| 1. |
- Chae, Younbyoung, et al.
(författare)
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The role of touch in acupuncture treatment
- 2017
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Ingår i: Acupuncture in Medicine. - : BMJ PUBLISHING GROUP. - 0964-5284 .- 1759-9873. ; 35:2, s. 148-152
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Forskningsöversikt (refereegranskat)abstract
- Acupuncture is a therapeutic treatment that is characterised by the insertion of a needle at a particular location on the body. Acupuncture stimulation includes sensory-discriminative and affective-social touch dimensions. In this review, we discuss the role of touch during acupuncture stimulation with an emphasis on the therapeutic, sensory-discriminative and affective-social aspects. In the discriminative dimension, de qi, which is associated with needling, includes a combination of various sensations, such as heaviness, numbness, soreness and distension. Achieving the appropriate de qi sensation appears to be fundamental to the therapeutic outcome following acupuncture treatment. In the affective dimension, the acupuncture procedure typically includes gentle manual touch stimulation, which induces feelings of calm and well-being, perhaps by activating C tactile fibres. Enhanced activity of C tactile afferents may induce a limbic touch response, resulting in emotional and hormonal reactions. Because acupuncture is a therapist intensive and complex intervention, it is necessary to understand the role of social touch between the practitioner and patient. Both sensory-discriminative and affective-social touch aspects play an important role in the therapeutic effect of acupuncture treatment in clinical practice.
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| 2. |
- Enblom, Anna
(författare)
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Patients and physiotherapists belief in and use of acupuncture for cancer-related symptoms
- 2017
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Ingår i: Acupuncture in Medicine. - : BMJ PUBLISHING GROUP. - 0964-5284 .- 1759-9873. ; 35:4, s. 251-258
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Tidskriftsartikel (refereegranskat)abstract
- Background It is important to investigate attitudes to acupuncture, because therapists and patients expectations may affect the treatment outcome. Aim To explore the use of and belief in acupuncture among oncological physiotherapists and to explore patients interest in receiving acupuncture during cancer therapy and their belief in its effectiveness. Methods 522 patients (80% female, mean age 67 years) reported on their interest in receiving acupuncture for nausea during radiotherapy treatment; a subgroup (n=198) additionally disclosed their belief in the effectiveness of acupuncture. 117 Swedish oncological physiotherapists (96% female, mean age 48 years) answered a questionnaire regarding their use of and belief in acupuncture. Results Of the patients initiating cancer therapy, 359 (69%) were interested in receiving acupuncture. The patients believed acupuncture to be effective for pain (79%), nausea (79%) and vasomotor symptoms (48%). Of the 117 physiotherapists, 66 (56%) practised acupuncture. Physiotherapists generally believed in the effectiveness of acupuncture. For pain, 89% believed that acupuncture was effective and 42% of them practised it. Similar responses were noted for chemotherapy-induced nausea (86% and 38%, respectively) and vasomotor symptoms (80% and 28%, respectively). Younger physiotherapists and patients were more likely to believe in the effectiveness of acupuncture compared with older ones. Conclusions More than two thirds of patients with cancer were interested in receiving acupuncture during therapy. Patients and oncological physiotherapists believed that acupuncture was effective for cancer pain, nausea and vasomotor symptoms. Further studies of acupuncture for cancer-related symptoms and of the effect of patients and clinicians therapeutic relationships, including treatment expectations, would be welcome.
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| 3. |
- Enblom, Anna, et al.
(författare)
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Pilot testing of methods for evaluation of acupuncture for emesis during radiotherapy: a randomised single subject experimental design
- 2011
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Ingår i: ACUPUNCTURE IN MEDICINE. - : The British Medical Acupuncture Society. - 0964-5284 .- 1759-9873. ; 29:2, s. 94-102
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Tidskriftsartikel (refereegranskat)abstract
- Background Many acupuncture studies are of weak methodological quality, possibly due to lack of pilot testing. This pilot study tested design features, including test of feasibility, compliance to treatment and data collection, level of blinding success and the patients potential perceived effects of the treatment, in preparation for an efficacy study. Method A modified single subject experimental design was conducted. 10 cancer patients were randomised to verum penetrating acupuncture or non-penetrating sham needles for 30 min 2-3 times/week during radiotherapy over abdomen/pelvis. They answered test-retested emesis questions (r=0.527-1.0) covering nausea, vomiting, use of antiemetics, wellbeing and activities of daily living. Results Overall, the patients completed 98% of the 345 emesis-questionnaire days and 101 of the 115 offered treatments. All patients believed they received verum acupuncture. 10 patients experienced antiemetic effects, seven relaxation, five pain-reduction and five experienced sleep improvement. Two types of nausea questions showed absolute concordance (r=1.0) (n of observations=456). Nausea was experienced by one of five verum acupuncture treated patients (duration median 0% of the radiotherapy-days) and four of five sham acupuncture treated patients (duration median 24% of the radiotherapy-days). Patients experiencing nausea rated decreased wellbeing and performance of daily activities compared to patients free from nausea. Conclusions All patients were blinded, complied with verum/sham treatments and data-collection, and believed they had effects of the received treatment. The methods for verum/sham treatment and data collection may thus be used in an adequately powered randomised controlled study of the effect of acupuncture for radiotherapy-induced emesis.
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| 4. |
- Enblom, Anna, et al.
(författare)
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Type and frequency of side effects during PC6 acupuncture : observations from therapists and patients participating in clinical efficacy trials of acupuncture
- 2017
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Ingår i: Acupuncture in Medicine. - : SAGE Publications. - 1759-9873 .- 0964-5284. ; 35:6, s. 421-429
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Many therapists practise PC6 acupuncture for emesis (nausea and vomiting) during pregnancy, different cancer therapies, palliative care, after surgery, or to induce relaxing effects in general. Knowledge of side effects is central to shared decision-making.AIM: To describe the type and frequency of side effects and the level of needle-induced pain during PC6 acupuncture.METHODS: We included 1298 PC6 acupuncture treatments, delivered to 221 participants (77% women, mean age 52.5, range 18-91 years). The subjects had received genuine PC6 acupuncture, in one of two previous randomised controlled trials, aimed at inducing antiemetic (n=100, with 100 providing data on side effects and 94 on needle-induced pain, respectively) or relaxing (n=121, with 120 providing data) effects. Side effects during and after the acupuncture treatments were registered in structured treatment protocols and study diaries.RESULTS: No serious complications occurred. Side effects during the acupuncture sessions included minor bleeding in 5.0%, tiredness in 4.9%, numbness in 4.5% and dizziness in 1.4% of the 1298 treatments. After treatment, the mean proportions of participants reporting side effects each week were: tiredness 25.8%; feeling cold 17.8%; dizziness 9.7%; sweating 9.3%; haematoma 8.8%; and soreness at the needling sites 4.3%. Participants perceived the needling to be not painful (47.4% of participants), or mildly (39.1%), moderately (11.6%) or very painful (1.4%).CONCLUSIONS: Few side effects occurred and those that did were mild. Nearly 90% found PC6 acupuncture to be not painful or only mildly painful. Healthcare professionals may consider the observed levels of side effects when informing patients about side effects of PC6 acupuncture.
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| 5. |
- Hansson, Y, et al.
(författare)
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Intramuscular and periosteal acupuncture in patients suffering from chronic musculoskeletal pain - a controlled trial
- 2008
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Ingår i: Acupuncture in medicine : journal of the British Medical Acupuncture Society. - : SAGE Publications. - 0964-5284. ; 26:4, s. 214-223
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Tidskriftsartikel (refereegranskat)abstract
- Periosteal acupuncture has shown promising results in clinical practice. The aim was to compare three patient groups: one with intramuscular acupuncture, one with periosteal acupuncture, and a third information control group, with respect to clinically relevant pain relief, physical functioning and intake of analgesics in patients with chronic musculoskeletal pain in the neck or low back or both. We reported the psychological changes in these patients in a previous issue of this journal. Methods 144 consecutive patients with nociceptive pain for >3 months, aged 18–70 years were alternately allocated to: intramuscular acupuncture (n=59); periosteal acupuncture (n=55); or control group with information only (n=30). All patients were encouraged to stay active. Acupuncture was administered with eight treatments during five weeks, and two optional additional treatments after one month. Pain was estimated with a daily VAS in a pain diary and with an average weekly pain score. Clinically relevant pain relief was defined as at least a 30% decrease from the initial value. Physical functioning was evaluated with Disability Rating Index. All estimations were performed prior to treatment, one week after, and one, three and six months after treatment. Results There were no differences between the effects of the two acupuncture methods. There were differences between each of the two acupuncture groups compared with the control group on all test occasions up to one month after treatment with respect to the pain diary and one week after treatment with respect to pain last week (P<0.05). Pain relief as measured by a pain diary was obtained in 29 patients in the intramuscular acupuncture group, 25 in the periosteal acupuncture group, and 5 patients in the control group. Six months after treatment, 46% of the intramuscular acupuncture patients and 45% of the periosteal acupuncture patients had obtained pain relief in terms of the pain diary. The corresponding figure for pain last week was 29% in each group. Conclusion Periosteal pecking was no more effective than standard intramuscular acupuncture, but both were more effective than information only.
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| 6. |
- Landgren, Kajsa, et al.
(författare)
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Acupuncture reduces crying in infants with infantile colic: a randomised, controlled, blind clinical study.
- 2010
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Ingår i: Acupuncture in Medicine. - : SAGE Publications. - 1759-9873 .- 0964-5284. ; 28, s. 174-179
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate whether acupuncture reduces the duration and intensity of crying in infants with colic. Patients and methods 90 otherwise healthy infants, 2-8 weeks old, with infantile colic were randomised in this controlled blind study. 81 completed a structured programme consisting of six visits during 3 weeks to an acupuncture clinic in Sweden. Parents blinded to the allocation of their children met a blinded nurse. The infant was subsequently given to another nurse in a separate room, who handled all infants similarly except that infants allocated to receive acupuncture were given minimal, standardised acupuncture for 2 s in LI4. RESULTS: There was a difference (p=0.034) favouring the acupuncture group in the time which passed from inclusion until the infant no longer met the criteria for colic. The duration of fussing was lower in the acupuncture group the first (74 vs 129 min; p=0.029) and second week (71 vs 102 min; p=0.047) as well as the duration of colicky crying in the second intervention week (9 vs 13 min; p=0.046) was lower in the acupuncture group. The total duration of fussing, crying and colicky crying (TC) was lower in the acupuncture group during the first (193 vs 225 min; p=0.025) and the second intervention week (164 vs 188 min; p=0.016). The relative difference from baseline throughout the intervention weeks showed differences between groups for fussing in the first week (22 vs 6 min; p=0.028), for colicky crying in the second week (92 vs 73 min; p=0.041) and for TC in the second week (44 vs 29 min; p=0.024), demonstrating favour towards the acupuncture group. CONCLUSIONS: Minimal acupuncture shortened the duration and reduced the intensity of crying in infants with colic. Further research using different acupuncture points, needle techniques and intervals between treatments is required.
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| 7. |
- Landgren, Kajsa
(författare)
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Ear acupuncture as an adjunct in a treatment protocol for anorexia nervosa : utilization rate and nurses’ experience
- 2022
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Ingår i: Acupuncture in Medicine. - : SAGE Publications. - 0964-5284 .- 1759-9873. ; 40:4, s. 322-332
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Tidskriftsartikel (refereegranskat)abstract
- Background: Anorexia nervosa (AN) is a life-threatening illness. Sometimes long inpatient treatment is necessary, increasing the anxiety that comes with hospitalization and the necessary weight gain. Safe, non-pharmacological adjunctive therapies that improve subjective health are called for. Objective: The aim of this non-randomized, mixed-methods observational study was to describe the utilization rate and nurses’ experiences of ear acupuncture in a highly specialized clinic for eating disorders in Sweden, in which acupuncture had been implemented as part of routine clinical care. Twenty-five patients with AN-treated voluntarily or by law were included. The semi-standardized National Acupuncture Detoxification Association (NADA) ear acupuncture protocol, sometimes combined with needling at 2 traditional acupuncture point locations on the body, had been implemented as a voluntary adjunct to usual care, twice weekly. To evaluate the acceptance of acupuncture, the study examined how often patients chose acupuncture when offered on schedule, and how often they asked for extra acupuncture sessions. Patients rated their subjective health using the hospital anxiety and depression scale (HADS) and visual analogue scale (VAS), treatment satisfaction with usual care and acupuncture, and health-related quality of life with the RAND36 instrument. A credibility/expectancy questionnaire (CEQ) was used to measure confidence in treatment. Body mass index (BMI) was calculated to follow the patients’ recovery. Nurses’ experiences of giving acupuncture as a part of routine care were captured in interviews, and analysed with content analysis. Ethical approval was obtained. Results: Despite an initially moderate level of trust in acupuncture, the utilization rate of the scheduled acupuncture was 89% and patients asked for extra acupuncture sessions on 28 occasions. No serious side effects were reported. Nurses’ experiences of providing acupuncture were positive. They were generally enthusiastic, although they reported finding it difficult to organize group treatments and to find time for acupuncture sessions if they were not scheduled. Conclusion: Further research into the effectiveness and costs of acupuncture in psychiatric care is needed. This study provides relevant information for clinicians as well as researchers planning future randomized controlled trials.
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| 8. |
- Landgren, Kajsa, et al.
(författare)
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Effect of minimal acupuncture for infantile colic : A multicentre, three-armed, single-blind, randomised controlled trial (ACU-COL)
- 2017
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Ingår i: Acupuncture in Medicine. - : SAGE Publications. - 0964-5284 .- 1759-9873. ; 35, s. 171-179
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Tidskriftsartikel (refereegranskat)abstract
- Background Evidence for treating infantile colic with acupuncture is contradictory. Aim To evaluate and compare the effect of two types of acupuncture versus no acupuncture in infants with colic in public child health centres (CHCs). Methods A multicentre, randomised controlled, single-blind, three-armed trial (ACU-COL) comparing two styles of acupuncture with no acupuncture, as an adjunct to standard care, was conducted. Among 426 infants whose parents sought help for colic and registered their child's fussing/crying in a diary, 157 fulfilled the criteria for colic and 147 started the intervention. All infants received usual care plus four extra visits to CHCs with advice/support (twice a week for 2 weeks), comprising gold standard care. The infants were randomly allocated to three groups: (A) standardised minimal acupuncture at LI4; (B) semistandardised individual acupuncture inspired by Traditional Chinese Medicine; and (C) no acupuncture. The CHC nurses and parents were blinded. Acupuncture was given by nurses with extensive experience of acupuncture. Results The effect of the two types of acupuncture was similar and both were superior to gold standard care alone. Relative to baseline, there was a greater relative reduction in time spent crying and colicky crying by the second intervention week (p=0.050) and follow-up period (p=0.031), respectively, in infants receiving either type of acupuncture. More infants receiving acupuncture cried <3 hours/day, and thereby no longer fulfilled criteria for colic, in the first (p=0.040) and second (p=0.006) intervention weeks. No serious adverse events were reported. Conclusions Acupuncture appears to reduce crying in infants with colic safely.
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| 9. |
- Landgren, Kajsa, et al.
(författare)
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The effect of two types of minimal acupuncture on stooling, sleeping and feeding in infants with colic : secondary analysis of a multicentre RCT in Sweden (ACU-COL)
- 2021
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Ingår i: Acupuncture in Medicine. - : SAGE Publications. - 0964-5284 .- 1759-9873. ; 39:2, s. 106-115
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Tidskriftsartikel (refereegranskat)abstract
- Background: Evidence for the effect of minimal acupuncture in infants with colic is limited. Aim: To compare the effect of standardized minimal acupuncture, individualized acupuncture (where traditional acupuncture points were chosen according to the infant’s symptoms) and no acupuncture on objective measures of stooling, feeding and sleeping in infants with colic (based on diaries) and perceived changes in these parameters (based on parental questionnaires). Methods: This was a secondary analysis of a multicentre randomized controlled three-armed trial conducted in four counties in Sweden between January 2013 and May 2015 (ACU-COL). The effect on crying has already been published and showed a decrease in crying time for the acupuncture groups. Infants, 2–8 weeks old, who cried and fussed for more than 3 h/day for more than 3 days/week, and thereby fulfilled the criteria for infantile colic, received four extra visits to their ordinary child health centre. The infants (n = 147) were randomly allocated via a computer-generated list to standardized minimal acupuncture at LI4 for 5 s (group A, n = 48), semi-standardized individual acupuncture with a maximum of five insertions for up to 30 s (group B, n = 49), or no acupuncture (group C, n = 48). The parents and the ordinary staff were blinded. Data were collected using: (1) diaries at baseline, during the two intervention weeks and 1-week follow-up; and (2) questionnaires with quantitative and qualitative components used at the second and fourth visits and during a follow-up telephone call. Outcomes were the changes in frequency of stooling and in hours of sleep per day. Results: There were no differences between groups for stooling, feeding, or sleeping at any time point according to data from the diaries. At the follow-up phone call, more parents in groups A and B (compared to group C) perceived that feeding and sleep had changed and that the symptoms of colic had improved.
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| 10. |
- Li, J, et al.
(författare)
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A prospective pilot study of the effect of acupuncture on insulin sensitivity in women with polycystic ovary syndrome and insulin resistance
- 2020
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Ingår i: Acupuncture in medicine : journal of the British Medical Acupuncture Society. - : SAGE Publications. - 1759-9873. ; 38:5, s. 310-318
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Tidskriftsartikel (refereegranskat)abstract
- To test the hypothesis that acupuncture improves insulin sensitivity in women with polycystic ovary syndrome (PCOS) and insulin resistance (IR). Design: Prospective pilot study. Setting: Guangzhou, China, 2014–2016. Participants: Eighty women with PCOS aged 18–40 years with body mass index (BMI) above 18.5 kg/m2 and with homeostatic model assessment for insulin resistance (HOMA-IR) index ⩾2.14. Interventions: Subjects received acupuncture with combined manual and low-frequency electrical stimulation of the needles three times per week for 6 months. Primary and secondary outcome measures: The primary outcome was the change in HOMA-IR after 6 months of acupuncture relative to baseline. Secondary outcomes included changes after 6 months of acupuncture and at 3 months of follow-up (both relative to baseline) in oral glucose tolerance test (OGTT) parameters (glucose and insulin levels), anthropometric measurements, and circulating metabolic and endocrine variables. Results: HOMA-IR and fasting plasma glucose and insulin levels were significantly decreased after 6 months of acupuncture, and both HOMA-IR and fasting insulin remained significantly decreased at 3 months of follow-up. In a subgroup analysis of normal-weight and overweight/obese women, HOMA-IR was reduced after 6 months of acupuncture in both subgroups, but there was no significant difference between the two groups. Conclusions: Acupuncture treatment in Chinese women with PCOS and IR was associated with an encouraging improvement in insulin sensitivity. Further randomized controlled studies are required to confirm the efficacy of acupuncture for this indication.
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