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Evidence based acupuncture

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  • Sham vs mock vs verum acupuncture
    Varying vs non-varying
    Blinding issues
    fMRI with blood O2 level-dependent (BOLD) most used to evaluate for cortical association
    Acupuncture points: rich in neuroreceptors
    Modulates the pain network via analgesic effects
    Central nervous system hormone release in the hypothalamus and limbic system
    Causes changes in the interpretation of pain
    Acupuncture points: rich in neuroreceptors
    A vertical column of loose connective tissue surrounded by less conductive dense connective tissue
    Activate small myelinated muscle nerve fibers
    A-delta efferents
    Modulates analgesic effects, modulates the pain network to include hypothalamus and limbic system
    Single needle—releases cGRP, Ach, stimulates sympathetic fibers in the paravertebral ganglia
    Releases Substance P—affects capillaries, mast cells, symp ganglia
    Causes changes in the interpretation of pain
  • 2-8 Hz
    Low-frequency, high intensity
    “Qi”—group III fibers, may be blocked by injecting procaine deep to site
    Aβ and Aδ, group II and III fibers that synapse w/ dorsal horn
    Enkephalin release from periaqueductal gray
    Endorphin dependent release from the hypothalamus
    May be reversed/blocked by naloxone
    Continues after stimulation
    More general effect
    More than 10 Hz
    High frequency, low intensity
    Endorphin independent
    Dynorphin in the spinal cord
    Activates low-threshold skin and muscle receptors
    5HT, NE release in midbrain
    Rapid onset
    More segmental effect
  • 2-8 Hz
    Low-frequency, high intensity
    “Qi”—group III fibers, may be blocked by injecting procaine deep to site
    Aβ and Aδ, group II and III fibers that synapse w/ dorsal horn
    Enkephalin release from periaqueductal gray
    Endorphin dependent release from the hypothalamus
    May be reversed/blocked by naloxone
    Continues after stimulation
    More general effect
    More than 10 Hz
    High frequency, low intensity
    Endorphin independent
    Dynorphin in the spinal cord
    Activates low-threshold skin and muscle receptors
    5HT, NE release in midbrain
    Rapid onset
    More segmental effect
  • Transcript

    • 1. DR.S.IBRAHIM SHERIFF P.T. M.P.T.,M.D.(Acu).,M.D.(AM).,PGDHM.,PGDCE.,PGDip.varma.,MIAP., DIRECTOR GLOBAL INSTITUTE FOR ACUPUNCTURE THERAPY MADURAI
    • 2. BRANCH OF TRADITIONAL CHINESES MEDICINE(TCM)
    • 3.  What is Acupuncture?  INTERNATIONAL RECOGNITION  TYPES OF ACUPUNCTURE  PHILOSOPHY  Mechanisms of Action  Indications for Acupuncture  GLOBAL COLLEGE-COURSES
    • 4.  Acupuncture is an alternative medicine  methodology originating in ancient China that treats patients by manipulating thin, solid needles that have been inserted into acupuncture points in the skin. According to Traditional Chinese medicine, stimulating these points can correct imbalances in the flow of qi through channels known as meridians
    • 5.  United States- National Institutes of Health,   National Health Service- United Kingdom  World Health Organization   National Center for Complementary and Alternative Medicine
    • 6.  MOXIBUSTION  CUPPING  TUINA (ACUPRESSURE)  ELECTROACUPUNCTURE  EAR ACUPUNCTURE(AURICULAR)  HAND ACUPUNCTURE (SUJOK)  MEDICAL ACUPUNCTURE  COSMETIC ACUPUNCTURE
    • 7.  The general theory of acupuncture is based on the premise that bodily functions are regulated by an energy called qi which flows through the body; disruptions of this flow are believed to be responsible for disease.   Acupuncture describes a family of procedures aiming to correct imbalances in the flow of qi by stimulation of anatomical locations on or under the skin (usually called acupuncture points or acupoints), by a variety of techniques  The most common mechanism of stimulation of acupuncture points employs penetration of the skin by thin metal needles, which are manipulated manually or by electrical stimulation.[
    • 8.  Good health is balance btwn man & the natural world; balance btwn Yin &Yang; everything has a Y&Y component  Yin - assoc w/ earth, coldness, dampness  Yang - assoc w/ heaven, sky, warmth, dryness  Balance is regulated by the flow of chi (qi); the “life energy” flowing along meridians. Imbalance disrupts flow of chi - resulting in pain or illness - stimulation of points restores balance.
    • 9.  Most points are highly conductive  High concentrations of free nerve endings and sensory receptors have been are commonly found at points.  Electroacupuncture causes increased levels of beta- endorphin in the CSF  Some parasympathetic effects have been documented - lowered BP & stress; even fainting/hypnotic state  Moderately strong relationship between trigger points, motor points & acupuncture points (location)  Possible placebo effect  Unknown – traditional Chinese philosophy (mysticism)
    • 10.  fMRI with blood oxygen level-dependent (BOLD) measurements  Acupuncture points: rich in neuroreceptors  Modulates pain network via analgesic effects  CNS hormones release in hypothalamus and limbic system  Causes changes in interpretation of pain
    • 11.  Fascia is bath of conductive fluid  General tx (2-8 Hz) • Enkephalin released from periaqueductal gray • Endorphin released from the hypothalamus • May be reversed/blocked by Naloxone  Local tx (above 10 Hz)  Dynorphin released in spinal cord  Activates low-threshold skin and muscle receptors  Serotonin/Norepinephrine released in midbrain
    • 12.  Fascia is bath of conductive fluid  General tx (2-8 Hz) • Enkephalin released from periaqueductal gray • Endorphin released from the hypothalamus • May be reversed/blocked by Naloxone  Local tx (above 10 Hz)  Dynorphin released in spinal cord  Activates low-threshold skin and muscle receptors  Serotonin/Norepinephrine released in midbrain
    • 13. INDICATIONS RELATED WITH PHYSIOTHERAPY (WORLD HEALTH ORGANIZATION-DECEMBER 1979 INDICATIONS OF ACUPUNCTURE) Respiratory Diseases • Acute sinusitis • Acute rhinitis • Common cold • Acute tonsillitis Bronchopulmonary Diseases • Acute bronchitis • Bronchial asthma Eye Disorders • Acute conjuctivitis • Cataract(without complications) • Myopia • Central retinitis Disorders of the Mouth Cavity • Toothache • Pain after tooth extraction • Gingivitis • Pharyngitis Orthopedic Disorders • Periarthritis humeroscapularis • Tennis elbow • Sciatica • Low back pain • Rheumatoid arthritis Gastrointestinal Disorders • Spasm of the esophagus and cardia • Hiccups • Gastroptosis • Acute and chronic gastritis • Gastric hyperacidity • Chronic duodenal ulcer • Acute and chronic colitis • Acute bacterial dysentery • Constipation • Diarrhea • Paralytic ileus Neurologic Disorders • Headache • Migraine • Trigeminal neuralgia • Facial paralysis • Paralysis after apoplectic fit • Peripheral neuropathy • Paralysis caused by poliomyelitis • Meniere's syndrome • Neurogenic bladder dysfunction • Nocturnal enuresis • Intercostal neuralgia
    • 14.  Chronic Pain/Fatigue Syndromes  Osteoarthritis  Joint disease/back pain  Acute Pain--Sprains, Strains,  Post-Operative Pain  Migraines  Fibromyalgia  Depression, Anxiety The NIH consensus panel stated that promising results emerged, for example, efficacy of acupuncture in: adult post-operative and chemotherapy nausea and vomiting postoperative dental pain.
    • 15.  Classic Acupuncture - Needling - Needling w/ manual stimulation of needle - Needling w/ electrical stimulation thru needle  Physical Therapy on acupuncture pts. - Manual pressure (acupressure) - TENS on the points - Laser on the points - Ultrasound on the points
    • 16.  The Prescription method: certain points are for particular clinical presentations & symptoms. A Western adaptation  Stimulate point in the same area as the pain / stimulate known MTPs in the area / stimulate Ah Shi points  Classical method: Holistic assessment w/ detailed understanding on body, mind, lifestyle, environment, etc.. (ie.Yin & Yang)
    • 17.  Global college of paramedical college was started in the year of 2009 at Alanganallur, Madurai district,tamilnadu, aim is the meet the challenges of new era in the hospital industry.  The institution is affiliated by BSS, National Development agency and promoted by Government of India. Registration No:TN/1693  Approved by Tamilnadu Physical Education & Sports University, Chennai –DDE
    • 18.  APPROVED BY  BHARAT SEVAK SAMAJ ,NATIONAL DEVELOPMENT AGENCY,PROMOTED BY GOVT OF INDIA  TAMILNADU PHYSICAL EDUCATION AND SPORTS UNIVERSITY-DDE,CHENNAI
    • 19. BSS COURSES TNPESU COURSES (distance education ) MASTER DIPLOMA IN ACUPUNCTURE THERAPY(M.D.Acu) DIPLOMA IN ACUPUNCTURE THERAPY (D.Acu) Nursing assistant Medical laboratory Technician Xray Technician Operation theatre Technician M.Sc /B.Sc (Yoga &naturopathy) M.B.A.(General) M.B.A.(SPORTS MANAGEMENT) M.Sc (Psychology) PG Diploma in onfield sports injury mangement PG Diploma in fitness and nutrition PG Diploma in Gym and Fitness Instructor PG diploma in Varma and Thokkanam sciences
    • 20.  GLOBAL COLLEGE OF PARAMEDICAL SCIENCES  275,VELLIMALAYAN II STREET,  KALAIVANAR NAGAR,  ALANGANALLUR,MADURAI-625 501 PH:04543-244255  Dr.S.Ibrahim sheriff : 9659392525  Dr.K.Saravanan : 9489966956  EMAIL: globcps@gmail.com SPECIAL CONCESSION FOR PHYSIOTHERAPY STUDENTS & PHYSIOTHERAPISTS

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