Effects of non-invasive stimulation of acupoints on the cardiovascular system

Complementary and alternative medicine (CAM) following traumatic brain injury (TBI): Opportunities and challenges

Traumatic brain injury (TBI) is highly prevalent and occurs in a variety of populations. Because of the complexity of its sequelae, treatment strategies pose a challenge. Given this complexity, TBI provides a unique target of opportunity for complementary and alternative medicine (CAM) treatments. The present review describes and discusses current opportunitites and challenges associated with CAM research and clinical applications in civilian, veteran and military service populations. In addition to a brief overview of CAM, the translational capacity from basic to clinical research to clinical practice will be described. Finally, a systematic approach to developing an adoptable evidence base, with proof of effectiveness based on the literature will be discussed. Inherent in this discussion will be the methodological and ethical challenges associated with CAM research in those with TBI and associated comorbidities, specifically in terms of how these challenges relate to practice and policy issues, implementation and dissemination. This article is part of a Special Issue entitled SI:Brain injury and recovery.

Differences in the microcirculatory effects of local skin surface contact pressure stimulation between acupoints and nonacupoints: possible relevance to acupressure

In the present study, laser Doppler measurement was used to quantitatively investigate the microcirculatory effects of contact pressure stimulation (PS) underneath the Hoku acupoint and its nearby nonacupoint, to improve the understanding of the mechanisms underlying acupressure therapy. A control group (no PS applied) and three experimental groups with different applied PS (group A, 60 mmHg on the Hoku acupoint; group B, 60 mmHg on a nearby nonacupoint; group C, 50 mmHg on a nearby nonacupoint) were studied. Each experiment involved recording data of a 20 min baseline and two periods of effects after stopping PS. The relative energy contribution (REC) in five frequency bands, as revealed by Morlet wavelet transformation, was calculated. At the pressed site, the average value of the laser Doppler flux signal was increased only in group A, and coefficient of variance of the amplitude sequence was only significantly decreased during measurement (M1: 0 to 20 min) in group B. The RECs of the myogenic-related band were significantly increased in groups A and C, whereas there were no significant changes found in group B. The improved microcirculatory blood-flow perfusion at Hoku may partly explain why acupressure can exert better therapeutic effects than PS applied to other sites. The laser Doppler spectra responses illustrated that the induced pressure-induced vasodilation can be attributed mainly to the myogenic response. Laser Doppler measurement and analysis therefore represent a noninvasive method of examining the microcirculatory efficacy of acupressure therapy.

Cardiovascular benefits of acupressure (Jin Shin) following stroke

OBJECTIVES

Acupressure, a complementary and alternative medicine (CAM) treatment, uses fingertips, rather than needles, to stimulate acupoints on the skin and has been implicated as a successful treatment for a variety of medical disorders. However, acupressure's underlying mechanisms remain unclear. One theory is that acupoint stimulation modulates autonomic nervous system activity. Previous studies have suggested that acupressure may positively affect heart rate and blood pressure. The current study investigated the effects of a type of acupressure, Jin Shin, on cardiovascular function in stroke survivors, a population that could especially benefit from a treatment promoting cardiovascular health. The study tested the hypothesis that active acupressure treatments would reduce heart rate and blood pressure (i.e., induce a greater relaxation response) above and beyond that seen during placebo acupressure treatments.

METHODS

A randomised, placebo-controlled, single-blind crossover design was utilised, in which 16 participants received 8 weeks of either active or placebo acupressure followed by washout and crossover into the opposite treatment condition. Heart rate and blood pressure measurements were taken throughout treatments.

RESULTS

Active acupressure treatments were associated with a significantly greater (p=.043, eta(2)=.30) and faster (p=.002, eta(2)=.76) reduction in heart rate compared to that seen during placebo treatments. No treatment effect on blood pressure was found.

CONCLUSIONS

Active acupressure reduced heart rate significantly more than did placebo acupressure during treatments. Although no treatment effect on blood pressure was found, this could be due to 67% of participants taking antihypertensive medications during the study.

Effects of acupressure on lower limb blood flow for the treatment of peripheral arterial occlusive diseases

PURPOSE

To investigate the effects of acupressure on lower limb blood flow for the treatment of peripheral arterial occlusive diseases (PAOD).

METHODS

From February 2004 to February 2005, 30 patients with stage II PAOD underwent measurements of the lower limb blood flow. Six patients (group A) were assigned as controls without any acupoint stimulation, while 24 (group B) underwent stimulation at acupoints by acupressure. The acupoints Yanglingquan (GB34), Zusanli (ST36), Yinlingquan (SP9), and Sanyinjiao (SP6) of the symptomatic lower limbs were stimulated for 3 min. Transcutaneous oximetry (tcPO2) was used to determine the blood flow of the chest wall, bilateral distal crura, and bilateral dorsa of the foot before and during the stimulations at the acupoints.

RESULTS

Group A showed no significant change in the lower limb blood flow. In group B, the tcPO2 values of chest wall, bilateral distal crura, and the dorsum of foot of the stimulated lower limb increased significantly during acupressure (P < 0.01), whereas no significant change was shown in the dorsum of the foot of the non-stimulated lower limb. Moreover, the blood flow of the lower limbs that had undergone an ipsilateral sympathectomy increased significantly (P < 0.01).

CONCLUSIONS

Acupressure was found to cause significant increases in the lower limb blood flow of stage II PAOD patients. This treatment modality may therefore be effective for improving the symptoms of such patients.

Heart Rate and Electroencephalogram Changes Caused by Finger Acupressure on Planta Pedis

Preliminary experiments were carried out to investigate the feasibility of using an electroencephalogram and heart rates to evaluate the efficacy of finger acupressure on the key points of planta pedis (both soles). Continuous electroencephalograms were recorded from 19 electrodes based on the International 10-20 electrode placement system on 22 university students (21+/-2.3 years). Spectral power changes were obtained at each electrode site. The power of the alpha1 frequency range (8-10 Hz) increased slightly during acupressure although no statistical significance was observed, while heart rates decreased in all subjects (p<0.05). Cerebral cortex asymmetry in the spectral power changes was not clearly observed during the right and left sole acupressure. This preliminary study suggests that a classification of subjects is necessary in understanding brain wave data during acupressure on soles.

The short-term effects of myofascial trigger point massage therapy on cardiac autonomic tone in healthy subjects

AIM OF THE STUDY

To investigate the effects of myofascial trigger-point massage therapy to the head, neck and shoulder areas on cardiac autonomic tone.Background. No studies have reported on the effect of back massage on autonomic tone as measured by heart rate variability. This is especially relevant to the nursing profession, as massage is increasingly available as a therapy complementary to conventional nursing practice.

DESIGN/METHODS

An experimental study in which subjects were initially placed in age- and sex-matched groups and then randomized to treatment or control by alternate allocation. The study involved 30 healthy subjects (16 female and 14 male, aged 32.47 +/- 1.55 years, mean +/- standard error). A 5-minute cardiac interbeat interval recording, systolic and diastolic blood pressure and subjective self-evaluations of muscle tension and emotional state were taken before and after intervention. Autonomic function was measured using time and frequency domain analysis of heart rate variability.

RESULTS

Following myofascial trigger-point massage therapy there was a significant decrease in heart rate (P < 0.01), systolic blood pressure (P=0.02) and diastolic blood pressure (P < 0.01). Analysis of heart rate variability revealed a significant increase in parasympathetic activity (P < 0.01) following myofascial trigger-point massage therapy. Additionally both muscle tension and emotional state, showed significant improvement (P < 0.01).

CONCLUSIONS

In normal healthy subjects myofascial trigger-point massage therapy to the head, neck and shoulder areas is effective in increasing cardiac parasympathetic activity and improving measures of relaxation.