for age, gender, and duration of lower back pain in regression models (p<0.01). Traditional wet-cupping care delivered in a primary care setting was safe and acceptable to patients with nonspecific low back pain. Wet-cupping care was significantly more effective in reducing bodily pain than usual care at 3-month follow-up.
Article
This study was undertaken to investigate any relationship between sensory features and neck pain in female office workers using quantitative sensory measures to better understand neck pain in this group. Office workers who used a visual display monitor for more than four hours per day with varying levels of neck pain and disability were eligible for inclusion. There were 85 participants categorized according to their scores on the neck disability index (NDI): 33 with no pain (NDI<8); 38 with mild levels of pain and disability (NDI 9-29); 14 with moderate levels of pain (NDI30). A fourth group of women without neck pain (n=22) who did not work formed the control group. Measures included: thermal pain thresholds over the posterior cervical spine; pressure pain thresholds over the posterior neck, trapezius, levator scapulae and tibialis anterior muscles, and the median nerve trunk; sensitivity to vibrotactile stimulus over areas of the hand innervated by the median, ulnar and radial nerves; sympathetic vasoconstrictor response. All tests were conducted bilaterally. ANCOVA models were used to determine group differences between the means for each sensory measure. Office workers with greater self-reported neck pain demonstrated hyperalgesia to thermal stimuli over the neck, hyperalgesia to pressure stimulation over several sites tested; hypoaesthesia to vibration stimulation but no changes in the sympathetic vasoconstrictor response. There is evidence of multiple peripheral nerve dysfunction with widespread sensitivity most likely due to altered central nociceptive processing initiated and sustained by nociceptive input from the periphery.
Ben Cao Gang Mu Shi Yi; People's Medical Publishing House
  • X M Zhao
Zhao, X.M. Ben Cao Gang Mu Shi Yi; People's Medical Publishing House: Beijing, China, 1963. (In Chinese)
Practical Cupping Therapy
  • L W Gao
Gao, L.W. Practical Cupping Therapy; Academy Press: Beijing, China, 2004. (In Chinese)
Benefits of cupping therapy
  • I Z Chirali
Chirali, I.Z. Benefits of cupping therapy. In Traditional Chinese Medicine Cupping Therapy;