MVF can exert a strong influence on the motor network, mainly through increased cognitive penetration in action control, though the variance in methodology and the lack of studies that shed light on the functional connectivity between areas still limit insight into the actual underlying mechanisms.
Background Traditionally, acupuncturists manipulate needles to enhance sensations referred to as de qi or 'acupuncture needle sensation'. Acupuncture needle sensations are complex and quantifying the experience has been diffi cult. The aim of this crossover study was to measure self-reported needle sensation during deep and bi-directional rotated needling in 15 healthy volunteers. Methods Each participant received an experimental intervention consisting of superfi cial needling followed by deep needling and then deep needling with bi-directional rotation. The control intervention consisted of superfi cial needling, followed by mock deep needling and then mock bi-directional rotation of the needle. The intensity of overall needle sensation was measured using a visual analogue scale (VAS). The subjective acupuncture sensation scale was used to capture component sensations. Results VAS scores were higher during 'deep' needle penetration when compared to superfi cial needling with mock deep insertion (p=0.0002). VAS scores were also higher during deep needling with bi-directional rotation compared to superfi cial needling with mock bi-directional rotation (p<0.0001). There were higher scores for total component sensation scores and for the sensation of throbbing during the deep needling with bi-directional rotation (p=0.001) when compared to superfi cial needling with mock bi-directional rotation. Tentative evidence that bi-directional needle rotation generated stabbing, tingling, heaviness, soreness and aching was also found. Conclusion Bi-directional rotation of a needle inserted into deep soft tissue produced higher acupuncture needle sensation intensities when compared to superfi cial needle insertion with mock deep penetration and bi-directional rotation. INTRODUCTIONManual manipulation of acupuncture needles is commonly used in clinical practice to increase the intensity of stimulation in order to improve therapeutic effects. Manipulation techniques include deep insertion of needles into deep soft tissue and/ or bi-directional rotation of needles. The relationship between manual needle technique and acupuncture needle sensation is poorly understood. 1There is some evidence that deep needling may be more effective than superfi cial needling for shoulder and low back pain 2 3 although a randomised controlled clinical trial involving 1162 low back pain patients found that deep acupuncture generated only 'marginally' superior pain relief than superficial acupuncture. 4 Manual manipulation of acupuncture needles can evoke 'de qi' in patients. 5 De qi is a term derived from traditional Chinese medicine to describe sensations experienced by the patient as a direct result of needling and to describe 'needle grasp' where the acupuncturist feels resistance to movement of a needle that has been inserted through the patient's skin. 6 More recently, the term 'acupuncture needle sensation' has been used to describe sensations experienced by the patient local to the inserted needle. 7 It is claimed that acupuncture n...
Background The proportion of the world's population aged over 60 years is increasing. Therefore, there is a need to examine different methods of healthcare provision for this population. Medical day hospitals provide multidisciplinary health services to older people in one location. Objectives To examine the effectiveness of medical day hospitals for older people in preventing death, disability, institutionalisation and improving subjective health status.
During acupuncture some patients experience distinct sensations which are often referred to as needle sensation. Needle sensation may be related to treatment outcome, although what constitutes adequate acupuncture needle sensation is not known. In this paper, we debate the possibility of using the self-report of the overall intensity of needle sensation as a predictor of analgesic outcome to acupuncture. We describe how our approach to establish criteria to determine adequacy of transcutaneous electrical nerve stimulation interventions in clinical trials has been used to inform our search for markers of adequacy of procedural technique for acupuncture. We describe previous research which has focused on developing tools to capture the nature of the descriptors used by patients when they self-report needle sensation and reveal that little attention has been given to its role in outcome. We demonstrate that needle sensation is a complex phenomenon with subjects using multiple descriptors to report their experience. We argue that the intensity of the overall experience of needle sensation may prove useful as a gross marker of the adequacy of acupuncture. We briefly describe our research which isolates individual components of needling technique, such as depth of needle penetration and bidirectional needle rotation, in order to assess their contribution to overall needle sensation intensity.
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