Laser therapy / acupuncture, laser puncture, auricular medicine

Integrative Medicine Research 9 (2020) 100561

The effects of laser acupuncture for facial paralysis: A summary of ongoing clinical trial

Gil Ton, Yu-Chen Lee

Graduate institute of acupuncture science, China Medical University, Taichung, Taiwan

Bell’s palsy is the most frequent cause of unilateral peripheral facial palsy, a condition that third of patients can have inadequate recovery and subsequent physical and social impairments. The largely ineffective and even controversial nature of the various medical and surgical treatment options means that novel, alternative approaches are needed. In preclinical and clinical evidence, low-level laser therapy has demonstrated the ability to regenerate peripheral nerves. Laser acupuncture treatment (LAT), the stimulation of traditional acupoints with low-intensity, non-thermal laser irradiation, is a common treatment modality, but its efficacy in chronic Bell’s palsy is undetermined. Based on our on-going ran[1]domized, double-blind, sham-controlled clinical study, the aim of this lecture is to outline the effects of LAT in treating facial paralysis and demonstrate how to integrate LAT in the treatment of facial paralysis. https://doi.org/10.1016/j.imr.2020.10056


Complementary Therapies in Medicine 43 (2019) 306–310

Effects of laser acupuncture in a patient with a 12-year history of facial paralysis: A case report

Gil Ton , Li-Wen Lee , Yi-Hung Chena , Cheng-Hao Tua , Yu-Chen Lee

Graduate Institute of Acupuncture Science, China Medical University, Taichung 40402, Taiwan b Department of Acupuncture, China Medical University Hospital, Taichung 40402 Taiwan

ABSTRACT

Background: Traumatic facial palsy, whether accidental or iatrogenic, is a common cause of facial paralysis. Laser acupuncture therapy (LAT) is a non-invasive, pain-free method to stimulate traditional acupuncture points with non-thermal laser irradiation. Low-level laser therapy has proven beneficial in the regeneration of peripheral nerves. This case report describes the feasibility of this innovative treatment in a patient with a 12-year history of traumatic facial palsy and severe sequelae.

Case summary: A52-year-old male presented with a severe left-sided facial paralysis that had lasted for 12 years. At initial presentation, the man could not fully close his left eye and had difficulty eating solid foods. The paralysis of his left-sided facial muscles had resulted in dysarthria. He was administered 30 LAT sessions in the Acupuncture Department of China Medical University Hospital, Taichung, Taiwan, over a 4-month period. His recovery was monitored by scores on the Facial Disability Index, the Sunnybrook Facial Nerve Grading System and measurements of the vertical palpebral distance in his left eye. Photographs were taken after every treatment. On the 10th treatment, a change in closure of the left eye was noticed and facial muscle strength was improved. After 22 treatments, the patient could fully close his left eye.

Conclusion: LAT significantly improved the sequelae of long-term facial paralysis in this patient. Large-scale prospective studies are needed to confirm this observation.


Hu et al. Medicine (2018) 97:22

Effect of laser acupuncture on dry eye

A study protocol for a 2-center randomized controlled trial

Wen-Long Hu, MD, MSa,b,c,∗ , Pei-Chang Wu, MD, PhDd , Li-Yen Pan, MDe , Hun-Ju Yu, MDd , Chih-Chin Pan, MDf , Yu-Chiang Hung, MD, PhDa,g 

Abstract Background: Dry eye is a common ophthalmologic disorder that causes ocular discomfort and has become a worldwide health concern. Patients with dry eye often turn to complementary and alternative medicine (CAM) because of unsatisfactory conventional treatments. Acupuncture is one of the most popular interventions of CAM used, and laser acupuncture (LA) is a noninvasive technique.

Methods: This protocol is a 2-center randomized controlled trial investigating the effect of laser acupuncture on dry eye. Two hundred participants aged 20 to 65 years will be randomly assigned to the experimental group (LA plus conventional treatment) or the sham control group (LA without laser output plus conventional treatment) at 2 clinical research centers in South Taiwan. The subjects will undergo LA treatment thrice a week for 12 weeks. The subjects in the experimental group will sequentially receive 0.375 J of energy at each of the following acupoints: BL2, TE23, ST2, LI4, ST36, and GB37. The subjects in the control group will also receive a sham LA treatment, without any laser output. Outcome assessments will include evaluation of the ocular surface disease index (OSDI), tear film break-up time (TFBUT), Schirmer-I test finding, and the visual analog scale (VAS) score at 4 and 12 weeks before treatment. The OSDI, TFBUT, Schirmer-I test result, and VAS score of the participants will be analyzed and compared between the experimental and control groups using the paired t test and one-way analysis of variance.

Objectives: The aim of this protocol is to investigate the efficacy of LA therapy in patients with dry eye.

Trial registration: ClinicalTrials.gov NCT03204903. Abbreviations: CAM = complementary and alternative medicine, DTS = dysfunctional tear syndrome, LA = laser acupuncture, OSDI = ocular surface disease index, TFBUT = tear film break-up time, VAS = visual analog scale.

Keywords: dry eye, laser acupuncture, traditional Chinese medicine


Science Direct Biomedical Journal, 18 June 2020

Comparison of the effects between lasers applied to myofascial trigger points and to classical acupoints for patients with cervical myofascial pain syndrome

Wei-Han Chang a , Li-Wen Tu a , Yu-Cheng Pei b,c,d,e , Chih-Kuang Chen a,c , Szu-Heng Wang b , Alice MK. Wong a,e,f,* a

Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Taoyuan, 333, Taoyuan, Taiwan b Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, 333, Taoyuan, Taiwan c School of Medicine, Chang Gung University, 333, Taoyuan, Taiwan d Center of Vascularized Tissue Allograft, Chang Gung Memorial Hospital at Linkou, 333, Taoyuan, Taiwan e Healthy Aging Research Center, Chang Gung University, 333, Taoyuan, Taiwan f Graduate Institute of Rehabilitation Science, Chang Gung University, 333, Taoyuan, Taiwan

 Abstract
Objectives: To compare the immediate effectiveness of low-level laser therapy applied to classical acupoints versus trigger points for patients with cervical myofascial pain syndrome (MPS).
Materials and methods: This was a single-blinded, randomized, placebo-controlled trial. This study was performed in a university-affiliated medical center. One hundred participants with cervical myofascial pain syndrome were randomly allocated to four treatment groups, including (1) acupoint therapy, (2) acupoint control, (3) trigger point therapy, and (4) trigger
point control groups. Low-level laser (810-nm) therapy was used in both therapy groups, while the same procedure was performed without laser in the control groups. The patients were evaluated based on visual analogue scale pain score, pressure pain threshold, and Q2 cervical range of motion before and after the therapy.
Results: Immediate pain relief was observed in the trigger point therapy group (p < 0.01). The trigger point therapy group showed improved cervical range-of-motion in ipsilateral bending (p < 0.01), while the acupoint therapy group did not.
Conclusions: Low-level laser therapy applied to trigger points could significantly relieve myofascial pain and was effective in relieving cervical range-of-motion limitations.


Hidawi Publications Research Article | Open Access

Volume 2019 |Article ID 8136967 | https://doi.org/10.1155/2019/8136967

Adjuvant laser meridian massage in men with opioid use disorder on methadone maintenance treatment Protocol for a case-controlled study

Wen-Long Hu, MD, MSa,b,c,∗ , Meng-Chang Tsai, MDd , Chun-En Kuo, MD, MSa,e, Chun-Ting Liu, MDa , Szu-Ying Wu, MDa,e,f, Tzu-Chan Wu, MDa , Yu-Chiang Hung, MD, PhDa,g

Abstract

Study Objectives. This study investigates the therapeutic effect of Low Level Laser Therapy (LLLT) acupuncture for chronic insomnia.

Methods. Thirty-seven adult subjects with chronic insomnia were recruited and randomly assigned to three groups, namely, Group A (6 pairs of acupoints: Ex-HN 22, HT 7, SP 6, KI 3, LR 3, and PC 6, bilaterally distributed); Group B (acupoints as for Group A other than PC 6, which was applied only on the left side [i.e., the dominant side of the PC meridian] and the addition of DU 20, which is the main tonic acupoint for integration of all the meridians); and a control group (sham LLLT). The subjects in the treatment groups (i.e., Groups A and B) received LLLT acupuncture and those in the control group received sham LLLT for 15 minutes per session twice a week for five weeks. The sleep quality of all the subjects was evaluated using the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS), the Hospital Anxiety and Depression Scale (HADS), and a sleep diary. In addition, the sympathetic activity before and after every treatment sessions was measured using the Heart Rate Variability (HRV). 

Results. All three groups showed an improved PSQI score. However, only Group A showed a significant reduction in the sleep onset latency and number of awakenings at night and a higher sleep efficiency and ESS score. Furthermore, Group B showed an increased low frequency power and normalized low frequency of the HRV signal and a lower normalized high frequency power, suggesting an increased sympathetic activity and decreased parasympathetic activity. 

Conclusions. For chronic insomnia insomniacs, LLLT appears to shorten the sleep latency, decrease the number of awakening events at night, and improve the sleep efficiency.

 


 

Journal of Acupuncture and Meridian Studies

Volume 13, Issue 5, October 2020, Pages 152-156

Research Article

The Effect of Laser Acupuncture on Spasticity in Children with Spastic Cerebral Palsy

Dian E. Putri 1, * , Adiningsih Srilestari 1 , Kemas Abdurrohim 1 , Irawan Mangunatmadja 2 , Luh K. Wahyuni 3 1 Department of Medical Acupuncture, Faculty of Medicine, University of Indonesia, Jalan Diponegoro no. 71, Central Jakarta, Indonesia 2 Department of Pediatrics, Faculty of Medicine, University of Indonesia, Jalan Diponegoro no. 71, Central Jakarta, Indonesia 3 Department of Rehabilitation Medicine, Faculty of Medicine, University of Indonesia, Jalan Diponegoro no. 71, Central Jakarta, Indonesia

Abstract Background: Spasticity in cerebral palsy is one of the most common disabilities of children in developing countries.

Objectives: The objective of this study was to determine the efficacy of laser acupuncture on spasticity in children with spastic cerebral palsy. Methods: This clinical trial was conducted on 60 patients with spastic cerebral palsy at 2 to 10 years. The patients were categorized into two groups: the control group and treatment group. Laser acupuncture was applied on GV20, GV14, LI4, GB34, and LR3 (power 50 mW, 785 nm, 1 Joule, 40 seconds) three times a week for 12 sessions in the treatment group and placebo laser acupuncture on the same points in the control group. The spasticity was measured using the Modified Ashworth Scale before and after complete sessions.

Results: The results showed that there was a significant reduction in the Modified Ashworth Scale score in the treatment group compared with the control group (p ¼ 0.003).

Conclusions: This study suggest that laser acupuncture on GV20, GV14, LI4, GB34, and LR3 can reduce spasticity for children with spastic cerebral palsy.

© 2020 Medical Association of Pharmacopuncture Institute, Publishing services by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

 


 

Hindawi Evidence-Based Complementary and Alternative Medicine Volume 2019, Article ID 8136967, 9 pages https://doi.org/10.1155/2019/8136967

Effectiveness of Laser Acupuncture in Alleviating Chronic Insomnia: A Single-Blinded Randomized Controlled Trial

Chih-Kuang Chen , 1,2 Yin-Chou Lin , 1,2 Ju-Wen Cheng , 1,2 Yu-Cheng Pei , 1,3 Geng-Hao Liu , 4,5,6,7 Yen-Lung Chen , 4,5,6,7 and Alice May-Kuen Wong 1,3 1 Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Taoyuan 33378, Taiwan 2 School of Medicine, Chang Gung University, Taoyuan 33302, Taiwan 3 Healthy Aging Research Center, Chang Gung University, Taoyuan 33302, Taiwan 4 Division of Acupuncture and Moxibustion, Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Linkou 33305, Taiwan 5 Sleep Center, Chang Gung Memorial Hospital, Taoyuan 33378, Taiwan 6 School of Traditional Chinese Medicine, Chang Gung University, Taoyuan 33302, Taiwan 7 Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan Correspondence should be addressed to Alice May-Kuen Wong; This email address is being protected from spambots. You need JavaScript enabled to view it.

Received 26 July 2018; Revised 19 April 2019; Accepted 23 April 2019; Published 13 June 2019 Academic Editor: Mark Moss Copyright © 2019 Chih-Kuang Chen et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Study Objectives.This study investigates the therapeutic effect of Low Level Laser Therapy (LLLT) acupuncture for chronic insomnia.

Methods. Thirty-seven adult subjects with chronic insomnia were recruited and randomly assigned to three groups, namely, Group A (6 pairs of acupoints: Ex-HN 22, HT 7, SP 6, KI 3, LR 3, and PC 6, bilaterally distributed); Group B (acupoints as for Group A other than PC 6, which was applied only on the left side [i.e., the dominant side of the PC meridian] and the addition of DU 20, which is the main tonic acupoint for integration of all the meridians); and a control group (sham LLLT). The subjects in the treatment groups (i.e., Groups A and B) received LLLT acupuncture and those in the control group received sham LLLT for 15 minutes per session twice a week for five weeks. The sleep quality of all the subjects was evaluated using the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS), the Hospital Anxiety and Depression Scale (HADS), and a sleep diary. In addition, the sympathetic activity before and after every treatment sessions was measured using the Heart Rate Variability (HRV).

Results. All three groups showed an improved PSQI score. However, only Group A showed a significant reduction in the sleep onset latency and number of awakenings at night and a higher sleep efficiency and ESS score. Furthermore, Group B showed an increased low frequency power and normalized low frequency of the HRV signal and a lower normalized high frequency power, suggesting an increased sympathetic activity and decreased parasympathetic activity.

Conclusions. For chronic insomnia insomniacs, LLLT appears to shorten the sleep latency, decrease the number of awakening events at night, and improve the sleep efficiency.

 


Correspondence: Chun-En Aurea Kuo, Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital, No. 123, Dapi Rd., Niaosong District, Kaohsiung 833, Taiwan (e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.).

Laser acupuncture for refractory coccydynia after traumatic coccyx fracture A case report

Chien-Hung Lin, MDa , Szu-Ying Wu, MDa,b, Wen-Long Hu, MD, MSa,c,d, Chia-Hung Hung, MDe , Yu-Chiang Hung, MD, PhDa,f, Chun-En Aurea Kuo, MD, MSa,g,∗

Abstract Rationale: Coccyx fracture is an injury usually caused by trauma. In most cases, the fractures recover after conservative therapy. For refractory cases that exhibit coccydynia after more than 2 months of conservative treatment, coccygectomy is indicated. However, limited information about the efficacy of this procedure is available, and it is known to have a high complication rate. As such, other therapeutic approaches are needed. Here, we report our experience using another conservative treatment option, low-level laser therapy, to successfully reduce refractory coccydynia in a patient with coccyx fracture. Patient concerns: A 23-year-old woman had refractory coccydynia and increased pain after a traffic accident-induced coccyx fracture.

Diagnoses: Initially, the patient reported transient improvement after conservative treatment with non-steroidal anti-inflammatory drugs. However, the pain increased in severity (numerical rating scale score of 8) soon after she resumed work in her office and progressed in the following 2 months. Surgical intervention was suggested owing to the prolonged coccydynia following the failure of conservative treatment and difficulties in performing daily life activities. However, she sought other conservative therapy options, because she was concerned about the risks associated with the coccygectomy surgery. Interventions: The patient received low-level laser therapy once a week, for 24 weeks.

Outcomes: After 11 weeks of treatment, the patient reported significant improvements in her symptoms; her pain was reduced to a numerical rating scale score of 2 and bone healing was noted on radiographs. The patient could eventually perform her daily activities satisfactorily, without coccydynia, after 24 weeks of treatment.

Lessons: Laser acupuncture produced analgesic effects in this patient with refractory coccydynia after traumatic coccyx fracture. This is the first case report to apply laser acupuncture for refractory coccydynia after traumatic coccyx fracture. Our findings imply that laser acupuncture may be a good conservative therapy option for coccyx fracture.

Abbreviations: LLLT = low-level laser therapy, NRS = numerical rating scale. Keywords: bone healing, coccydynia, coccyx fracture, laser acupuncture


 MEDICAL ACUPUNCTURE Volume 32, Number 5, 2020 # Mary Ann Liebert, Inc. DOI: 10.1089/acu.2020.1417

Laser Acupuncture Effects on Speech and Social Interaction in Patients with Autism Spectrum Disorder

Imtiaz Amrinusantara Surapaty, MD, SpAk,1 Christina Simadibrata, MD, MKes, SpAk (K)1 Ekky Sri Rejeki, MD, MH, SpAk,2 and Irawan Mangunatmadja, DR, MD, SpA (K)3 ABSTRACT

Objective: Disorders of speech ability and social interaction are the most-common symptoms in children with autism spectrum disorder (ASD). Acupuncture, as an adjunctive therapy, is known to help improve speech ability and social interaction in children with this condition. One of the acupuncture modalities with minimal side-effects, and that is safe for children, is laser acupuncture or laserpuncture. This study’s aim was to determine laserpuncture’s effects on speech ability and social interactions in patients with ASD.

Materials and Methods: This randomized, double-blinded clinical trial involved 46 patients in 2 groups. All respondents qualified, and none dropped out. The treatment group (n = 23) received sensory–occupational integrative therapy and verum laserpuncture therapy and the control group (n = 23) received sensory– occupational integrative therapy and placebo laserpuncture. The groups’ speech ability and social interaction were evaluated with a WeeFIM questionnaire; parental reports were collected, using sensory profiles before and after treatment.

Results: There were improvements in speech ability and social interaction in the verum laserpuncture group more than in the placebo group after treatment. Perception score was P < 0.001; odds ratio (OR): 18.8; 95% confidence interval (CI): 4.09–87.17. Expression score was P < 0.001; OR: 50.2; 95% CI: 5.61–450.2. Social interaction score was P = 0.005; OR:7.2; 95% CI: 1.68–31.42. Parental report score was P = 0.765.

Conclusions: Verum laserpuncture in this clinical trial improved speech ability and social interaction scores more effectively than placebo laserpuncture did in patients with ASD. Keywords: speech ability, social interaction, autism spectrum disorder, laser acupuncture.

  


 

Hindawi Evidence-Based Complementary and Alternative Medicine Volume 2019, Article ID 8136967, 9 pages https://doi.org/10.1155/2019/8136967

Research Article

Effectiveness of Laser Acupuncture in Alleviating Chronic Insomnia: A Single-Blinded Randomized Controlled Trial

Chih-Kuang Chen , 1,2 Yin-Chou Lin , 1,2 Ju-Wen Cheng , 1,2 Yu-Cheng Pei , 1,3 Geng-Hao Liu , 4,5,6,7 Yen-Lung Chen , 4,5,6,7 and Alice May-Kuen Wong 1,3 1 Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Taoyuan 33378, Taiwan 2 School of Medicine, Chang Gung University, Taoyuan 33302, Taiwan 3 Healthy Aging Research Center, Chang Gung University, Taoyuan 33302, Taiwan 4 Division of Acupuncture and Moxibustion, Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Linkou 33305, Taiwan 5 Sleep Center, Chang Gung Memorial Hospital, Taoyuan 33378, Taiwan 6 School of Traditional Chinese Medicine, Chang Gung University, Taoyuan 33302, Taiwan 7 Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan Correspondence should be addressed to Alice May-Kuen Wong; This email address is being protected from spambots. You need JavaScript enabled to view it. Received 26 July 2018; Revised 19 April 2019; Accepted 23 April 2019; Published 13 June 2019 Academic Editor: Mark Moss Copyright © 2019 Chih-Kuang Chen et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Study Objectives.This study investigates the therapeutic effect of Low Level LaserTerapy (LLLT) acupuncture for chronic insomnia. Methods. Tirty-seven adult subjects with chronic insomnia were recruited and randomly assigned to three groups, namely, Group A (6 pairs of acupoints: Ex-HN 22, HT 7, SP 6, KI 3, LR 3, and PC 6, bilaterally distributed); Group B (acupoints as for Group A other than PC 6, which was applied only on the lef side [i.e., the dominant side of the PC meridian] and the addition of DU 20, which is the main tonic acupoint for integration of all the meridians); and a control group (sham LLLT). The subjects in the treatment groups (i.e., Groups A and B) received LLLT acupuncture and those in the control group received sham LLLT for 15 minutes per session twice a week for fve weeks. Te sleep quality of all the subjects was evaluated using the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS), the Hospital Anxiety and Depression Scale (HADS), and a sleep diary. In addition, the sympathetic activity before and afer every treatment sessions was measured using the Heart Rate Variability (HRV).

Results. All three groups showed an improved PSQI score. However, only Group A showed a signifcant reduction in the sleep onset latency and number of awakenings at night and a higher sleep efciency and ESS score. Furthermore, Group B showed an increased low frequency power and normalized low frequency of the HRV signal and a lower normalized high frequency power, suggesting an increased sympathetic activity and decreased parasympathetic activity.

Conclusions. For chronic insomnia insomniacs, LLLT appears to shorten the sleep latency, decrease the number of awakening events at night, and improve the sleep efciency 


 

The American Journal of Chinese Medicine, Vol. 38, No. 5, 861–867 © 2010 World Scientific Publishing Company Institute for Advanced Research in Asian Science and Medicine

Clinical Observations on Laser Acupuncture in Simple Obesity Therapy

Wen-Long Hu,*,y,z Chih-Hao Changy,z,x and Yu-Chiang Hung*
*Department of Chinese Medicine
Chang Gung Memorial Hospital Kaohsiung Medical Center
Chang Gung University College of Medicine, Taiwan
yKaohsiung Medical University College of Medicine, Taiwan
zFooyin University College of Nursing, Taiwan
xDivision of Chinese Internal Medicine
Kaohsiung Municipal Chinese Medical Hospital, Taiwan

Abstract

Objective: A previous study has shown that laser acupuncture is a useful healing method for the  treatment of visceral postmenopausal obesity in combination with a low-calorie diet. We observe and evaluate the therapeutic effect of laser acupuncture in subjects of simple obesity with a non-restrictive diet protocol. 

Background data: Subjects included 73 women and 22 men with simple obesity and body mass indices _ 27 kg=m2. Daily energy intake recommendations for obese females and males were 1620.0 and 1894.2 kcal in average, respectively.


Methods: The gallium aluminum arsenide Handylaser Trion was used to apply 0.25 J of energy to each of the following acupuncture points three times per week for four consecutive weeks: Stomach, Hunger, ST25, ST28, ST40, SP15, and CV9. The subjects’ body weights and body mass indices were recorded before treatment, and four weeks after treatment, and the percent reduction in each parameter was calculated.

Results: Statistically significant reductions in body weight and body mass index were detected after four weeks of treatment. The mean reduction and mean percent reduction in body weight were 3.17 kg and 3.80% (p < 0:0001), respectively. The corresponding values for the body mass index were 1:22 kg=m2 and 3.78% (p < 0:0001), respectively.


Conclusions: We concluded that laser acupuncture was found to exert a therapeutic effect on simple obesity by reducing both body weight and body mass index. Moreover, subjects showed good compliance with this comfortable and non-restrictive diet protocol.

 


 

THE JOURNAL OF ALTERNATIVE AND COMPLEMENTARY MEDICINE Volume 19, Number 5, 2013, pp. 474–477 ª Mary Ann Liebert, Inc. DOI: 10.1089/acm.2012.0163

Acupuncture Helps Regain Postoperative Consciousness in Patients with Traumatic Brain Injury: A Case Study

Ying-Jung Tseng, MD,1 Yu-Chiang Hung, MD, PhD,1 and Wen-Long Hu, MD, MS1–3

Abstract

Objective: This report of one case illustrates the potential effect of acupuncture therapy in addition to Western medicine for regaining postoperative consciousness in patients with traumatic brain injury (TBI). Clinical features: A 65-year-old man experienced a TBI after being involved in a motor vehicle accident. His initial Glasgow Coma Scale (GCS) score was E1V1M2, and brain computerized tomography showed a rightsided subdural hemorrhage. He received emergency medical treatment and underwent craniotomy to remove the lacerated portions of brain as well as subtemporal decompression, followed by a decompressive craniectomy the following day to remove an intracerebral hematoma due to late-onset temporo-parietal rebleeding. Twelve days after surgery, the patient remained in poor condition due to serious complications and the GCS was E2VeM4. His family then underwent counseling and he subsequently received acupuncture treatment.

Intervention and outcome: This patient was treated with acupuncture three times each week, consisting of strong stimulation at GV26 (Shuigou) and the 12 Well points using the half-needling technique. After 3 weeks of consecutive treatment, his GCS score improved to E4VtM6. In addition, he regained consciousness and could tolerate rehabilitation programs.

Conclusions: We believe that an experienced physician may use acupuncture as complementary therapy in patients with TBI who fail to regain consciousness postoperatively.

 


 

Photomedicine and Laser Surgery Volume 30, Number 9, 2012

Electrophysiological Effects of Single Point Transcutaneous 650 and 808nm Laser Irradiation of Rat Sciatic Nerve: A Study of Relevance for Low-Level Laser Therapy and Laser Acupuncture

Electrophysiological Effects of Single Point Transcutaneous 650 and 808nm Laser Irradiation of Rat Sciatic Nerve: A Study of Relevance for Low-Level Laser Therapy and Laser Acupuncture

Roberta Chow, MB BS (Hons), Ph.D., Weixing Yan, Ph.D., and Patricia Armati, Ph.D.

Abstract:

Objective: The purpose of this study was to evaluate effects of transcutaneous 650 and 808nm laser irradiation (LI) to a single point overlying rat sciatic nerve; a comparison to four point LI and relevance to the clinical application of low-level laser therapy (LLLT) and laser acupuncture (LA).

Background data: Transcutaneous LI inhibits somatosensory and motor conduction when delivered to four points overlying sciatic nerve; however, effects of the same total energy delivered to a single point over the nerve, equating to laser acupuncture, are undefined.

Methods: Transcutaneous 808 nm, 450mW, (13.5 or 54 J) continuous wave (cw) mode or 650 nm, 35mW, (1.1 or 4.4 J), cw LI or sham LI, was applied for 30 or 120 sec to a single point overlying the midpoint of rat sciatic nerve. Somatosensory evoked potentials (SSEPs) and compound muscle action potentials (CMAPs) were then recorded after 10 and 20 min, and after 24 and 48 h.

Results: 120 sec of 808nm LI increased SSEP amplitudes only at 10 min, with no effect of 30 or 120 sec at other time points on SSEPs or on CMAPs. LI 650nm for 30 or 120 sec did not alter SSEPs or CMAPs at any time point.

Conclusions: Localized transcutaneous 808 LI to a single point overlying sciatic nerve increases SSEP amplitudes when compared with delivery of the same total energy to four points, which causes decreased SSEP amplitudes and conduction block. Therefore, the area and duration of delivery are important, independent variables with implications for clinical delivery of both LLLT and LA.

ISSN: 0268-8921 (printed version)

ISSN: 1435-604X (electronic version)


Abstract Volume 15 Issue 1 (2000) pp 57-62
Specific Effects of Laserpuncture on the Cerebral Circulation

G. Litscher (1), L. Wang (1), M. Wiesner-Zechmeister (2)

(1) Biomedical Engineering, Department of Anesthesiology and Critical Care, University of Graz, Graz, Austria
(2) European Forum for Lasertherapy and Fractal Medicine

Paper received 10 May 1999; accepted after revision 23 August 1999.

Abstract: Acupuncture is a form of traditional Chinese medicine that has developed over thousands of years. We studied the effects of laser puncture, needle acupuncture, and light stimulation on cerebral blood flow in 15 healthy volunteers (mean age 25.0±1.9 years, 5 female, 10 male) with non-invasive transcranial Doppler sonography. In addition 40-Hz stimulus-induced brain oscillations, heart rate, blood pressure, peripheral and cerebral oxygen saturation, and the bispectral index of the EEG were recorded. Stimulation with light significantly increased blood flow velocity in the posterior cerebral artery (p<0.01, ANOVA). Similar but less pronounced effects were seen after needle acupuncture (p< 0.05, ANOVA) and laserpuncture (n.s.) of vision-related acupuncture points. Furthermore both, laserpuncture and needle acupuncture, led to a significant increase in the amplitudes of 40-Hz cerebral oscillations. Stimulation of vision-related acupuncture points with laser light or needle acupuncture elicits specific effects in specific areas of the brain. The results indicate that the brain plays a key intermediate role in acupuncture. However, brain activity of itself does not explain anything about the healing power of acupuncture.

Keywords: Acupuncture; Brain; 40 Hz brain oscillations; Cerebral blood flow velocity; Laserpuncture; Light stimulation; Middle cerebral artery (MCA); Posterior cerebral artery (PCA); Transcranial Doppler sonography (TCD)

Therapy of cervical tendomyosis

A randomised controlled double-blind trial comparing dosed lasertherapy on acupuncture points and classical acupuncture

Ulf Seidel, Christine Uhlemann

Klinik für Orthopädie Klinikum Neustadt
Institut für Physiotherapie Friedrich-Schiller-Universität Jena

Aim of this randomised controlled, concerning lasertherapy double-blind study was to investigate therapeutical efficacy of a dosed lasertherapy (low level laser therapy, LLLT) on acupuncture points and conventional acupuncture in influencing symptoms of cervical tendomyosis.

Methods: 48 patients (43 f, 5 m) with relevant neck pain were treated twice weekly for 4 weeks (8 treatments), randomised into four groups of different kinds of therapy: LLLT, output power 0 mW (placebo), 7 mW, 30 mW or needle acupuncture (4 ×n = 12).

Acupuncture was performed as a conventional meridian acupuncture, 15 minutes per session to a maximum of 15 needles.

LLLT was done as a stimulation to the same meridian points, 1 minute per point, totally 15 points. Laser parameters: cw-IR-GaAlAs-Laser, 830 nm, energy density 0 J/cm2; 21 J/cm2; 90 J/cm2, irradiation area 0.02 cm2, laser-skin-difference 8 mm. Subsequent evaluation was done four weeks after treatment (follow up). Assessment of outcome measurements comprised:

  • Primary outcomes:
    1. pain: pain intensity (visual analogue scale, VAS), pain sensation (pressure pain threshold, PPT);
    2. cervical mobility: range of motion (ROM) (clinical distance measure, three-dimensional analysis of cervical spine, Zebris®).
  • Secondary outcomes:
    1. mental health (questionnaire);
    2. subjective assessment (pain, mobility);
    3. clinical autonomic parameters (blood pressure, heart rate, skin temperature).

Results: Acupuncture and LLLT showed a significantly reducing of pain intensity, this effect could be proved four weeks after the end of the series (follow up): reduction in VAS by acupuncture 82.2 %, by LLLT 7 mW 55.4 %, 30 mW 29.1 %, 0 mW 26.1 %. PPT was significantly increased by all kinds of therapy.

There was a significant improvement of cervical mobility caused by acupuncture, LLLT 7 mW and LLLT 30 mW in contrast to placebo (0 mW LLLT).

Mental health was influenced positively by all therapy modes, significant only by LLLT 7 mW. With regard to subjective assessment (pain, mobility) there was no complaint aggravation. An increased (systolic and diastolic) blood pressure by decreased heart rate and increased skin temperature post each procedure with either method was measured.

Conclusions: Acupuncture is a therapeutical option in the treatment of common neck pain. Dose dependent effects of LLLT seems to be relevant, outcome power and energy density has to be considered as important parameters in efficacy of this method. LLLT 7 mW (energy density 21 J/cm2) seems to be more effective but also placebo influences pain and mental health positively.

Keywords: Acupuncture - Low level laser therapy (LLLT) - Dosed lasertherapy - Cervical tendomyosis - Clinical trial


Source: Dt Ztschr f Akup 2002; 258-269
DOI: 10.1055/s-2002-36555

LASERACUPUNCTURE

Pekka J. Pöntinen, M.D, Ph.D, F.I.C.A.E., Tampere University, Tampere, Kuopio University, Kuopio, Finland E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

Traditionally acupuncture means stimulation of specific points on the surface of the body in order to produce mainly regulatory effects on the functions of the internal organs. The same points have been used to increase or decrease the functional state of different organs. In Traditional Chinese Medicine (TCM) the acupuncture points (AP) are connected by channels or meridians in and under the skin and have deep connections to the internal organs. The selection of the proper points has been as important as the correct type of stimulation, either reinforcement or sedation. In the traditional Chinese medicine the human model has been mainly energetic, physiological, not anatomical. The changes in the energy flow induced by the blocks in the channels or acceleration of the flow leading either to the deficit or excess of the vital energy, Chih, were believed to be the origin of diseases. The APs were the loci to balance the energy flow through needle stimulation. Modern acupuncture has a different nature. For the consensus conference arranged by the National Institutes of Health (NIH) and held in Bethesda, Maryland in November 1997 the term acupuncture was defined as stimulation, primarily by the use of solid needles, of traditionally and clinically defined points on and beneath the skin, in an organized fashion for therapeutic and/or preventive purposes. Application of stimulus to the reactive points (by needle, heat, massage, transcutaneous electric nerve stimulation/TENS, laser, etc.) according to TCM can influence the pathophysiological function of the affected organ-meridian systems.

In modern Chinese AP therapy, a combination of local tender points (AHSHI) and classical peripheral APs is common. Laseracupuncture (LAP) Today LAP provides a noninvasive and low risk alternative to needle stimulation. A combination of local reactive (tender) points or Ahshi points and active muscle TPs form a practical and effective basis for LAP in pain treatment. LAP can replace needles in the treatment of functional disorders and is then directed to classical APs. As a painless modality of acupuncture LAP is well accepted by children and other sensitive patients. LAP provides excellent possibilities for clinical studies on acupuncture. Recently Schlager and coworkers confirmed the efficacy of AP Neiguan (PC6) in the prevention of postoperative vomiting in children undergoing strabismus surgery. In another randomized, double-blind placebo-controlled study low-intensity laser therapy effectively prevented the recurrence of Herpes simplex infection.

Our study groups at the Universities of Kuopio and Tampere have studied the analgetic effect of peripheral stimulation (needle acupuncture, transcutaneous electrical stimulation/TENS, massage, electric stimulation, low energy laser) applied on APs or TPs using pressure algometry . We have conducted a series of experiments using different wavelengths (633-904 nm) and both coherent and noncoherent irradiation. LEPT was given directly to TPs (1-2 J/TP) or local tender spots.

In blind, cross-over studies both HeNe- and IR-diode (904 nm) lasers elevated pressure pain threshold (PTH). In a follow-up study on 54 MPS patients LEPT (820 nm, 1-2 J/TP) PTH increased from 2.94+1.44 tp 6.56+0.96 kg/cm² (p<0.001) and MGF from 0.60+0.28 to 1.03+0.29 bar (p<0.05), whereas VAS decreased from 44.6+11.3 to 9.3+6.4 (p<0.001). In this and other series we have found that the effect is greater on the side where PTH and MGF values are initially lower. As in our earlier studies with low and high freguency TENS one sided HeNe-laser irradiation elevated PTH of the corresponding, contralateral nontreated TPs in addition to the response on the treated side. More recently the main emphasis has been turned to the central mechanisms and pathways. In a pilot study LED-light (880 nm, 1J/cm2) given to TPs in trapezius muscle (TE15) bilaterally and upon proc. spinosus of C7 (DU14) significantly altered regional cerebral blood flow e.g. in thalamus, caudate nucleus and prefrontal cortex.

In our experience less than 1 J/point or 100-200 J/cm² given in a contact mode is mainly ineffective in clinical practice when treating musculoskeletal disorders and myofascial pain through TPs. In many well controlled, blind and double-blind cross-over studies showing insignificant results the actual radiant exposure to the target site has been a mere fraction of the dose normally used in clinical practice. When treating APs of low resistance and high sensitivity the irradiation dose should be reduced to about 0.1-0.2 J/point (10 per cent of the normal dose [1-2 J/point] used at muscle TPs).

Treatment of the acute Periarthritis humeroscapular with laserpuncture.

Odalys Gonzáles Álvarez, Main Educational Clinic of Urgencies "Antonio Maceo", Cerro Municipality, Havana City.

The periarthritis humeroscapular is a syndrome that contains very precise affections: the bursitis, the calcified tendinitis of supraespinoso, the bicipital tendinitis, among others. Pain and limitation of the joint movements of the shoulder characterize it. The treatment with laser of low power can produce resolution of the lesion, whenever it is made in early phases of the disease. In this study we propose the use of the laserpuncture, due to our accumulated experience in the treatment of these affection in acute phase, with acupuncture.

A prospective study was carried out during 2 years (1997 - 1999), where 62 patients were selected because they accomplished the Approaches of Inclusion for the study. The sample was divided by aleatory assignment in 2 Groups of Treatment. Th study Group I was treated with laserpuncture, using Cuban laser equipment of HeNe of 632,8 nm and a dose of joule/cm2 was applied, and the Control Group II was treated with acupuncture needles. The conventional medical treatment was suspended. Daily sessions were given from Monday to Friday, for two weeks, until a total of 10. Both techniques demonstrated to be effective in the treatment of these affections, improving the clinical and radiological symptoms significantly when the treatment sessions was concluded. The patients accepted the laserpuncture better because of its painless character, less time of application, and the absence of bleeding and stress.

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