No full-text available
To read the full-text of this research,
you can request a copy directly from the authors.
Effects of Acupressure on Lower Limb Blood Flow for the Treatment of Peripheral Arterial Occlusive Diseases
Abstract
To investigate the effects of acupressure on lower limb blood flow for the treatment of peripheral arterial occlusive diseases (PAOD).
From February 2004 to February 2005, 30 patients with stage II PAOD underwent measurements of the lower limb blood flow. Six patients (group A) were assigned as controls without any acupoint stimulation, while 24 (group B) underwent stimulation at acupoints by acupressure. The acupoints Yanglingquan (GB34), Zusanli (ST36), Yinlingquan (SP9), and Sanyinjiao (SP6) of the symptomatic lower limbs were stimulated for 3 min. Transcutaneous oximetry (tcPO2) was used to determine the blood flow of the chest wall, bilateral distal crura, and bilateral dorsa of the foot before and during the stimulations at the acupoints.
Group A showed no significant change in the lower limb blood flow. In group B, the tcPO2 values of chest wall, bilateral distal crura, and the dorsum of foot of the stimulated lower limb increased significantly during acupressure (P < 0.01), whereas no significant change was shown in the dorsum of the foot of the non-stimulated lower limb. Moreover, the blood flow of the lower limbs that had undergone an ipsilateral sympathectomy increased significantly (P < 0.01).
Acupressure was found to cause significant increases in the lower limb blood flow of stage II PAOD patients. This treatment modality may therefore be effective for improving the symptoms of such patients.
... In contrast, acupressure relies on manual pressure application, which may lack precision and consistency. Nonetheless, one study indicated that acupressure on four lower-limb acupoints, including ST36, significantly increased blood flow in both stimulated and unstimulated lower legs [33]. This suggests that compensation for these limitations may require the application of acupressure at multiple acupoints to produce an additive effect on the autonomic nervous system, blood flow, and thermal responses. ...
Acupressure on ST36 (Zusanli), located on the lower leg, commonly used to optimize autonomic nerve activity and systemic blood flow in traditional Chinese medicine. However, its efficacy remains controversial. This study hypothesized that a single acupressure on ST36 attenuates sympathetic nerve activity and mitigate skin vasoconstriction in response to cold stimulation. Twelve participants received either 5-min acupressure or sham pressure in the right ST36; subsequently, their left hand was immersed in cold water (10°C) for 10 min. Heart rate (HR), arterial pressure, skin temperature, and blood flow in both fingers were monitored. Autonomic nerve activity was assessed by HR variability. Water immersion decreased skin temperature and blood flow in both fingers with an increase in arterial pressure. However, there were no differences in these values or HR variability between the acupressure and sham trials. Acupressure on ST36 affected neither sympathetic nerve activity nor skin vasoconstrictive response during cold-water immersion.
... Many previous studies have shown that muscle and skin blood flow increased with acupuncture and acupressure of acupoints (Hsiu et al. 2010;Li et al. 2007;Litscher et al. 2002;Sandberg et al. 2003). To our knowledge, no studies animal or human studies have examined the effects of acupuncture and acupressure of remote acupoints on tendon blood circulation. ...
Purpose
The purpose of this study was to compare the effects of acupuncture and acupressure of acupoints on tendon blood circulation with those of both types of stimulation of tendon itself.
Methods
Before, during (except for acupressure), and after acupuncture and acupressure of the tendon and acupoint, blood circulation of the Achilles tendon was measured using red laser lights.
Results
The blood volume of the treated and non-treated tendons increased after acupuncture of the tendon (effect of time p = 0.030), whereas that tended to increase after acupuncture of the acupoint (effect of time p = 0.063). In addition, no significant difference in the increases in blood volume was found among the four conditions, i.e., after acupuncture stimulation of the tendon and acupoint for the treated and non-treated tendons (p = 0.492). The blood volume of the treated tendon significantly increased after acupressure of the tendon (effect of time p < 0.001), but not of the acupoint (effect of time p = 0.260), whereas that of the non-treated tendon did not change after acupressure of both the tendon and acupoint.
Conclusion
These results suggested that acupuncture of the tendon and acupoint acted centrally to enhance blood circulation of both the treated and non-treated tendons during the recovery period, whereas acupressure of the tendon locally increased blood circulation of the treated tendon only, but not the non-treated tendon and both the treated and non-treated tendons after acupressure of acupoint.
... Li et al. assessed the effects of acupressure on the lower limb's blood flow for treating peripheral arterial occlusive diseases. They concluded that the lower limb blood flow in Stage II peripheral arterial occlusive diseases (PAOD) patients increased significantly by acupressure [31]. This technique has a significant impact on the autonomic nervous system (ANS). ...
Acupressure in Oriental medicine is used as a core therapeutic method due to its therapeutic efficacy and minimal side-effects. However, microcurrent stimulation, combined with acupressure and grounding, has not been studied under acupressure conditions in terms of how this combination might affect acupressure therapy's effectiveness. This paper clarifies the new concept of acupressure stimulation combined with a microcurrent that generates electron flow during earthing. In grounding the body, there is free electron movement from and to the body that creates microcurrent. Acupressure uses these currents to activate specific acupoints for therapeutic purposes and activating these acupoints adjust the imbalance between Qi across channels (meridians) and ultimately treat diseases. It is time for proper research and implementation of this technique to increase acupressure efficacy and reduce society's cost.
... Acupressure on the heel may have a pain relieving effect due to a local vascular effect. 40,41 Two studies used the same acupuncture point Yintang. In the study by Ecevit et al. 27 light needling for 30 s generated a significant pain reduction compared with laser acupuncture at Yintang, done by Abbasoglu et al. 29 A possible explanation for this could be the low energy dosage used, resulting in insufficient stimulation of tissues at the location of the acupuncture point. ...
Background:
Neonatal pain is an extensive research field and there are many possibilities to treat pain in neonates. Acupuncture is one new and non-pharmacological option and a promising tool to reduce pain in neonates undergoing minor painful interventions during routine medical care.
Objectives:
This review summarises trials of acupuncture for pain reduction in neonates undergoing painful interventions during routine medical care.
Data source:
MEDLINE, Embase, CINAHL, electronic clinical trials registry platforms and reference lists were systematically screened for trials from their dates of inception to February 2017 (English language database search).
Study selection:
Inclusion criteria were (1) preterm or term neonates, (2) acupuncture for painful medical interventions and (3) formal pain assessment as a primary or secondary study outcome. We included only randomised controlled trials.
Data extraction:
Data were extracted using a standardised protocol and individual risk of bias was assessed.
Results:
The literature search revealed a total of 12 196 records. After application of inclusion criteria, five studies were included in this review. Two studies demonstrated significant pain reduction, one found equal outcomes in comparison to standard care, and two showed significantly higher pain scores with acupuncture alone.
Limitations:
The main limitation of the results is the heterogeneity across trials in acupuncture modality, acupuncture point selection, control groups and pain assessment (heterogeneity: I2=87%).
Conclusion:
The results of this review suggest that acupuncture may have a positive pain-relieving effect in neonates. However, due to the low number of available high-quality trials and heterogeneity across the studies it is not possible to state clear recommendations.
... Deqi sensation is a composite of unique sensations described as aching, soreness, pressure, heaviness, fullness, warmth, cooling, numbness, tingling, and dull pain (Kong et al., 2007). Deqi sensations have also been induced by pressure stimulation at acupuncture points Tse, 2004, 2006;Li et al., 2007). Furthermore, sustained pressure stimulation at MTrPs has also elicited deqi-like sensations including aching and dull pain in the distal or proximal areas from the point of stimulation (Simons, 1995;Clark, 2008;Delany, 2014). ...
Compression at myofascial trigger points (MTrPs), known as “ischemic compression,” has been reported to provide immediate relief of musculoskeletal pain and reduce the sympathetic activity that exacerbates chronic pain. We conducted a pilot study to investigate the possible involvement of the prefrontal cortex in pain relief obtained by MTrP compression in the present study, and analyzed the relationships among prefrontal hemodynamic activity, activity of the autonomic nervous system, and subjective pain in patients with chronic neck pain, with and without MTrP compression. Twenty-one female subjects with chronic neck pain were randomly assigned to two groups: MTrP compression (n = 11) or Non-MTrP compression (n = 10). Compression for 30 s was conducted 4 times. During the experiment, prefrontal hemodynamic activity [changes in Oxy-hemoglobin (Hb), Deoxy-Hb, and Total-Hb concentrations] and autonomic activity based on heart rate variability (HRV) were monitored by using near infrared spectroscopy (NIRS) and electrocardiography (ECG), respectively. The results indicated that MTrP compression significantly reduced subjective pain compared with Non-MTrP compression. The spectral frequency-domain analyses of HRV indicated that a low frequency (LF) component of HRV was decreased, and a high frequency (HF) component of HRV was increased during MTrP compression, while LF/HF ratio was decreased during MTrP compression. In addition, prefrontal hemodynamic activity was significantly decreased during MTrP compression compared with Non-MTrP compression. Furthermore, changes in autonomic activity were significantly correlated with changes in subjective pain and prefrontal hemodynamic activity. Along with previous studies indicating a role for sympathetic activity in the exacerbation of chronic pain, the present results suggest that MTrP compression in the neck region alters the activity of the autonomic nervous system via the prefrontal cortex to reduce subjective pain.
... Sandberg, Lindberg, and Gerdle (2004) demonstrated that lower extremity acupoint stimulation increased skin and muscle blood flow. Li et al (2007) also demonstrated improved lower extremity perfusion associated with acupressure applied to selected sites in the lower extremities of patients with peripheral artery occlusive disease. While the mechanism related to these vascular responses to acupoint stimulation is not clearly understood, we attempted to stimulate similar locations to potentially facilitate improved blood flow. ...
The purpose of this study was to determine whether the application of near infrared (NIR) light could positively modulate symptoms associated with restless legs syndrome (RLS). Twenty-one subjects with RLS were treated with NIR three times weekly for four weeks. Baseline measures of: (1) international restless legs syndrome rating scale (IRLSRS) score; (2) Semmes Weinstein monofilament (SWM) test; (3) visual analog pain scale (VAS); (4) ankle-brachial index (ABI); and (5) sonographic imaging of the popliteal and posterior tibial arteries were compared to post-treatment values. NIR (850 nm) was delivered transcutaneously at 8 J/cm(2) to four locations on each leg and the plantar surface of each foot. A pre-test-post-test one group design was employed. Baseline and post-treatment measures were compared using either a dependent t-test when data were normal or the Wilcoxon signed rank test in the absence of normality. A significant improvement in IRLSRS scores was observed. Sensation improved from less than protective in 16.6% of sites tested at the baseline to 13.4% post-intervention. There was a significant improvement in ABI scores. VAS and sonographic imaging measures other than ABI remained unchanged. The use of NIR to modulate symptoms associated with RLS was supported by the data.
... Li et al. 28 observed that acupressure caused significant increase in lower limb blood flow while acupressure was applied to patients with occlusive peripheral arterial disease. Acupressure stimulates peripheral sensory nerve endings and causes the release of vasoactive neuropeptides, such as calcitonin gene-related peptide, and substance P. 29 These mediators induce local vasodilation, thus increasing skin blood flow. ...
Acupressure is an ancient Chinese healing art. In this pain-relieving method, the fingers are used to press key acupuncture points on the skin surface that stimulates the body׳s regulatory processes.
The aim of this study was to investigate the effect of acupressure at Kun Lun (UB60) and Taixi (K3) points for pain management in preterm infants prior to heel lancing for blood collection.
This was a prospective, randomized controlled study.
The study setting was the neonatal intensive care unit at Baskent University Hospital in Turkey.
A total of 32 preterm infants between 28 and 36 weeks׳ gestational age were randomly assigned to one of two groups: an acupressure group (n = 16) or a control group (n = 16).
In the acupressure group, immediately before the heel prick, acupressure was applied for three minutes at UB60 and K3 points.
A behavioral pain score was determined using the Premature Infant Pain Profile (PIPP) scale.
There were no significant differences between the groups with respect to gestational age, birth weight, sex, mode of delivery, age at time of procedure, weight at time of procedure, or PIPP score. Mean duration of procedure and mean duration of crying were both shorter in the acupressure group (both P = .001).
Applying acupressure at the BL60 and K3 points before heel lancing was associated with shorter procedural time and shorter duration of crying in preterm infants.
Copyright © 2015 Elsevier Inc. All rights reserved.
... Huantiao (GB30) 96 Xuehai (SP10) 96 Yanglingquan (GB34) [96][97][98] Zusanli (ST36) 68 103 104 Hegu (LI4) 105 103 104 Futu (LI18) 106 Renying (ST9) 107 Fengchi (GB 20) 103 104 107 appear to trigger different brain networks depending on how acupoints are stimulated. For EA, electrical modalities, including frequency and intensity, are important factors influencing its effect. ...
Accumulated evidences from clinical trials and updated reviews suggest that the role of acupuncture in perioperative medicine extends beyond the classical scope of anaesthesia and has been underestimated. Perioperative acupuncture reduces not only the consumption of anaesthetics and analgesics, but also anaesthesia-related complications, and protects organs in the perioperative period. These beneficial effects make acupuncture a promising approach in perioperative management, especially with respect to enhanced surgery recovery and specific surgical populations, such as elderly patients and 'triple-low' patients. Furthermore, efforts have been made to optimize the clinical application of perioperative acupuncture.
© The Author 2015. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
... The left TA muscle served as the control; the hind leg was shaved but no needle was inserted [58], in order to avoid the reported controversies associated with the placement of sham needles, which produce biological effects that may complicate interpretation of results [59]. ST 36 is the most commonly targeted acupuncture needle point in both clinical settings [60] and experimental studies [58] [61], and is considered to be more effective in restoring energy balance in humans than other points according to traditional acupuncture medical theory [62]. ...
... A controlled trial of acupressure for 30 patients with peripheral arterial occlusive diseases (PAOD) reported a significant reduction in transcutaneous oximetry [92]. This is a poor quality study with an apparent lack of randomisation and non-equivalent control group, poor reporting and no comparison of groups, although outcomes are objective and intervention is well reported. ...
Background: Shiatsu, similar to acupressure, uses finger pressure, manipulations and stretches, along Traditional Chinese Medicine meridians. Shiatsu is popular in Europe, but lacks reviews on its evidence-base.
... These characteristics of the TA muscle are most likely related to its functional demand; TA muscle helps coordinate the control of balance and foot stability during normal walking, and is therefore active for extended periods daily. ST36 is the most commonly targeted acupuncture needle point in both clinical settings (Li et al., 2004), and experimental studies (Ameis, 1991). Several pathways, including insulin-like growth factor (IGF-1) play vital role in regulating muscle regeneration (Machida & Booth, 2004 ). ...
... In a comparison of acupressure with oxybutinin for nocturnal enuresis in children[91], the main flaw was the very small sample size, with no details of sampling, comparison of groups or randomisation, potential selection bias and no placebo/sham group. A controlled trial of acupressure for 30 patients with peripheral arterial occlusive diseases (PAOD) reported a significant reduction in transcutaneous oximetry[92]. This is a poor quality study with an apparent lack of randomisation and non-equivalent control group, poor reporting and no comparison of groups, although outcomes are objective and intervention is well reported. ...
Shiatsu, similar to acupressure, uses finger pressure, manipulations and stretches, along Traditional Chinese Medicine meridians. Shiatsu is popular in Europe, but lacks reviews on its evidence-base.
Acupressure and Shiatsu clinical trials were identified using the MeSH term 'acupressure' in: EBM reviews; AMED; BNI; CINAHL; EMBASE; MEDLINE; PsycARTICLES; Science Direct; Blackwell Synergy; Ingenta Select; Wiley Interscience; Index to Theses and ZETOC. References of articles were checked. Inclusion criteria were Shiatsu or acupressure administered manually/bodily, published after January 1990. Two reviewers performed independent study selection and evaluation of study design and reporting, using standardised checklists (CONSORT, TREND, CASP and STRICTA).
Searches identified 1714 publications. Final inclusions were 9 Shiatsu and 71 acupressure studies. A quarter were graded A (highest quality). Shiatsu studies comprised 1 RCT, three controlled non-randomised, one within-subjects, one observational and 3 uncontrolled studies investigating mental and physical health issues. Evidence was of insufficient quantity and quality. Acupressure studies included 2 meta-analyses, 6 systematic reviews and 39 RCTs. Strongest evidence was for pain (particularly dysmenorrhoea, lower back and labour), post-operative nausea and vomiting. Additionally quality evidence found improvements in sleep in institutionalised elderly. Variable/poor quality evidence existed for renal disease symptoms, dementia, stress, anxiety and respiratory conditions. Appraisal tools may be inappropriate for some study designs. Potential biases included focus on UK/USA databases, limited grey literature, and exclusion of qualitative and pre-1989 studies.
Evidence is improving in quantity, quality and reporting, but more research is needed, particularly for Shiatsu, where evidence is poor. Acupressure may be beneficial for pain, nausea and vomiting and sleep.
... Calf claudication develops due to functional ischemia of the calf muscles during exercise. Transcutaneous oxygen pressure and skin perfusion pressure are used for patients with peripheral arterial disease in Fontaine stage 3 or 4 to primarily evaluate the microcirculation, 1,2 whereas the treadmill-walking test is widely used for Fontaine stage 2. Near-infrared spectroscopy (NIRS) monitors the oxygen delivery to tissues. Near-infrared spectroscopy combined with a treadmill-walking test provides an objective assessment of intermittent claudication (IC). ...
The aim of this study was to elucidate whether the ankle brachial pressure index (ABPI) or transfer function index (TFI) was useful as an alternative parameter to the treadmill-walking test using near-infrared spectroscopy (NIRS) in evaluating muscle ischemia for patients with intermittent claudication (IC).
In 155 claudicants, the treadmill-walking test using NIRS was performed to calculate the recovery ability index (=recovery time/walking time). The ABPI and TFI were measured at the calf (TFI(calf)) and ankle (TFI(ankle)) using pulse volume recording. The area under the curve (AUC) was calculated from the receiver operating characteristic (ROC) curve and cutoff value was determined using crossing point of the ROC curve with a diagonal line.
In the nondiabetics, AUCs were 77.3%, 80.0%, and 76.0% in the ABPI, TFI(calf), and TFI(ankle), respectively, which were not different significantly. In the diabetics, the AUC of TFI(calf) was 77.9%, which was different significantly from those of the other indices such as the ABPI or TFI(ankle) showing 66.2% or 68.1%. The cutoff value of ABPI indicating moderate or severe IC was 0.75 in the nondiabetics whereas that of TFI(calf) was 0.85 in the diabetics.
TFI(calf) was useful to distinguish moderate or severe IC from mild IC in diabetic patients even if the ABPI was sufficient in nondiabetic patients.
Objective:
The purpose of this study was to compare changes in blood circulation (blood volume and oxygen saturation [StO2]) of tendon by acupuncture (insertion depth of the needle was 4 mm) and intermittent compression.
Subjects:
Thirteen healthy volunteers (12 males and 1 female; age: 26.9 ± 9.8 years) participated in this study.
Methods:
Before the treatments (10 min for acupuncture, 3 min for intermittent compression, and 10 min for control condition) and the recovery period (40 min), the blood volume (total hemoglobin [THb]) and StO2 of treated and nontreated Achilles tendons were measured using red laser lights.
Results:
Regarding the acupuncture-induced changes in blood circulation of tendons, THb and StO2 of the treated tendon suddenly increased during acupuncture with up-and-down manipulation, and those of the treated and nontreated tendons gradually increased after removal of the needle. The authors were not able to present the measured variables during intermittent compression, since obvious noises were observed. After acupuncture and intermittent compression, THb and StO2 of the treated tendon remained high during the recovery period and those of the nontreated tendon gradually increased during the latter half of the recovery period. There were no differences in the mean changes of THb or StO2 of the treated and nontreated tendons during the recovery period between acupuncture and intermittent compression. Under the control condition, no significant changes were noted in the measured variables.
Conclusion:
These results suggest that intermittent compression to the tendon brought about increases in tendon blood circulation similar to those induced by acupuncture.
Massage therapies are widely employed for improving and recovering tissue functions and physical activities. It is generally believed that such therapies would promote health and well-being by many possible mechanisms, including fastening muscle blood flow, parasympathetic activity, releasing relaxation hormones and inhibiting muscle tension, neuromuscular excitability and stress hormones. Nonetheless, most of current research is based on statistics and thus qualitative, preventing the in-depth study of the effectiveness. This is partially due to the lack of appropriate tools for quantitative loading and in situ assessment of tissue performance. To address this, we develop a biomechanical device to mimic massage therapies by applying controllable mechanical forces to animal tissues during cyclic mechanical motions. The device can apply compressive loads normal to the tissue surface and generate lengthwise motion along the tissue surface. Mechanical forces are applied with controllable magnitudes, frequencies and durations. Tissue mechanical response is recorded and correlated to the loading parameters. The changes of bulk tissue compliance and viscoelastic properties under various loading conditions are evaluated. The improvement of tissue functions and inhibition of muscle inflammation are examined. The results show that the peak torque production increased after massage, which suggests the recovery of muscle functions. A reduced number of infiltrating leukocytes is also observed in the subject muscle fibers after massage. Findings of this study suggest that the biomechanical device offers a quantitative analysis of massage actions, which will help to determine the optimal range of loading conditions required for safe and effective use of massage therapies.
Massage therapies are widely used for improving and restoring the function of human tissues It is generally accepted that such therapies promote human health and well-being by several possible mechanisms including increase in blood flow and parasympathetic activity release of relaxation hormones, and inhibition of muscle tension neuromuscular excitability and stress hormones Nonetheless most of the purported beneficial/adverse effects of massage are based on anecdotal experiences providing little insight on us effectiveness or the mechanisms underlying its usefulness Furthermore most studies to date have not quantitatively demonstrated the efficacy of massage on human health This might be due to the lack of appropriate tools necessary for the application of quantitatively controlled loading and for the evaluation of the subsequent responses To address this issue we developed a device that applies compression in lengthwise strokes to the soft tissues of the New Zealand white rabbit thereby mimicking the rubbing and effleurage techniques of massage This device permits control of the magnitude and frequency of mechanical load applied to the rabbit s hind limb for various durations The measure men: of tissue compliance and the viscoelastic properties as a function of loading parameters was also demonstrated Findings of this study suggest that this device offers a quantitative analysis of the applied loads on the tissue to determine an optimal range of loading conditions required for the safe and effective use of massage therapies [DOI 10.1115/1.2996623]
Background: Muscle injury stimulates normal quiescent resident satellite (stem) cells to re-enter the cell cycle and execute the myogenic program, resulting in muscle fiber regeneration. We hypothesized that part of acupuncture's efficacy is a consequence of needle-induced injury that stimulates satellite cells within muscle tissue. Objective: To determine whether manual acupuncture needling on a single point (ST 36) in a rat model can produce focal muscle damage and activate satellite cells. Design and Setting: Four male Sprague-Dawley rats were studied in this experiment at a single US academic institution. Intervention: The rats were anesthetized and underwent needling at ST 36 in the tibialis anterior (TA) muscle. Main Outcome Measure: Assessment of TA muscle damage was determined using light microscopy. Immunofluorescence was used to detect MyoD antibody, and Western blot to determine MyoD protein. Results: Phenotypic and morphological changes associated with focal injury were demonstrated. Injury to the muscle fibers was accompanied by the presence of activated satellite cells at 72 hours following acupuncture, as defined by the increased expression of myogenic regulatory factor MyoD. Conclusions: These results suggest that the therapeutic benefits of acupuncture may correlate to the activation of satellite cells due to tissue injury and help to define the mechanisms that underlie the efficacy of acupuncture's clinical application. Prospective studies in diseased tissue and with evaluation at multiple time points are warranted.
Ce3+-activated yttrium aluminum garnet (YAG) was prepared by the solid-state reaction, in which H3BO3, LiF, NaF, KF and BaF2 were used as the fluxes. The effect of fluxes on optical properties of phosphors was studied in detail, especially the fluxes of alkali fluorides, which could enhance the emission intensity and change the wavelength of emission peaks. Among these YAG:Ce phosphors, the phosphor sintered with H3BO3 and NaF exhibited the strongest emission. The emission peaks of phosphors prepared with fluxes from LiF to KF were shifted to long wavelength. The effect of NaF concentration on the emission intensity of YAG:Ce was also investigated. The value of emission intensity reached the maximum when the concentration of NaF was 0.5%.
In this paper, we construct a new phenomenological isospin dependent global
neutron-nucleus optical model potential. Based on the existing experimental
data of elastic scattering angular distributions for neutron as projectile, we
obtain a set of the isospin dependent global neutron-nucleus optical model
potential parameters, which can basically reproduce the experimental data for
target nuclei from Mg to Pu with the energy region up to 200
MeV.
In the present study, laser Doppler measurement was used to quantitatively investigate the microcirculatory effects of contact pressure stimulation (PS) underneath the Hoku acupoint and its nearby nonacupoint, to improve the understanding of the mechanisms underlying acupressure therapy. A control group (no PS applied) and three experimental groups with different applied PS (group A, 60 mmHg on the Hoku acupoint; group B, 60 mmHg on a nearby nonacupoint; group C, 50 mmHg on a nearby nonacupoint) were studied. Each experiment involved recording data of a 20 min baseline and two periods of effects after stopping PS. The relative energy contribution (REC) in five frequency bands, as revealed by Morlet wavelet transformation, was calculated. At the pressed site, the average value of the laser Doppler flux signal was increased only in group A, and coefficient of variance of the amplitude sequence was only significantly decreased during measurement (M1: 0 to 20 min) in group B. The RECs of the myogenic-related band were significantly increased in groups A and C, whereas there were no significant changes found in group B. The improved microcirculatory blood-flow perfusion at Hoku may partly explain why acupressure can exert better therapeutic effects than PS applied to other sites. The laser Doppler spectra responses illustrated that the induced pressure-induced vasodilation can be attributed mainly to the myogenic response. Laser Doppler measurement and analysis therefore represent a noninvasive method of examining the microcirculatory efficacy of acupressure therapy.
We used laser Doppler flowmetry (LDF) and spectrum analysis to investigate the microcirculatory responses to pressure stimulation (PS) of the skin surface. A control group without PS applied, and four groups with different PS (20, 60, 100 and 160 mmHg in groups PS(20), PS(60), PS(100) and PS(160), respectively) were formed from seven volunteers. Each experiment involved recording a 20 min baseline and two effect data recorded at 0-20 and 50-70 min after stopping PS. The relative energy contribution (REC) in five frequency bands revealed by Morlet-wavelet transformation was calculated. At the pressed site, the dc component of the flux signal in the second effect increased significantly only in group PS(60) compared with the control values. The REC was significantly increased in a myogenic-related band in groups PS(60), PS(100) and PS(160), and was significantly decreased in a nerve-related band only in group PS(160). Different PS magnitudes compress vessels to different extents. The proposed vessel-pressing model-which is supported by the results of spectral analysis of flux signals-might help to elucidate the underlying mechanism. The study results indicate that an improved perfusion was sustained for the longest time when applying 60 mmHg PS. This might aid the development of techniques for improving skin microcirculatory perfusion.
This investigation was to determine whether intraoperative monitoring of the transcutaneous partial pressure of oxygen (tcPo2) can be used to assess the success or failure of vascular reconstruction. A total of 347 limbs in 224 patients were studied, including 136 limbs without ischemic symptoms or signs, 173 limbs with intermittent claudication, and 38 limbs with ischemic rest pain, ulceration, or gangrene. The tcPo2 values were determined just before surgery, just before vascular declamping, at 5-minute intervals for 30 minutes after declamping, and just after surgery. A stable tcPo2 value of ≥ 45 mm Hg within 30 minutes after declamping indicated a good outcome, while graft failure or poor distal vascular runoff was suggested by a tcPo2 level of ≤ 45 mm Hg. Extremely poor results were indicated by persistent tcPo2 levels of < 10 mm Hg. Continuous tcPo2 measurement can be used to sensitively reflect distal tissue perfusion and determine the success or failure of vascular reconstruction.
In 14 healthy female subjects, the effects of needle stimulation (acupuncture) on skin and muscle blood flow were investigated using a non-invasive custom-designed probe and photoplethysmography (PPG). In randomised order, 2-7 days apart, three modes of needle stimulation were performed on the anterior aspect of the tibia: superficial insertion (SF), insertion into the anterior tibial muscle (Mu), and insertion into the muscle including manipulation of the needle in order to elicit a distinct sensation of distension, heaviness or numbness (DeQi). Before intervention, the subjects rested for 30 min. After the intervention, the needle was left in situ for 20 min. Blood flow recordings were performed intermittently from 10 min prior to the intervention to the end of the trial. In a fourth session, serving as control, corresponding measurements were performed without any needle stimulation. Area under curve was calculated for 5-min periods prior to and after stimulation, respectively, and for the remaining 15-min period after stimulation. Compared to the control situation, muscle blood flow increased following both Mu and DeQi for 20 min, with the latter being more pronounced for the initial 5 min. Skin blood flow increased for 5 min following DeQi. However, no increase was found following SF. The DeQi stimulation was preceded by higher visual analogue scale ratings of anxiety prior to stimulation, which might have influenced skin blood flow to some extent. The results indicate that the intensity of the needling is of importance, the DeQi stimulation resulting in the most pronounced increase in both skin and muscle blood flow.
Acupoints tend to show higher electric conductivity and have a higher concentration of neural and vascular elements as well as mast cells. According to one model, the meridian is an extravascular fluid (interstitial fluid) pathway and circulation of this fluid is driven by skeletal muscle contraction. Our result derived from laser Doppler flowmetry shows that Yanglao (SI6) and Xiaohai (SI8) have larger amplitude of heartbeat and vasomotion than non-acupuncture points. The amplitude of blood flow on the SI8 shows a more significant increase (4.3 +/- 0.7 PU) than that of non-acupuncture points (1.1 +/- 0.2 PU). Our results indicate that acupuncture increases blood flow when the De-Qi sensation takes place. In the experiment, the needle was only entered into the subject by 2 mm for about 15 sec during a SI6 acupuncture session, and the blood flow increased immediately. The blood flow of SI8 began to rise 5 sec after implementation and increased by 11.1 +/- 0.9 PU. However, when the arm was tied up, the blood flow at the S18 point slowed down quickly. Even though insertion with a twirling needle was followed after the drop in blood flow, the blood flow at the S18 point did not accelerate again (0.7 +/- 0.2 PU). The present study seems to show that acupuncture is effective in regulating the autonomic nervous system. Implementation of acupuncture causes the sphincter of microvessel to relax, and the tissue fluid to flow out, and the propagated sensation along the meridian is caused by this large amount of tissue fluid that flows along the loosen body stalk. The interstitial fluid increases during the needling and blood capillary expansion, which may be one of the mechanisms of acupuncture regulation.
Shiatsu is a deep and effective hands-on treatment for many conditions as well as being very relaxing and providing support for general health and well-being. Through the balancing of the body's energy, better physiological and psychological functioning can occur. Recommendations for diet and lifestyle based on traditional Chinese medicine theory can also be offered, according to individual need. The 3-year part-time training in shiatsu is demanding but enables the nurse using shiatsu to offer a particularly beneficial complementary therapy.
Transcutaneous oximetry is gaining worldwide acceptance as a simple and effective means of evaluating the cutaneous circulation. Oximetry involves the use of Clark-type electrically heated oxygen-sensing electrodes that are attached to the skin; various protocols for the performance of studies (utilizing exercise, oxygen inhalation, leg elevation, and various other maneuvers) have been developed which may improve the accuracy when used in certain settings. Applications for transcutaneous oximetry are found in areas such as: (1) diagnosis of disease, (2) quantification of disease severity, (3) prediction of healing potential for skin ulcers or amputation sites, (4) assessment of microvascular disease, and (5) determination of cutaneous vasomotor status. Transcutaneous oxygen tension serves as an index of the adequacy of skin blood flow, and therefore yields valuable "functional" information not provided by noninvasive "anatomical" testing modalities such as echo-doppler ultrasound imaging.
The measurement of transcutaneous oxygen tension (TcPO2) has been adapted for the assessment of the blood supply of the lower limb. This study was undertaken to determine the most useful means of expressing TcPO2 measurements. We studied 176 patients with peripheral vascular disease and/or diabetes and 34 normal volunteers. Approximately++ half of the patients studied had ulceration or gangrene of the foot. A comparison of three methods of expressing TcPO2 measurement for predicting presence of ulceration was made using ROCA analysis. The absolute value of TcPO2 on the dorsum of the foot was the best predictor of the presence of ulceration or gangrene. An absolute value of TcPO2 of 30 mmHg on the dorsum of the foot had a sensitivity of 42% and specificity of 91%. The sensitivity of the test was as good in diabetic patients as in non-diabetic patients.
In the present work, an experimental observation was carried out with the determination method of bioelectric impedance in 78 cases of chronic hepatitis, 58 cases of chronic obstructive pulmonary disease, 45 of obstructive thromboendarteritis and 65 of coronary heart disease, who were diagnosed definitely and possessed the symptoms and signs of blood stasis and produced change in hemodynamics. Yanglingquan (G. B. 34) and Zhangmen (Liv.13) acupoints on right side were needled and four indices of liver blood circulation were determined for chronic hepatitis. Bilateral Kongzui (Lu.6) acupoints were needled and seven indices of lung blood circulation were detected for chronic obstructive pulmonary disease. Acupoint along the pathway of channel were needled and six indices of blood circulation in the extremities were examined for obstructive thromboendarteritis. Bilateral Neiguan (P.6) acupoints were needled and four indices of the cardiovascular function were detected for coronary heart disease. Results showed 95 cases of the above four diseases having Qi reaching to affected area. 84 cases had propagated sensation along the channel. 67 cases had local sensation. Experimental results indicated that Qi reaching affected area produced obvious effects of dredging the meridian passage, and promoting blood circulation to remove blood stasis.
Unlabelled:
This article reports the curative effects of acupuncture on 6 acupoints of Yang meridian in treating 32 cases of cerebral infarction in comparison with another 31 cases treated with calan tablets 55 out of 63 patients have been diagnosed as cerebral infarction by computer tomography. Diagnosis of 8 cases relied on history, symptoms, signs together with cerebrospinal fluid examination. Patients were divided randomly into two treatment groups: acupuncture group and calan tablet group. Therapeutic method: (1) For acupuncture group, main acupoints consisted of Jianyu (L.I. 15), Quchi (I. I. 11), Hegu (L. I.4) in the upper extremity and Huantiao (G. B. 30), Yanglingquan (G. B. 34), Guangming (G. B. 37) in the lower extremity. According to the syndrome differentiation, Taichong (Liv. 3), Fengchi (G. B. 20), Tianshu (St. 25), Fenglong (St. 40), Zusanli (St. 36), Sanyinjiao (Sp. 6), Taixi (K. 3) were added. The lifting and thrusting was manipulated. The needles were retained for 30 minutes after the patient felt local sourness, distension and heaviness. Acupuncture was carried out every day for 6 weeks. (2) For calan tablet group, calan tablet 5 mg was administered 3 times a day for the same treatment session as the former group.
Result:
The total effective rates were 93. 75% and 83.87% respectively. The therapeutic effect in the acupuncture group was much better than that in the calan tablet group (P less than 0.05). The majority of hemorheological indices of patients in two groups were obviously higher than those of the normal in the same age group.(ABSTRACT TRUNCATED AT 250 WORDS)
Effects of digital acupressure on the blood flow in the capillary arterioles of the cerebral pia mater covering the posterior sigmoidal gyrus in domestic dog (Canis familiaris) were observed. The speed of blood flow was found increased to 185% after continuous digital acupressure for 20 minutes. The increase was most prominent 15 minutes after the acupressure was completed; the effect subsided in 30 minutes. It was also found that in cases of low basal speed of flow before digital acupressure, the increase in the speed of blood flow after acupressure was more pronounced.
Many methods are available today for clinical evaluation of the blood supply to an extremity or part of an extremity, some of which are excellent for determining the presence and severity of arterial and venous disorders. These methods, however, do not give any information on the microvascular status of the diseased areas. This is particularly true for the skin circulation, which has a rather complex vascular network with nutritional and thermoregulatory vessels, arteriovenous shunts, etc. The most useful method for clinical evaluation of the skin capillary circulation is vital capillary microscopy. The skin capillaries in an area with a reduced microcirculation change in structure, and it is possible to evaluate the viability of the skin by microscopic studies of these capillary changes. Both morphology and blood flow can be investigated. By using different intravital fluorescent dyes, e.g. sodium fluorescein and indocyanine green, the microvascular dynamics, flow distribution and microvascular permeability can also be studied. The total skin microcirculation can be evaluated by Laser Doppler fluxmetry, which measures primarily the blood flow in the thermoregulatory vascular bed, i.e. the subpapillary arterial and venous plexa. It is easy to use in clinical practice, but interpretation of the results can sometimes be difficult. Measuring transcutaneous oxygen tension has for many years been used in clinical routine to evaluate the viability of skin in patients with vascular disorders. It has recently been shown that inhalation of oxygen may induce vasoconstriction in healthy subjects and in patients with moderate arterial insufficiency, but an increase of the skin microcirculation in areas of severe ischaemia. By using different combinations of the above mentioned microcirculatory techniques, valuable information can be gained regarding pathophysiological phenomena of the microcirculation in many diseases, e.g. vascular disorders, collagenosis. Raynaud's phenomenon, diabetes and hypertension. Using techniques for both macro- and microcirculation is also of great importance for evaluating the effect of therapeutic procedures in several of these disorders.
Using electromagnetic flowmeter and Laser Coppler Microcirculatory flowmeter, we studied the effect of electrical acupuncture at Zusanli (ST 36) and Quchi (LI 11) on cerebral blood flow and pial microcirculatory blood flow in dogs. The results showed that the cerebral blood flow increased remarkably, while the cerebral vascular resistance (CUR) decreased 1 min. after the acupuncture start and 20, 30, 60, 90 min. after stopping of the stimulation, and the blood flow of the pial microvessels increased 1, 5, 10 min. after starting of acupuncture and 30 min. after stopping of the stimulation. It indicates that one of the mechanisms of treatment of cerebral vascular diseases with acupuncture is that acupuncture increases the cerebral blood flow and improve the pial microcirculation.
An introduction to the therapeutic applications, history, and theory of acupuncture and acupressure is presented. The traditional concepts that underlie treatment of imbalances of ch'i, or vital energy, are presented, along with the theories of yin and yang, meridians, vital substances, pathogenic factors, five phases, and the eight principle patterns. Contemporary Western research findings on the biochemical mediaries and effects of acupuncture are reviewed. Clinical applications to women's reproductive care that are presented include treatment for dysmenorrhea, infertility, and childbearing. Data on clinical trials are reviewed, and licensure and educational preparation for practice of these modalities are discussed.
Effects of electroacupuncture (EA) and routine acupuncture with twirling reinforcing and reducing manipulation of the needle (RA) both at Zusanli point (St 36) on volume of microcirculatory blood flow in the cerebral pia mater were observed by fenestration of the cranial bone and laser Doppler microcirculatory blood flow analyser. Results showed that both RA and EA could increase the volume of microcirculatory blood flow in the cerebral pia mater; and that the increase in the EA group was superior to that in RA group. This suggests that a moderate and effective stimulation is a key to the production of a regulative effect on the organism.
To study the effect of two non-invasive methods to stimulate acupoints on the cardiovascular system.
Blind randomized-controlled trial.
An experimental setting in a university-affiliated hospital.
The subjects (24 healthy male volunteers) were randomized to receive either an active stimulation consisting of pressure on acupoints (P), an active stimulation consisting of stroking along the meridians (S) or a control stimulation (C).
Data on skin blood flow, arterial pressure, heart rate and EKG were recorded continuously from 20 min before stimulation to 30 min after.
In P group there was a decrease in systolic arterial pressure, diastolic arterial pressure, mean arterial pressure, heart rate and skin blood flow. These changes were significantly different from those in C group and, as regards diastolic pressure and mean pressure, also from those in S group. There were no significant differences between S and C groups.
Pressure on acupoints can significantly influence the cardiovascular system.
In anesthetized rats, the contribution of calcitonin gene-related peptide (CGRP) to antidromic vasodilation of skeletal muscle blood flow (MBF) following electrical stimulation of muscle afferent was investigated by measuring biceps femoris MBF using laser Doppler flowmetry. Repetitive antidromic electrical stimulation of unmyelinated C fibers in ipsilateral dorsal roots at the 3rd-5th lumbar segments for 30 s caused an increase in MBF for 3-15 min (mean 4.5 min) without significant change in systemic arterial blood pressure. The increase in skeletal MBF started about 10 s after the onset of stimulation, and peaked at approximately 130% of the control value at about 30 s after the end of the 30 s period of stimulation. The MBF response was totally abolished by topical application of hCGRP (8-37), a CGRP receptor antagonist. It is concluded that antidromic vasodilation in skeletal muscles following stimulation of unmyelinated C afferents in dorsal roots is independent of systemic blood pressure and is mediated essentially by CGRP. It is suggested that this CGRP-related antidromic vasodilation may be important in the clinical improvement of skeletal MBF produced by physical therapy, e.g. acupuncture.
To evaluate the influence of acupuncture on the blood flow in the umbilical artery (UA), fetal aorta and uterine artery and on the fetal heart rate using two different acupuncture points (SP-6 (Sanyinjiao) and LI-4 (Hegu)).
In group A (n = 50), measurements (Doppler ultrasound and fetal heart rate) were performed at term after an uneventful pregnancy (#1) followed by acupuncture treatment using the acupuncture-point SP-6 bilaterally. The treatment time lasted 15 min after which the next measurement (#2) was carried out. The needles were then inserted into the LI-4 acupuncture point for a further 15 min. A third measurement at the end of acupuncture treatment (#3) completed the session. In group B (n = 25), measurements were made before (#1) and after (#4) acupuncture at LI-4 acupuncture points only.
In group A, the mean systolic/diastolic (S/D) ratios of UA #1, UA #2 and UA #3 were 2.45, 2.38 and 2.22, respectively (P = 0.0012). The difference in mean S/D ratios between UA #1 and UA #3 as well as that between UA #2 and UA#3 were statistically significant (P = 0.0002 and P = 0.008, respectively). There was no difference between the mean S/D ratios of the uterine artery and between the mean resistance indices of the fetal aorta. In group B, the only significant difference between measurements following acupuncture treatment was in fetal heart rate (139 vs. 143 bpm, P = 0.02).
Our study indicates a positive influence of acupuncture treatment on umbilical artery waveforms when using a combination of SP-6 (Sanyinjiao) and LI-4 (Hegu) acupuncture points. Acupuncture performed at these sites either individually or in combination does not seem to affect blood flow in the fetal aorta or uterine artery.
The effects of mechanical afferent stimulation of either a hindpaw or a hind leg on ovarian blood flow and systemic arterial blood pressure were studied in anesthetized nonpregnant adult female rats. Ovarian blood flow at the left side was continuously measured using a laser Doppler flowmeter. A mechanical stimulus (by pinching, brushing or pressing) was delivered for 30 s to either a hindpaw or a hind leg, at the right or left side. Pinching of a hindpaw at the right or left side decreased ovarian blood flow 8+/-3% accompanied with an increase in blood pressure. Brushing or pressing of a hindpaw produced no effects on these two parameters measured. Pressing stimulation of a hind leg at the right or left side produced a decrease in ovarian blood flow 8+/-2% accompanied with a decrease in blood pressure. Pinching or brushing of a hind leg produced no effects on both parameters measured. All responses of ovarian blood flow and blood pressure mentioned above were abolished after severing the femoral and sciatic nerves at the same side in which stimulation was unilaterally delivered. The blood pressure response, either increased or decreased depending on the stimulus modality and location stimulated, was not influenced by severing of ovarian sympathetic nerves. However, the decrease response in ovarian blood flow following pinching of a hindpaw reversed to the increase response, while the decrease response in ovarian blood flow following pressing of a hind leg was slightly augmented. The activity of sympathetic nerves innervating the ovary was increased during pinching of a hindpaw of either side, and decreased during pressing of a hind leg of either side. Electrical stimulation of the distal part of the severed splanchnic nerve at the left side decreased the left ovarian blood flow, and this response was abolished by intravenous injection of phentolamine, the alpha-adrenoceptor antagonist. The present results demonstrate that ovarian blood flow increase or decrease passively to responses of an increase or a decrease in systemic arterial blood pressure following mechanical afferent stimulation of a hindlimb, and these passive responses of ovarian blood flow are modulated by reflexive activity of ovarian sympathetic vasoconstrictor nerves to attenuate blood pressure-dependent passive changes in ovarian blood flow.
In anesthesized rats, the effects of electrical stimulation (ES) to the saphenous nerve on the microcirculation of the gracilis muscle were assessed through the measurement of two different hemodynamic parameters: (a). the muscle blood flow (MBF) using a laser Doppler flowmeter; and (b). the changes in diameter of the muscle arterioles observed directly using an intravital microscope system. Ipsilateral ES (5 V, 20 Hz, for 30 s) produced increases in MBF and mean arterial pressure (47+/-10% and 18+/-5%) over the baseline, while no significant changes in MBF were observed in the contralateral muscle. Neither selective nor simultaneous alpha- and beta-adrenergic blockade altered the increases in MBF induced by ipsilateral ES. The arteriolar diameter was found to increase by 38.9+/-5% following ipsilateral ES. This response in diameter was abolished after the topical application of a calcitonin gene-related peptide receptor antagonist (CGRP(8-37)). Contralateral ES produced a decrease in arteriolar diameter by 26+/-14%. Thus, ipsilateral nerve ES produced vasodilative responses in the muscle accompanied by increases in MBF independently of the sympathetic activity. Furthermore, CGRP was found directly involved in the reflex neural regulation of the muscle microcirculation, which suggests the participation of an axon reflex mechanism.
The psychophysiological effect of different modes of manual acupuncture stimulation was investigated in 12 healthy, right handed, male subjects (mean age 29). The cerebral blood flow velocity (CBFV) in both middle cerebral arteries, arterial blood pressure (BP), heart rate (HR) and the perceived intensity of the stimulation were monitored while an acupuncture needle in the right dorsal thenar muscle (point Hegu, Li 4) was repetitively rotated with either high frequency (4-8 Hz) and low amplitude (hf-la) or low frequency (1-2 Hz) and high amplitude (lf-ha). Response patterns induced by hf-la and 1f-ha [corrected] stimulation differed significantly (P < 0.05) as tested by Student's t-test: (1), 1f-ha [corrected] stimulation was perceived as more intense and induced a more marked right hemispheric CBFV increase; (2), while hf-la stimulation lead to a slight decrease of BP and HR, lf-ha stimulation induced an initial pressor response (increase of BP, decrease of HR) and a more marked long term decrease of BP. Data indicate that the mode of manual acupuncture stimulation has a differential effect on the perceived stimulation intensity, the cerebral activation and the cardiovascular reflex response.
Transcutaneous oxygen tension measure-ments in the assessment of limb ischaemia
- Quigley Fg
- Ib
Quigley FG, Faris IB. Transcutaneous oxygen tension measure-ments in the assessment of limb ischaemia. Clin Physiol 1991;11:315–20.