1. Chinese Medical Journal 2009;122(13):1587-1590 1587
Brief report
Effect of auricular acupuncture on oxygen consumption
of boxing athletes
LIN Zen-Pin, WANG Chung-Yuan, JANG Tsong-Rong, MA Tso-chiang, CHIA Fan, LIN Jaung-Geng, HSU Jen-Jeng
and HO Tsung-Jung
Keywords: auricular acupuncture; oxygen consumption; boxing athletes
B oxing is an official sport at the 2008 Beijing
Olympic Games and the fast development of
world-class high strength training and sport science has
dysfunction by stimulation of definite points on the ear.6
The resultant amelioration of pain and illness is believed
to be through the reticular formation and the sympathetic
made a significant impact on scientific training. Boxing and parasympathetic nervous systems.7 Current clinical
needs high cardio-respiratory function, speed, muscle and basic research has proved the efficacy of ear
strength, and anaerobic and intensive physical demands acupuncture mostly in the treatment of acute or chronic
including weight control covering the grading of athlete′s pain8-12 and anxiety-related disorders.13-15 Therefore, ear
body weight and balancing physical ability and health. acupuncture is a technique similar to reflexology, and is
Sport training is important even for talented athletes. speculated that it works because groups of pluripotent
Weight cycling is a term used to describe rapid weight cells contain information from the whole organism and
loss following self food limitation and/or dehydration. create regional organization centers representing different
Both gradual (seasonal) and rapid (weekly) weight parts of the body, through the recruitment of more cortex
reduction cycles are used by athletes, and have been cells dedicated to specific areas of the body.6 The
investigated for potential effects on nutrition and resultant amelioration of pain and illness is believed to be
performance.1 These cycles are used in such sports as due to the reticular formation and the sympathetic and
wrestling, judo, rowing, and boxing in order to make a parasympathetic nervous systems.7 In the contemporary
weight category. Like the other of these sports, boxing athletic world, nations strive to develop a competitive
needs repeated efforts and high-intensity physical advantage in sports using various scientific methods to
strength. Only when the cardio-respiratory function, improve the performance of athletes. Designing methods
energy expenditure and blood lactate system of athletes to help athletes to outperform others and win the gold
are well controlled can they show their potential and medals in international competitions is the goal for many
maintain high performance.2 Overtraining syndrome, a researchers. From the scientific perspective, various
neuroendocrine disorder, is characterized by poor elements including muscular strength, speed, power,
performance in competition, inability to maintain training muscular and cardiopulmonary endurance, flexibility,
loads, persistent fatigue, reduced catecholamine excretion, agility, balance and coordination were combined to
frequent illness, disturbed sleep and alterations in mood constitute athletic ability. Among these elements,
state.3 Sport training is important even for talented cardiopulmonary endurance is the absolute element for
athletes. Peaking or the ability of an athlete to have a athletes in all types of sports. VO2max as a fundamental
peak performance during the tough competition or games
DOI: 10.3760/cma.j.issn.0366-6999.2009.13.022
of the year is also related to strength training. The Department of Holistic Wellness, MingDao University, Taiwan,
determination of physiological variables such as the China (Lin ZP, Chia F and Hsu JJ)
anaerobic threshold (AT) and maximal oxygen uptake Athletics Department & Graduate School, National Taiwan Sport
(VO2max) through incremental exercise testing and the University (Taichung), Taiwan, China (Wang CY and Jang TR)
relevance of these variables to endurance performance is Department of Public Health, China Medical University, Taiwan,
China (Ma TC)
a major requirement for coaches and athletes.4 To Graduate Institute of Chinese Medical Science, China Medical
maintain good performance throughout the competitive University, Taiwan, China (Lin JG)
phase, this physiological base must be maintained.5 School of Chinese Medicine, College of Chinese Medicine, China
Bompa5 investigated boxing and martial arts, and found Medical University, Taichung, Taiwan, China (Ho TJ)
that a quick and powerful start of an offensive skill Chinese Medicine Department, China Medical University Beigang
Hospital, Taiwan, China (Ho TJ)
prevents an opponent from using an effective action. The Chia-Yi Hospital, Department of Health, Executive Yuan, Taiwan,
elastic, reactive component of muscle is of vital China (Ho TJ)
importance for delivering quick action and powerful LIN Zen-Pin, WANG Chung-Yuan and JANG Tsong-Rong
starts. contributed equally to this work as co-first author.
Correspondence to: Prof. HO Tsung-Jung, School of Chinese
Medicine, College of Chinese Medicine, China Medical
However, auricular acupuncture is a diagnostic and University, 91 Hsueh-Shih Rd., Taichung 404, Taiwan, China (Tel:
treatment system based on normalizing the body′s 886-4-22053366 ext 3120. Email: tjho@mail.cmu.edu.tw)

2. 1588 Chin Med J 2009;122(13):1587-1590
indicator for evaluating cardiovascular endurance is one
of the critical elements for succeeding in endurance sports.
Auricular stimulation also known as ear acupuncture is an
internationally recognized medical method.16 Ear
acupuncture was first proposed in 1957 by Nogier, who
theorized that acupuncture points on the ear are shaped
like an inverted embryo. In 1986, ZHANG Ying-qing
described the bio-holographic theory with an ear
acupuncture chart and the effects of ear acupuncture.
These theories present how ear acupuncture enhances
sporting abilities by lowering the heart rates of athletes at
rest, decreasing oxygen intake, and expediting excretion
of post-exercise blood lactic acids. The present study
aimed to investigate the effects of auricular acupuncture
and to develop effective methods to help boxing athletes
recover quickly from major competition events.
METHODS
Figure 1. The distribution of simulative auricular acupoints.
Subjects
Thirty male boxing athletes (age (19.8±1.1) years, height
(172.0±2.5) cm, and weight (66.3±3.2) kg) from the
National Taiwan Sport University (Taichung, China) were
selected to participate in the study. Each subject
underwent a treadmill training program for complete Figure 2. Experiment process flowchart for AS group, PC6
exhaustion at a starting speed of 15 m/h, followed by an group and control group.
increment of 5 m/h every 2 minutes.
equipments. To prevent injury during the experiment, the
These athletes were randomly assigned to three groups: subjects got prepared for sufficient warm-up before
auricular stimulation group (AS group, n=10), exercise. In the second phase, body temperature of the
acupuncture Neiguan group (PC6 group, n=10) and subjects was measured after use of auricular stimulation
control group (n=10). Magnetic stud patches were used to patches and 3M tape for detecting the body temperature
stimulate the ear acupuncture points in the AS group for reaction during the experiment. With the graded jogging
30 minutes prior to exercise, which was continued until program proposed by Jackson and Pollock in 1978,17 the
treadmill was set at a constant speed, and a slope program
exhaustion determined by the subjects. 3M tape was used
was set to raise the treadmill by a 2.5% grade every two
on the auricular points without stimulation in the control
minutes. Each of the participants was asked to provide
group.
feedback in accordance with the self-awareness chart
during the last 5 seconds of each stage. Each participant
Settings and process of experiment was required to wear a mask and a breathing collector. All
This study was conducted in the physical laboratory of participants warmed up their muscles on the treadmill till
the National Taiwan College of Physical Education. The the RQ indicator was 0.7–0.8 on the Vmax29c before the
research equipments included a Quinton ST65 Med track start of the experiment. The time lag was 24 hours
treadmill; a Vmax29c cardiopulmonary measuring device; between each experiment (an experiment including
auricular needles; 3M tape, and an electronic body pre-experiment and post-experiment graded exercise tests)
thermometer. The study included two phases. In the first as the time was passed to reduce the cross-over effects. It
phase the experiment was conducted without laboratory potentially provided a better comparison for the effects of
control. Magnetic stud patches were used to stimulate stimulation.
such acupuncture points as Shen-men, heart, lung, liver,
Triple warmer, adrenal cortex and endocrine on both ears Statistical analysis
in the AS group (Figure 1). In the second phase, thirty SPSS 12.0 for Windows was used for data analysis. First,
male boxing athletes were randomly assigned to three a descriptive analysis was made of the age, height and
groups: AS group, PC6 group, and control group (Figure weight of the participants. One-way analysis of variance
2). (ANOVA) and Schfee′ way method were repeated to
analyze the age, height, weight, VO2max, body
3M tape was stuck on the same acupoints on both ears of temperature, VEmax, TV and RR before and after the
the subjects of the control group without stimulation for experiment to determine if there are statistically
30 minutes prior to the exercise. The subjects were fully significant differences in the measurements. The
informed of the experimental procedures and the use of statistical significance was set at P <0.05.

3. Chinese Medical Journal 2009;122(13):1587-1590 1589
RESULTS showed that VO2max was only significantly different
between the pre-experiment and post-experiment
The VO2max of the AS group was significantly higher than measurements in the AS group, but not in the control
that of the control and acupuncture PC6 groups (Table) group. Many researchers, however, used VO2max as an
respectively. However, the VE2max, TV, RR, and body important indicator for evaluating aerobic ability and
temperature in both the acupuncture PC6 and control sport performance.19-22 From the present study we
groups were not significantly different. conclude that auricular acupuncture stimulation could
potentially enhance the aerobic ability of athletes while
Table. Difference of cardiopulmonary endurance for AS group, improving sport performance.
acupuncture PC6 group and control group (n=30)
Variables AS group
Acupuncture PC6
Control group Acupuncture stimulation is an internationally recognized
group alternative therapy for substantial improvement of
-1 -1 *†
VO2max (ml · kg · min ) 58.86±1.03 53.45±1.21 53.38±0.93
cardiopulmonary function.23,24 In this study, auricular
VEmax (L/min) 141.70±14.59 135.40±14.73 136.57±13.89
TV (L) 2.28±2.28 2.24±0.31 2.29±0.32 stimulation enhanced the physical capabilities of athletes
RR 53.50±10.91 58.10±6.57 56.80±6.72 including the improvement of indicators of aerobic
Body temperature (°C) 36.94±0.84 36.90±1.05 36.77±0.74 function such as VO2max and VEmax. Thus we suggest that
*
P <0.05 when compared with control group; †P <0.05 when compared with auricular stimulation could improve the performance
acupuncture PC6 group. results of athletes who are devoted to marathons, 400
meter sprints, and 800 meter long distance runs.
Obviously, auricular acupuncture could significantly Furthermore, significant differences were observed in the
enhance the recovery after exercise oxygen consumption. present study in body temperatures of athletes before and
Auricular acupuncture at the Shen-men point, heart point, after auricular stimulation. Previously the rising body
lung point, liver point, Triple warmer, adrenal cortex and temperature was reported to increase enzyme activities,
endocrine helped improve the ability of recovery of elite muscular blood volume, oxygen intake and the time
boxing athletes. Understanding the effects of auricular between contraction and relaxation of muscles to enhance
acupuncture on the recovery and profile of boxing the performance and avoid injuries.26,27 The acupoints
athletes is important because it will help coaches in Neiguan (PC6) and Zusanli (ST36) can decrease the
training and athletes in recovery. resting heart rate and carbon dioxide production.28 In the
present study, the levels of HRmax, VO2max and blood
DISCUSSION lactic acid were significantly lower in the acupuncture
group (stimulating acupoints PC6 and ST36) than in
There are few studies on auricular acupuncture involving the sham and normal groups 30 minutes after exercise.
VO2max changes in boxing athletes. But during The level of blood lactic acid of the acupuncture group
competition phases it is important to ensure a peak was also significantly lower than that of the other two
performance and a quick recovery for athletes. The groups 60 minutes after exercise. These results have been
finding can be used to improve the sport performance of implemented in developing effective acupuncture
athletes. The determination of physiological variables schemes to enhance the recovery ability of basketball
such as AT and VO2max shown by incremental exercise athletes.29 Our study also demonstrated that in addition to
testing and relevance of these variables to endurance improve the function of elements necessary for athletic
performance is thought to be advisable for both athletes performance, stimulation at auricular acupoints before
and coaches.4 Bompa5 found that a quick and powerful exercise also decreases the warm-up time necessary for
start of an offensive skill prevents an opponent from an athletes so as to prevent any injuries.
effective action. The elastic, reactive component of
muscle is of vital importance for delivering a quick action Limitations of this study included: (1) a relatively small
and a powerful start. group of athletes were enrolled because the experiment
required the participants to exercise on the treadmill
However, auricular acupuncture is a diagnostic and training machine till exhaustion; (2) the participants were
treatment system based on normalizing the body's primary competitive athletes who desired to improve their
dysfunction through stimulation of definite points on the competition performance through auricular stimulation;
ear, and its reflex system does not correlate with modern and (3) the lifestyle of participants could potentially
knowledge of anatomy and physiology. Auricular influence athletic performance. The lifestyles of athletes
acupuncture stimulation can significantly improve need to be closely monitored to decrease external
oxygen intake in athletes. The VO2max per minute is variations that could affect the result of the study.
higher in athletes with auricular acupuncture stimulation
than in those without the stimulation. Similar results were Auricular stimulation has significant effects on the
found by Sa and Lin.18 In their research, six males from maximal oxygen intake (VO2max). Understanding these
physical education were given stimulation from auricular effects during competition would also help to improve the
acupuncture patches on points of the lung, kidney, spleen, aerobic capabilities and performance results of athletes in
Triple warmer, adrenal cortex and endocrine, attempting addition to cardiopulmonary function. The stimulation is
to improve VO2max during aggressive exercise. The results recommended to use appropriately in the three phases of

4. 1590 Chin Med J 2009;122(13):1587-1590
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