Change of Safe Needling Depth at Acupoint GB21 according to Posture and Breathing

Abstract

Acupoint GB21 (Jianjing) is used for treating back and shoulder pain but is associated with a risk of pneumothorax. We aimed to determine the SND (safe needling depth) at GB21 according to posture and breathing in real time. Ultrasonographic images of GB21 during normal breathing, inspiration, and expiration in a SP (sitting position) were acquired for 52 healthy volunteers. Images were also acquired during normal respiration in the PP (prone position) with arms raised and lowered. The average SND was greater for men than for women (p < 0.05). Analysis of variance revealed that the SND was greater for the PP than for the SP (p = 0.01 and p < 0.05, resp.). Although the SND tended to change according to posture, the average depth tended to deviate widely in some subjects. During breathing, the differences between inspiration and expiration were less than 1 mm in most subjects, but some showed differences more than 4.5 mm. The SND at GB21 was greater in overweight subjects and significantly greater in the PP and during maximal expiration. However, intragroup differences were greater than the intergroup differences. Therefore, it is dangerous to simply apply needling depth on a gender or BMI basis. The practitioner would adjust the SND by examining the individual anatomical structures.

Implementation of Objective Structured Clinical Examination on Diagnostic Musculoskeletal Ultrasonography Training in Undergraduate Traditional Korean Medicine Education: An Action Research

“…The two diagnostic criteria for carpal tunnel syndrome used in ultrasound training are as follows: (1) the cutoff value of the vertical distance between the line connecting the top of the scaphoid and the pisiform in the proximal carpal tunnel and the apex of the retinaculum is between 3 and 4 mm [22][23][24] (Figure 2); (2) the cross-sectional area of the median nerve proximal to the tunnel inlet is 10 mm 2 or more [25][26][27] (Figure 3). The preceptor in charge of this lecture has experience in two ultrasound clinical research studies [9,11] and in performing multiple OSCEs [7,8]. The lecture was designed with the advice of two traditional medicine doctors who obtained a certification (Registered in Musculoskeletal Sonography (RMSK)) hosted by the American Registry for Diagnostic Medical Sonography (ARDMS) [28].…”

“…The time to practice ultrasound in person under the supervision of the preceptor was 1 h per group of 4-5 people. The preceptor in charge of this lecture has experience in two ultrasound clinical research studies [9,11] and in performing multiple OSCEs [7,8]. The lecture was designed with the advice of two traditional medicine doctors who obtained a certification (Registered in Musculoskeletal Sonography (RMSK)) hosted by the American Registry for Diagnostic Medical Sonography (ARDMS) [28].…”

“…In traditional medicine, the introduction of OSCE is expected to enhance clinical competency and strengthen the authenticity of education [ 6 , 7 , 8 ]. Studies on ultrasound to scan the anatomical structure of acupoints for accurate diagnosis and safe treatment [ 9 , 10 , 11 ], cases utilizing ultrasound for diagnosis and treatment [ 12 , 13 ], and the efficacy of ultrasound-guided intervention [ 14 , 15 ] have been reported by traditional medicine physicians. Nevertheless, in traditional medicine education, to date, no evidence on standardized ultrasound education and OSCE on musculoskeletal diseases has been published to our knowledge.…”

An Observational Study on the Anatomical Characteristics of Acupoint CV23 (Lianquan) with Ultrasonography

“…Ultrasound is actively applied for safe and effective acupuncture treatment, and education and training of acupuncture [1,2]. The use of ultrasound during acupuncture has the advantage of preventing damages to vulnerable structures in close proximity to the acupoints and enables precise stimulation for the target structure.…”

Prospects for the Development of Acupuncture Treatment Led by the Use of Ultrasound Imaging Devices

“…, 침 치료 효과 전달을 위한 신경 생리학적 기전 [3][4][5] , 침 시술부위의 물리적 변형 6,7) , 및 다양한 생물학적, 화학적 기전연구 16) , 안태석등이 보고한 늑골골절연구 17) , 박정욱 등이 보고한 교통사고후 급성요통 연구 등 18) 에서 임상적 효능 을 확인하였다고 보고 하였고, 김성하등은 총비골신경 마비에 서 초음파 유도하 도침치료 효과 19) [13][14][15] 초음파 유도하 약침(Ultrasound guided pharmacopuncture; 봉약침, 소염약침, 자하거약침 등) [16][17][18] 초음파 유도하 시술(Ultrasound guided stimulation; 도침, 등) 19,20) 10 https://doi.org/10.54461/JKMST.2021.…”