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Acupuncture, as an ancient practice for healthcare in China, is now widely used in the world and regarded as a non-conventional therapy (NCT) in many Western countries. In Portugal, acupuncture has been structured and well regulated for the market of teaching and clinical practice, but little effort has been put in to explore it in depth. This article aims to disclose the current education of acupuncture as a NCT in Portugal through investigation of acupuncture laws, field surveys, teaching work, and interviews with people from the NCT field. We found that according to the academic norms and rules of education in Portugal, there is a gradual difficulty in the progression and maintenance of the degree training dynamics. The reasons are the lack of more tolerant transitional measures and many practical difficulties confronted by the institutions that embark on these complementary programs. Therefore, it will be necessary to promote additional programs and measures to avoid a total emptiness of the teaching of acupuncture and at the same time losses of clinicians, competencies, and quality of information that are difficult to recover. It could be very meaningful and thought provoking to the future development and improvement of acupuncture in Portugal and in other countries that welcome acupuncture and intend to have better legislation and application.
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A growing interest in integrating traditional Chinese medicine (TCM) and conventional medicine (CM) to create a more comprehensive approach to healthcare has been verified. Scientific evidence supports acupuncture as an integrative treatment for specific health conditions. The aim of this study was to assess the acceptance and feasibility by patients and healthcare professionals of integrating acupuncture in a dialysis center. Individuals undergoing hemodialysis (HD) who participated in a patient-assessor-blinded randomized controlled trial that evaluated the effect of acupuncture on functional capacity and quality of life were included. Acceptance was measured by adherence (percentage of patients who completed treatments and dropouts) and patients' and healthcare professionals' opinions toward acupuncture (pre- and pro-intervention questionnaires). Feasibility was measured by safety (number of reported adverse events) and effectiveness (changes in functional capacity, peripheral muscle strength, and health-related quality of life scores after treatment). Forty-eight patients were included, and forty-five (93.8%) were analyzed. No adverse events were reported. All patients completed the treatment, and only three patients (6.2%) were lost to the 12-week post-treatment follow-up. The attitudes of patients and health professionals were favorable to acupuncture, namely in relation to its use, degree of discomfort, recommendation to others, and interference with routine care and clinical setting. Integrating acupuncture into a dialysis center seems viable and well-accepted by patients with kidney failure on maintenance HD, doctors and nurses.
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Patients with kidney failure (KF) receiving maintenance hemodialysis (HD) experience numerous symptoms that impair their health-related quality of life (HRQOL) and contribute to high mortality rates. Acupuncture is often used for symptom enhancement and HRQOL. This blinded, randomized, controlled patient-assessor trial evaluated the effectiveness of acupuncture compared with sham acupuncture on patients' HRQOL receiving maintenance HD as a secondary analysis. Seventy-two participants were randomly assigned to verum acupuncture (VA), sham acupuncture (SA), or waiting-list (WL) groups. The outcome was an improvement in HRQOL, assessed using the Kidney Disease Quality of Life-Short Form, version 1.3 (KDQOL-SF™ v1.3) at baseline, after treatment, and at 12-week follow-up. Non-parametric tests were used for statistical analysis. Of the 72 randomized patients, 67 were included in the complete analysis set. As for the changes between baseline and after treatment, the VA group showed significantly increased scores on most of the KDQOL-SF™ v1.3 scales compared to SA or WL groups (p < 0.05). No statistically significant differences between groups were observed in the changes from baseline to follow-up (p > 0.05). Compared to the sham treatment, acupuncture improved the HRQOL in patients receiving maintenance HD after treatment but not at follow-up.
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Background: Taijiquan and qigong are traditional Chinese therapeutic disciplines with several health benefits and the ability to improve the quality of life of their practitioners. As traditional vegetative biofeedback therapies, they can activate functional vegetative changes in the body. These neurovegetative actions have been studied in the last few years to better explain the mechanisms through which these techniques of traditional Chinese medicine work. Primary Study Objective: To support current research, it is important to further explore these neurovegetative actions according to contemporary Chinese medicine models to clarify the mechanisms of their working in light of conventional medical terms. This study aims to explore the health benefits that these practices may produce for practitioners. Methods: 345 taijiquan and qigong practitioners were recruited for this study to assess the perceived health benefits of taijiquan and qigong. We conducted a survey to assist in this purpose. Results: Taijiquan combined with qigong may be more beneficial than taijiquan alone. Additionally, these practices seem to produce notable benefits for anxiety, depression, and other emotional disturbances. They also seem to have positive results in addressing arthritis and pain in the back, shoulder, neck, and knees. In addition, taijiquan and qigong may have benefits in managing several digestive, neurological, cardiovascular, and respiratory diseases, and provide some assistance in the management of some oncologic conditions. Conclusion: Breathing exercises, slow and controlled movement, self-massage, and directed thought are the therapeutic characteristics that allow this wide range of potential, perceived health benefits. More scientific studies are needed to confirm the mechanisms through which taijiquan and qigong may benefit health. However, it is suggested that these techniques may have an impact on health mainly via the modulation of the autonomic nervous system.
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Qigong , Tai Chi Chuan , Humanos , Qualidade de Vida , Medicina Tradicional Chinesa/métodos , Exercícios RespiratóriosRESUMO
INTRODUCTION: Electro-acupuncture, an innovative adaptation of traditional acupuncture, combines electrical stimulation with acupuncture needles to enhance therapeutic effects. While acupuncture is widely used, its biological mechanisms remain incompletely understood. Recent research has explored the neurophysiological aspects of acupuncture, particularly through functional magnetic resonance imaging (fMRI) to investigate its effects on brain activity. METHODS: In this systematic review, we conducted an extensive search for randomized clinical trials examining electro-acupuncture effects measured by fMRI. We employed strict eligibility criteria, quality assessment, and data extraction. RESULTS: Five studies met our inclusion criteria and were analyzed. The selected studies investigated electro-acupuncture in various medical conditions, including carpal tunnel syndrome, fibromyalgia, Crohn's disease, irritable bowel syndrome, and obesity. Notably, electro-acupuncture was found to modulate brain activity and connectivity in regions associated with pain perception, emotional regulation, and cognitive processing. These findings align with the holistic approach of traditional Chinese medicine, emphasizing the interconnectedness of body and mind. DISCUSSION: In carpal tunnel syndrome, electro-acupuncture at both local and distal sites showed neurophysiological improvements, suggesting distinct neuroplasticity mechanisms. In fibromyalgia, somatosensory electro-acupuncture correlated with reduced pain severity, enhanced brain connectivity, and increased gamma-aminobutyric acid levels. For Crohn's disease, electro-acupuncture influenced the homeostatic afferent processing network, potentially mitigating gut inflammation. Electro-acupuncture for irritable bowel syndrome led to decreased activity in the anterior cingulate cortex, offering pain relief, while electro-acupuncture for obesity impacted brain regions associated with dietary inhibition and emotional regulation. CONCLUSION: This systematic review provides evidence that electro-acupuncture can positively impact a range of medical conditions, possibly by modulating brain activity and connectivity. While the quality of the reviewed studies is generally good, further research with larger sample sizes and longer-term assessments is needed to better understand the mechanisms and optimize electro-acupuncture protocols for specific health conditions. The limited number of studies in this review emphasizes the need for broader investigations in this promising field. The research protocol was registered in PROSPERO (CRD42023465866).
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Decreased functional capacity (FC) in patients undergoing hemodialysis (HD) is associated with adverse health events and poor survival. Acupuncture is recognized as a safe and effective integrative treatment. The aim of this study is to evaluate the effect of acupuncture treatment on the FC in chronic kidney disease with GFR category 5 (CKG G5) patients undergoing HD. In this patient-assessor blinded randomized controlled trial, seventy-two KF patients were randomly assigned to experimental (n = 24), placebo (n = 24) and control groups (n = 24). The primary outcome was the improvement in FC assessed by the 6-Minute Walk Test (6-MWT). Secondary outcomes included assessment of peripheral muscle strength by the Handgrip Strength Test (HGS) and the 30-Second Sit-to-Stand Test (STS-30) at baseline, after treatment and at 12-week follow up. A mixed ANOVA with interaction time*group was used. The experimental group increased walk distance (p < 0.001), lower limbs strength (p < 0.001) and handgrip strength (p = 0.012) after nine acupuncture sessions and stabilized in the follow-up (p > 0.05). In the placebo and control groups the 6-MWT and 30STS results decreased (p < 0.001) and the HGS scores did not change through time (p > 0.05). Acupuncture treatment improved FC and muscle strength in patients undergoing HD.
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Practices such as "Reiki", therapeutic touch, healing touch, and external "Qigong" have been regarded as some form of "energy medicine" or "biofield therapy". The biofield concept has been studied and debated by researchers of distinct areas of expertise, and although the phenomenon was sometimes described as physically related to electromagnetics, other factors such as "subtle energy" and focused intention might be involved. These nonconventional practices integrate contact and non-contact techniques, and those dealing with so-called distant healing interventions are perhaps the most difficult to understand and accept. Practitioners describe these so-called nonlocal interventions as involving intentional factors and particular states of consciousness. With a spiritual mindset and a particular state of awareness, compassion is said to work out as a catalyst to produce physiological and physical changes through mechanisms that are still unknown. At the body level, these vegetative changes might be related to individual self-perception variations as part of the body neurovegetative feedback system of regulation. Further mechanisms are difficult to document and measure, and might be more accessible to research by using physical signal detectors, chemical dynamics methods, detectors using biological materials, detectors using living sensors, and detectors using the human body. The growing interest in these practices and the considerable amount of research exploring their effects and clinical applications encouraged this narrative review, which aims to provide an easy to consult partial overview of the history, theory and findings of quantitative research strategies exploring non-contact biofield-based practices. This work also aims to stimulate the reader's mind with the raised hypotheses, catalyzing further research on the subject to confirm or deny the reported outcomes.
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Terapias Mente-Corpo , Qigong , Estado de Consciência , Fenômenos Eletromagnéticos , Humanos , IntençãoRESUMO
INTRODUCTION: Acupoints have bioelectrical properties distinct from common skin. Besides the higher electrical conductivity and lower resistance, acupoints show capacitor-like properties, which can be related to their endogenous electrical potential. Traditional Chinese Medicine (TCM) postulates that meridians are physiological structures connecting acupoints and working as a conduit for the flow of two essential substances known as qi and xue. OBJECTIVES: This pilot study was focused in evaluating whether the electrical potential of acupoints can be correlated objectively to the functional properties as described by ancient Chinese medical theories, such as the theories of coupled meridians of the same phase ('elements'), and the principle of coupled points. METHODS: Direct needle moxibustion on LU5 and needle dispulsion of LI4 were performed in 21 subjects. The electrical potential of each acupoint was measured with a high-resolution data acquisition system taking to reference the acupoint SP6 of the Spleen conduit. RESULTS: The results may indicate a functional relationship between the therapeutics and the electrical potential response on the selected acupoints. These effects seem to be explainable considering the specific properties of each acupoint, the relationship between TCM phases, and the dynamics between coupled conduits. CONCLUSION: The evaluation of the endogenous electrical potential of acupoints and the changes caused by an external stimulus might contribute to the understanding of TCM concepts, mechanisms, and the effects of associated therapeutics. The observed phenomena encourage the systematic assessment of the functional vegetative status via skin electrophysiology and using objective measurements.
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Terapia por Acupuntura , Meridianos , Moxibustão , Pontos de Acupuntura , Análise de Dados , Humanos , Projetos PilotoRESUMO
INTRODUCTION: The development and well-being of children are directly linked to several aspects. Among those aspects, physical activity, an adequate nutrition, and a healthy mind, seem to be of crucial importance. Psychopathologies, such as anxiety and depression, have a negative impact on life, especially when co-occurring (mixed-anxiety depression disorder/cothymia), and the clinical implications include a higher risk of suicide and psychiatric hospitalization, elevated disability, decreased compliance with medical treatment, and considerably increased usage of medical services. Thus, research in conventional and nonconventional modalities is necessary to address this issue. The main objective of this study was to understand if TJQ and QG could be effective as a mindfulness cognitive-behavioural based therapeutic tool with body movement, for the treatment of children suffering from cothymia. METHODS: In this small study, six selected children, four males and two females aged between 7 and 11 years old, were taught a set of exercises of TaijiQuan (TJQ) and Qi Gong (QG). To obtain the results, the Achenbach Teacher's Report Form (TRF) was applied at the beginning of the experimental period, as well as at the ending of the experimental period. The resulting scores were analysed to observe the difference between both moments of evaluation. RESULTS: Results showed some improvements in symptoms, with an average improvement of 46%. CONCLUSION: TJQ and QG seem to be a promising complementary therapeutic tool in cognitive-behavioural approaches for children who suffer from cothymia, as well as prevention and control for children who may not display symptoms at a clinical level. However, further research is needed in order to understand the full potential of these therapeutic exercises.
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Atenção Plena , Qigong , Tai Chi Chuan , Criança , Cognição , Feminino , Humanos , Masculino , Instituições AcadêmicasRESUMO
Traditional Chinese medicine (TCM) is a systematic healthcare system developed from clinical experience based on a scientific model of regulation. TCM relies on unique theories and practices to treat diseases and enhance health. These practices include Chinese herbal medicine and dietetics, acupuncture and moxibustion, and other non-medication therapies such as Chinese bodywork or manual therapy, known as "Tuina", and traditional biofeedback exercises, known as "Qigong" and "Taijiquan". The integration of TCM in Western health systems and research requires a rational communicable theory, scientific proof of efficacy and safety, and quality control measures. Understanding the structural concepts of the TCM language makes possible the parallelism to Western physiology, and the inherent rational use of the reflex therapeutic systems, anti-inflammatory mechanisms and mental training involved, for example, in acupuncture and "Qigong". The results of TCM clinical trials and fundamental research on its nature and mechanisms have encouraged the development and application of well-designed research strategies such as double blinding in acupucture to overcome limitations and resistances in integrating these practices into the existing biomedical paradigms of the West. This review aims to overview some TCM theoretical concepts and the evidence-based clinical application of TCM's leading practices to create an easy-to-consult and condensed source of information, available for the healthcare community, facilitating the understanding and communication between conventional health professionals and TCM practitioners and acupuncturists.
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The integration of Traditional Chinese Medicine (TCM) in Western health systems and research requires a rational communicable theory, scientific proof of efficacy and safety, and quality control measures. The existence of clear definitions and the diagnosis standardization are critical factors to establish the patient's vegetative functional status accurately and, therefore, systematically apply TCM therapeutics such as the stimulation of reflex skin areas known as acupoints. This science-based conceptualization entails using validated methods, or even developing new systems able to parameterize the diagnosis and assess TCM related effects by objective measurements. Traditionally, tongue and pulse diagnosis and the functional evaluation of action points by pressure sensitivity and physical examination may be regarded as essential diagnostic tools. Parameterizing these techniques is a future key point in the objectification of TCM diagnosis, such as by electronic digital image analysis, mechanical pulse diagnostic systems, or the systematic evaluation of acupoints' electrophysiology. This review aims to demonstrate and critically analyze some achievements and limitations in the clinical application of device-assisted TCM diagnosis systems to evaluate functional physiological patterns. Despite some limitations, tongue, pulse, and electrophysiological diagnosis devices have been reported as a useful tool while establishing a person's functional status.
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Child development and wellness are strictly dependent on several factors among them physical activity, a proper nutrition and, of critical importance, a healthy mind. Psychopathologies like attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD) and conduct disorder (CD) have a direct negative impact on social, academic or occupational functioning of the affected children. If left untreated, these pathologies may progress to adulthood, thus requiring research strategies on conventional and nonconventional modalities of treatment. In this pilot study, conducted during the academic year 2015/2016, a combination of exercises of TaijiQuan (TJQ) and Qi Gong (QG) were taught to four selected children, three males and one female, aged between 6 and 10, suffering from the above mentioned behavioural disorders. The main goal was to understand if it is possible to achieve any kind of improvement in their condition, by evaluating the scores of the Achenbach Teacher's Report Form (TRF) in the beginning and ending of the experimental period. Results showed very interesting improvements in symptoms of CD, ODD and ADHD-HI (hyperactive-impulsive), while ADHD-PI (predominantly inattentive) showed only minor improvements. The overall symptom improvement was 43% across pathologies, which demonstrates that TJQ and QG may be a promising treatment of symptoms for children with behavioural disorders. More research is needed with controlled experimental designs and statistically representative samples in order to fully comprehend the versatility of these modalities.
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Transtornos de Deficit da Atenção e do Comportamento Disruptivo/terapia , Transtornos do Comportamento Infantil/terapia , Qigong/métodos , Tai Chi Chuan/métodos , Transtorno do Deficit de Atenção com Hiperatividade/terapia , Criança , Feminino , Humanos , Masculino , Projetos PilotoRESUMO
Background: Traditional Chinese medicine (TCM) may be understood as a system of sensations and findings designed to establish the functional vegetative state of the body. This state may be treated by several therapeutic methods such as acupuncture, Chinese pharmacotherapy, dietetics, Tuina, and Qigong. Nowadays, as a result of several evidence-based reported beneficial effects over specific pathological conditions, there is an increasing tendency to integrate some of these practices in Western medicine. The main goal of this study was to perform a bibliometric analysis of TCM scientific production between 1982 and 2016 indexed in PubMed, by analyzing several parameters including time and location distribution, publication quality, experimental design, and treatment methods. Methods: The methodology was based on the quantitative inventory of published scientific research indexed in PubMed medical subject headings (MeSH), sorted within the broad term “Traditional Chinese Medicine” and integrating the following criteria as limit filters: “Species: Humans”, “Article Type: Clinical Trial”. In addition, the articles’ triage was ruled by temporal limitations set between 1945 and 2016. Results: The overall analysis of data allowed observation of an average annual growth of approximately 33%, with a productive peak of 122 articles in 2007. The scientific production was distributed in 27 countries, led by China (76.1%), followed by the United States of America (3.0%) and South Korea (2.1%). A significant amount of references were published in Chinese journals: more than 50%; however, these journals had a low impact factor. The most cited treatments in the keywords section of the articles were phytotherapy (55%) and acupuncture (40%). Conclusion: The increasing demand for TCM seems to be due to factors such as lower side effects and greater efficacy in some patients not responding well to conventional therapy. As a result, a considerable amount of TCM science-based literature has been produced, supporting the rational integration of these practices in Western healthcare systems and research. Our results show that the quality of TCM research and inherent publications have been increasing over the last decades, with a higher incidence of studies published in well-ranked journals.
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BACKGROUND: Acupuncture appears to reduce the mechanosensitivity of peripheral nerves in animal models; yet, this possibility has not been demonstrated in humans. OBJECTIVES: The main objective of this exploratory trial was to evaluate the immediate effects of acupuncture on the mechanosensitivity of the median nerve, measured by the elbow extension range-of-motion (EE-ROM) at pain onset and maximum tolerance during the upper limb neurodynamic test 1 (ULNT1). Additional objectives were to test the effects of two different points in ULNT1 responses and critically appraise pre-/post-intervention changes for conducting future research. METHODS: Thirty-one asymptomatic individuals, randomly assigned to the PC group (n=14) or the LU group (n=17) by the coin flip procedure, underwent acupuncture (leopard spot needling) at PC5 or LU5'', respectively. Two-way mixed-model analysis of variance (ANOVA) with time (pre-intervention vs post-intervention) as the within-subject factor and group (PC vs LU) as the between-subject factor, plus time×group interaction, were used to determine the effects of acupuncture therapy on EE-ROM at pain onset and maximum tolerance during ULNT1. RESULTS: At baseline there were no differences between groups (p>0.05). After acupuncture, mean EE-ROM increased 3.1° at pain onset (p=0.029, η2p=0.154) and 5.6° at maximum tolerance (p=0.002, η2p=0.277) with no differences between groups (p>0.05, η2p<0.01). CONCLUSION: Immediately after acupuncture, the mechanosensitivity of the median nerve appears to be reduced as observed by an increase in EE-ROM during the ULNT1. Further studies are needed to confirm these preliminary findings. TRIAL REGISTRATION NUMBER: NCT02150915; Post-results.
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Terapia por Acupuntura , Nervo Mediano/fisiologia , Pontos de Acupuntura , Adulto , Articulação do Cotovelo/fisiologia , Feminino , Humanos , Masculino , Mecanotransdução Celular , Pessoa de Meia-Idade , Exame Neurológico , Amplitude de Movimento Articular , Adulto JovemRESUMO
Background: Osteoarthritis is a widespread chronic disease seen as a continuum of clinical occurrences within several phases, which go from synovial inflammation and microscopic changes of bone and cartilage to painful destructive changes of all the joint structures. Being the most common joint disease, it is the leading cause of disability in working individuals above 50 years of age. In some cases, conventional treatments produce just a mild and brief pain reduction and have considerable side-effects. Contemporary Traditional Chinese Medicine (TCM) is a model of systems biology based on a logically accessible theoretical background. It integrates several therapeutic approaches, among them acupuncture, which has shown effective results in the treatment of knee and hip osteoarthritis, minimizing pain, improving functionality and consequently leading to a better quality of life. Methods: The present case study included two patients with clinical signs of osteoarthritis and diagnosis of medial pain, as defined by the Heidelberg Model of TCM. Over 6 weeks, those patients were treated with acupuncture, with a frequency of one session a week. The sessions lasted for thirty minutes and were based on the needling of 4 local acupoints. Before and after each session, pain and mobility assessments were performed. Results: The results were positive, with significant reduction of pain and increased knee joint flexion amplitude and mobility. Conclusion: Acupuncture was effective as an alternative or complementary treatment of knee osteoarthritis, with high levels of improvement within a modest intervention period.