Medical Acupuncture in Stroke Rehabilitation

stroke rehabI have found that clinically Medical Acupuncture (including Dry Needling) is effective in reducing muscle tone during the rehabilitation phase in those who have suffered from a stroke. It has become an integral part in my approach to treating hemiplegia.

The mechanism is most likely an inhibitory effect at the anterior horn cells when the hypertonic muscles are needled directly. The reason for the hyperactivity at the anterior horn cells, which in turn controls resting muscle tone, may be reduced proximal modulation of the anterior horn cell activity after a stroke, in others words less ‘top down’ control from the brain.

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Medical Acupuncture Mechanisms - Revisited With Prof. Thomas Lundeberg

(This post was originally posted on the 24th February 2014 and in light of new research has been updated on the 26th March 2017.)

To assist us in our understanding on the mechanisms of Medical Acupuncture I thoroughly recommend watching a recent presentation by a Professor Lundeberg. You can find the 23min video presentation at the bottom of this article.

In this post I offer some highlights from this presentation.

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Medical Acupuncture On The Wrong Side Of NICE

Medical Acupuncture on the wrong side of NICE

The last Cochrane review which considered the role of Medical Acupuncture (MA) in the treatment of Low Back Pain (LBP) was carried out by Furlan et al in 2005. In this review verum MA was shown to be efficacious (more effective than ‘sham’) in providing short term pain relief. A good result from research point of view.

The NICE guidelines for the treatment of LBP published in 2009 were partly based on the abovementioned review as well as the GERAC trial which showed MA (including ‘sham’) to be more than twice as effective as conventional treatment in the primary outcome measures. In the GERAC trial, verum MA was not shown to be significantly more effective than ‘sham’ needling however there was a small trend in favour of verum needling.

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Medical Acupuncture in Cardiology

cardio acupuncture"Cardio-acupuncture" -  My introduction to this term was at the Autumn Scientific Meeting hosted by the British Medical Acupuncture Society at the Royal College of Physicians in London last month.

Dr. Fokke Jonkman, a cardiologist, gave a very interesting account as to how he uses medical acupuncture to complement his cardiology practice. Being more well versed with the role of acupuncture in pain management, most of what he had to say took me into less familiar territory in terms of my understanding of a wider application of acupuncture in medicine.

Broadly speaking, the cardiovascular system i.e the heart, lungs and the vessels which circulate blood around the body is controlled by the autonomic nervous system which in turn is divided into a sympathetic (excitatory) and parasympathetic (more inhibitory) portion.

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An Audit of Treatments for Fibromyalgia by Esther Odetunde

An audit of treatments for fibromyalgia at the Royal London Hospital for Integrated Medicine - Esther Odetunde, Chartered Physiotherapist.

fibro acuEsther is a specialist physiotherapist working at the Royal London Hospital for Integrated Medicine (RLHIM) known for the high number of patients she treats, the vast majority of whom must feel well looked after given her very high attendance rate. Esther treats a challenging group of patients, those diagnosed with fibromyalgia. She is part of a small team offering a programme of care for those suffering with this potentially debilitating chronic pain condition. The team is multidisciplinary in nature and also comprises a physician, psychologist, dietician and occupational therapist.

Referred patients with fibromyalgia enter a care pathway based on the Eular fibromyalgia treatment guidelines (2007) and are selected either for group or individualized treatment. The care pathway also determines which part of programme is most applicable for the patient. For example if depression is the main issue, the patient would receive a course of CBT, in the case reduced function, pain and mobility issues physiotherapy would be offered. Different types of treatment may be offered concurrently.

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