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Thread: NIH funded acupuncture research in stroke and spinal cord injury"

  1. #1
    Senior Member Max's Avatar
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    NIH funded acupuncture research in stroke and spinal cord injury"

    NIH funded acupuncture research in stroke and spinal cord injury"

    Samuel C. Shiflett vom Center for Healing and Health, Beth Israel Medical Center, New York, NY

    Three small pilot research projects studying acupuncture have been conducted at Kessler Institute for Rehabilitation (and its affiliated research organization, Kessler Medical Rehabilitation Research and Education Corporation). These have been part of a broader research program funded by grant #U24-HD32994, from the NIH, to study complementary and alternative therapies in the treatment of neurological disorders, including stroke, and spinal cord injury. Two studies involved treatment of pain in spinal cord injured subjects, the other involved the treatment of dysphagia in stroke patients. Data collection in all studies has been completed, and is in various stages of preparation for publication.

    Acupuncture for dysphagia in stroke (Noel Nowicki, MD, and Allison Averell, MD, principal investigators). 18 stroke inpatients diagnosed with swallowing disorders using VFSS (Video fluoroscopic swallowing study) were treated with acupuncture and contrasted to 22 control patients who received only standard of care. Using a specially constructed aspiration rating scale, it was found that the acupuncture treated group was somewhat improved compared to the control group. An interaction suggested that the treatment was more effective for men than for women, who appeared to have a better natural recovery rate.

    Acupuncture and Trager for wheelchair induced shoulder pain in spinal cord patients. (Trevor Dyson-Hudson, MD, principal investigator). 18 spinal cord injured individuals with shoulder pain attributable to wheelchair overuse were randomized to either acupuncture or a Trager bodywork condition. Both interventions showed substantial and roughly equal improvement in pain following a course of treatment. There was marginal evidence that suggested that acupuncture resulted in quicker resolution of pain than Trager, but that after three months the benefit of acupuncture was beginning to disappear (level of pain was increasing) while in the Trager group, pain remained at a lower level.

    Acupuncture for pain and depression in spinal cord injured patients (Sangeetha Nayak, Ph.D., principal investigator) (co-funded by grant # 287 from the American Association of Spinal Cord Injury Psychologists and Social Workers). Twenty-two people with SCI who experienced moderate to severe pain of at least 6 months duration. The intervention consisted of a course of 15 acupuncture treatments administered over a 7½-week period. Forty-six percent of the sample showed improvement in pain intensity and pain sequelae following treatment. Treatment success may be related to whether the injury is complete and whether pain is above or below the level of injury. Risk of autonomic dysreflexia was monitored and found to be negligible.


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    Ein weiterer interessanter Beitrag beschäftigt sich mit dem Phänomen, daß Nadeln in den Akupunkturpunkten festgehalten werden.

    Acupuncture needle grasp: Ultrasound analysis and clinical implications

    Helene M Langevin, Junru Wu, David L Churchill, Gary J Badger and Jason A Yandow
    Department of Neurology, University of Vermont, Burlington, VT

    The insertion and manipulation of acupuncture needles is associated with a measurable biomechanical phenomenon termed "needle grasp", characterized by an increase in the force necessary to pull the acupuncture needle out of the skin (pullout force). Needle grasp is not due to a muscle contraction, and histological observations in rat tissue explants suggest that needle grasp involves connective tissue. We used high frequency (50 MHz) ultrasound scanning acoustic microscopy to further confirm quantitatively that changes in connective tissue architecture occur as a result of acupuncture needle rotation. Using this technique, we obtained high-resolution images of viable rat abdominal wall tissue explants into which an acupuncture needle had been inserted and either rotated for 32 revolutions, or not rotated. We hypothesized that the acoustic pattern generated by the main components of connective tissue (collagen, elastic fibers, fat, extracellular matrix) is more ordered after acupuncture needle rotation, compared with needle insertion alone without rotation.

    A Fourier Transform analysis was performed on standardized polar coordinate lines (using the center of the needle as the origin) from the bitmap gray scale images created by the scanning acoustic microscope. For each line, this analysis yielded spatial frequency peaks corresponding to spatial periodicity in the image. The maximum peak gray level at a significantly low spatial periodicity (0.3-1.4 mm) was significantly higher with needle rotation (vs. p&lt compared with acupuncture needle insertion alone without rotation (mean ± SE: 28.7 ± 2.2 vs. 21.9 ± 1.4, p=0.02). This indicates that connective tissue architectural order increased with acupuncture needle rotation. The images also suggest that this increased order is due to tissue winding around the needle and reorganization of tissue structures relative to the needle. Changes in connective tissue architecture may be perceived by the acupuncturist holding the needle, and therefore may be important clinically. This perception may constitute important feedback affecting how the acupuncturist chooses to further move (or not move) the needle.

    During their training, acupuncturists learn to apply needle stimulation that is quantitatively and qualitatively appropriate to each clinical situation. Before needling, the acupuncturist will usually decide roughly what type of manipulation will be used (e.g. reducing method, reinforcing method, deep or shallow needling). Once the needle is inserted, the acupuncturist will carefully observe and feel for changes in the patient, and modify his/her behavior accordingly. This response to the feedback provided by the patient during needling is a key component of the acupuncturist's skills. This feedback includes verbal communication of sensations experienced by the patient during needling, and also includes direct observation of changes such as skin color, facial expression, as well as local changes in the area of the needle. Local changes in the area of the needle can be perceived by acupuncturists with extremely small amounts of needle movement (less than one revolution of the needle, or up-and-down movements of a few millimeters). These changes can be very subtle, leading some authors to suggest that they occur on an "energetic" plane. Another possibility is that subtle material changes in the tissues are taking place, perhaps accompanied by related energetic phenomena.

    In this study, we describe pronounced tissue architectural changes occurring as a result of a relatively large amount of acupuncture needle rotation (corresponding to pullout forces of the order of 500 grams in related experiments). Smaller amounts of needle manipulation are likely to be associated with more subtle tissue architectural changes. Whether large or small in magnitude, these changes in connective tissue architecture may have profound downstream effects. Mounting evidence suggests that mechanical deformation of tissue can lead to mechanical signal transduction into cells, polymerization of cellular actin cytoskeleton, activation of intracellular signaling pathways, changes in gene expression and cell contraction. These biochemical events may further contribute to the sensation perceived by the acupuncturist, and also may be components of acupuncture's therapeutic effect. Modification of the acupuncturist's skilled behavior in response to tissue changes caused by needle manipulation therefore may be a key to the treatment's outcome.

    Funded by the National Center for Complementary and Alternative Medicine, Grant #R21 AT00300.

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    http://www.akupunktur-aktuell.de/fb0150_2.htm

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    Senior Member alan's Avatar
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    I've tried accupuncture for pain. It worked as well as everything else - it didn't. However, when I'd have problems with bowel accidents between program days, the accupuncturist was able to stop them. If that problem pops up again, I'd call her in a second.

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    Is acupuncture beneficial for SCI patients to recover motion/feeling?

    Does anyone have any research or information about Acupunture and SCI for my 21 year old brother who this month suffered a spinal stroke ascending from a deep dive? Would acupuncture help him to recover in any way?

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    Senior Member giambjj's Avatar
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    Angry accupunture

    laser puncture is now used for SCI with varying results in the US and other countries. No scientific published studies available.


    Joe
    Jake's Pop

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    Senior Member DA's Avatar
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    RIP Max

    this is a speed bump research. designed to slow research with bull crap.

  6. #6
    miss you max, rest in peace
    cauda equina

  7. #7
    Soldier's salute buddy. RIP.

  8. #8
    Quote Originally Posted by deniset View Post
    Does anyone have any research or information about Acupunture and SCI for my 21 year old brother who this month suffered a spinal stroke ascending from a deep dive? Would acupuncture help him to recover in any way?
    In China, when I first went there in 1999, most hospitals there devoted half or more of their hospitals to traditional Chinese medicine (TCM), including acupuncture. I have talked with the heads of the acupuncture departments. I find their attitudes quite refreshing and honest. They don't claim that acupuncture brings back function in people with spinal cord injury. However, they say that it will reduce spasticty or pain temporarily, alter blood flow or bowel function, and change temperature (or perception of temperature). They are also very practical and point out that most of these effects are transient and the acupuncture has to be done daily to maintain the effects, something that they cannot afford to do.

    I have also had the opportunity to talk the the head of the Department of TCM at Hong Kong University, one of the most respected and scholarly groups studying TCM. The principles of TCM are very different from western medicine. In western medicine, all our drugs and procedures are aimed at eliminating the pathology, i.e. getting rid of the "bad guys" that are causing our problems. This is a reasonable approach for certain types of diseases, i.e. those caused by infectious agents, genetic disorders, and cancer. In contrast, TCM is more concerned with balance or imbalance in the body. The goal of TCM is the restore that balance. Acupuncture is intended to restore balance. Once balanced, the body then applies its own solutions to make things better.

    Please understand that TCM is not that different from western medicine in terms of practice. There are good and not so good doctors in both TCM and western medicine. There are those who claim that their treatments do things that they cannot or do not. There are many doctors who have little experience with, don't understand spinal cord injury, and should not be treating people with spinal cord injury. Finally, many doctors have a conflict of interest because they stand to make money from the procedures. That is one of the reasons why clinical trials of controversial therapies are necessary, to provide credible data of safety and efficacy.

    No doctor has a miraculous cure for spinal cord injury at the present. If there is a proven cure, wouldn't it be discussed in a forum such as this? Be suspicious, check out the clinic or doctor who is offering the cure, and use your common sense. It is very unlikely that any doctor has a stem cell cure that nobody knows about and only that doctor has. Don't trust testimonials, they are very likely to be misleading because patients who have received a therapy have a conflict of interest: they want to be cured by the treatment they have received. Observe the warning signs. Turn away from the therapy if the doctor or clinic says that they can't tell you what is in the therapy because it is secret or proprietary.

    Above all, don't think that "it can't hurt". A false therapy hurts not only the pocketbook but the hope of the person. I have known many who have gone overseas for some experimental therapy, paid substantial sums for the therapies, and then found out that they have been duped. These people frequently drop out of CareCure and stop hoping. It is like getting divorced. It hurts not only in the sense of pain but in the emptying of the spirit. I didn't think about this until about a year ago, when a Buddhist nun (Master Cheng Yen) told me that we must be very careful with people's hope. Hope is fragile and it is very difficult to restore once it has been crushed.

    Wise.
    Last edited by Wise Young; 01-29-2010 at 04:07 AM.

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    Senior Member lunasicc42's Avatar
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    good post wise
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