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1.
Medicine (Baltimore) ; 98(40): e17118, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31577701

RESUMO

BACKGROUND: Mild cognitive impairment (MCI) is an intermediate stage between the cognitive changes of normal aging and early dementia. Tai Chi (TC) may be particularly beneficial to patients with MCI due to its whole-body coordination characteristics. This systematic review protocol aims to outline the methods that will be used to assess the comparative effectiveness and safety of TC for MCI through a systematic review and meta-analysis. METHODS: A systematic review will identify and evaluate randomized controlled trials (RCTs) that examined the effects and safety of TC compared to a placebo, conventional treatment, and no treatment on cognitive function in individuals with MCI. Studies from databases of MEDLINE, PubMed, Embase, Global Health, Cochrane Library, and Scopus from January 1990 to March 2019 reported in English will be searched. Two independent reviewers will screen the studies for inclusion with the eligibility criteria and extract data. Risk of bias of individual studies will be assessed in line with Cochrane risk of bias tool. The overall quality of cumulative evidence will be assessed using selected Grading of Recommendations, Assessment, Development, and Evaluations criteria. Statistics will be used for heterogeneity assessment, sensitivity analysis, data synthesis, generating funnel plots, and subgroup analysis. Meta-analysis will be performed, if sufficiently homogeneous studies are found. A narrative synthesis will be conducted, grouping studies by exposure and outcome definitions, and describing any differences by subgroups. RESULTS: This study will provide practical and targeted evidence in investigating the impact of TC exercise for individuals with MCI. CONCLUSION: The findings of our study will provide updated evidence to determine whether TC is an effective intervention to patients with MCI. TRIAL REGISTRATION NUMBER: International Prospective Register for Systematic Reviews (PROSPERO) number CRD42019125104.


Assuntos
Disfunção Cognitiva/terapia , Tai Ji/métodos , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa
2.
Med Acupunct ; 31(3): 164-168, 2019 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-31297170

RESUMO

Background: Laser acupuncture (LA)-the use of nonthermal, low-intensity laser irradiation to stimulate acupuncture points-has become more common among acupuncture practitioners in recent years. LA is promoted as a safer pain-free alternative to traditional acupuncture, with minimal adverse effects and greater versatility. However, little is known about the mechanism of action of LA, laser characteristics, and effectiveness of LA therapy. Objective: This concise review of LA describes basic parameters and procedures, potential mechanisms of action, and the current evidence for its clinical efficacy. The article also highlights the need for more robust research on LA that can be translated into evidence-based clinical practices. Conclusions: LA has many features that make it an attractive option as a treatment modality, including minimal sensation; short duration of treatment; and minimal risks of infection, trauma, and bleeding complications. Future studies with high-quality methodologies, ample sample sizes, and consistent and reproducible laser parameters are critically needed to increase understanding and establish potential future clinical applications.

3.
Aust J Rural Health ; 27(5): 386-391, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31348571

RESUMO

OBJECTIVE: The objective of this study is to define the epidemiology of melanoma in rural communities in southern Queensland. DESIGN: The design used was a 6-year clinical record audit of melanoma cases identified by billing records and electronic clinical records, confirmed and typed with histology. SETTING AND PARTICIPANTS: This study was based on seven agricultural communities on the Darling Downs with patients presenting to local primary care clinics. MAIN OUTCOME MEASURES: Outcomes measured were confirmed type, depth and anatomic distribution of melanoma identified at these practices during the study period. RESULTS: The results from 317 cases of melanoma found anatomic distribution was significantly different (χ2  = 9.6, P < 0.05) to that reported previously from the Queensland Cancer Registry. A high proportion (87%) of melanoma diagnosed by these general practitioners were 1 mm or less when treated. CONCLUSIONS: Conclusions drawn from these findings are that melanoma risk is not so much lesser in rural, inland communities compared with coastal and metropolitan regions, but different. Differences may relate to comprehensive data capture available in rural community studies and to different sun exposure and protection behaviours. The higher proportion of melanoma identified at early stages suggests rural primary care is an effective method of secondary prevention.

4.
Am J Phys Med Rehabil ; 98(11): 964-970, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31135462

RESUMO

OBJECTIVE: The aims of the study were to assess the feasibility of performing acupuncture on multiple adolescent athletes in a warm weather, high-intensity training environment and to measure perceived effects of acupuncture on delayed-onset muscle soreness and sense of well-being. DESIGN: This is a prospective feasibility study (registered clinical trial NCT03478800). Forty-two healthy male participants, aged 13-18 yrs, were involved in at least 1 of 5 treatment days for a total of 147 individual treatment sessions. Fifteen-minute treatments of traditional needle acupuncture were administered at the football field. Time, cost, adverse effects, and participant/provider ratio were observed. Effect on delayed-onset muscle soreness and sense of well-being were measured via pretreatment and posttreatment visual analog scale (0-10) rating analyses. RESULTS: The results are as follows: time required by research staff on treatment days, 75 mins; total cost, US $700; temperature range, 21°C-28°C; and largest participant to acupuncturist ratio, 7-10:1. No major adverse effects occurred; 55% reported minimal adverse effects, such as mild focal numbness or tingling. Overall pretreatment to posttreatment effect on delayed-onset muscle soreness (average over 5 days) demonstrated significantly improved posttreatment scores (pre 4.6 ± 2.0; post 2.9 ± 2.2, P < 0.001). There was no significant effect on sense of well-being (P = 0.12). CONCLUSIONS: Effectively providing acupuncture to multiple adolescent football players in their training environment is feasible with appropriate staff and resources. Despite mild adverse effects, treatment was well tolerated. This study provides guidance on acupuncture delivery to other athletes in their training environments.

5.
Chin J Integr Med ; 23(11): 816-821, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29080195

RESUMO

OBJECTIVE: To understand patient satisfaction with acupuncture appointment duration for the first and subsequent appointments in the plan of care, time spent with the acupuncture provider, willingness to pay for longer duration appointments, and lack of insurance coverage. METHODS: Patients who were referred for an acupuncture consult to the Center for Integrative Medicine at Mayo Clinic were asked to participate in the survey in August 2014. Patients were given paper survey at time of appointment check-in and entered into Research Electronic Data Capture Survey database tool to reveal patient-reported outcomes. RESULTS: In total, 104 of 329 patients receiving acupuncture treatment responded to the survey with a 32% response rate. Insight and recommended changes to the duration of the initial and subsequent appointments were obtained. Most patients reported that time spent with the provider (76 cases, 74%) and appointment length (74 cases, 68%) were "just right". Seventy cases (70%) of respondents indicated that they wanted longer treatment. Patients reported return appointments with duration of 30 min was not enough. Fifty-three patients (62%) were willing to pay for additional costs not covered by insurance. CONCLUSIONS: We used patient feedback to assess the acupuncture practice in a complementary and integrative medicine program. Most patients referred for the acupuncture consult appeared to be satisfied with the current level of practice. These findings were used to establish a quality improvement plan that may be implemented to improve patient satisfaction with the acupuncture practice.


Assuntos
Terapia por Acupuntura , Retroalimentação , Satisfação do Paciente , Padrões de Prática Médica , Inquéritos e Questionários , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
6.
PM R ; 9(8): 795-803, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27915067

RESUMO

BACKGROUND: Studies investigating the use and effectiveness of acupuncture in adults after exercise have been well documented. Fewer studies involving acupuncture have been completed in the adolescent athlete population. To our knowledge, there are no published studies that investigate the use of acupuncture in adolescent athletes within their field of play. OBJECTIVE: To primarily assess the feasibility of performing acupuncture in adolescent Nordic skiers within their athletic environment, and secondarily to measure the effect of acupuncture on muscle soreness and sense of well-being. DESIGN: Prospective feasibility study. SETTING: Local outdoor cross country ski trails and indoor lodge. PARTICIPANTS: Fifteen healthy participants (80% female, 20% male; age 14-17 years) were involved on at least 1 of 5 treatment days. INTERVENTION: Fifteen-minute treatments were administered using traditional needle acupuncture following the first 5 consecutive Nordic Ski Team practices of the season in an attempt to capture the effect of acupuncture on delayed-onset muscle soreness (DOMS). Acupuncture points specific to muscle groups in the lower limbs that are commonly reported as painful during Nordic skiing were chosen. Pre- and posttreatment surveys included visual analogue scales (VAS) to track participant responses. OUTCOME MEASURES: Time, cost, side effects, and participant to provider ratio was observed to determine feasibility. Effect on muscle soreness and sense of well-being was measured via pre- and posttreatment VAS (0-10) rating analyses. RESULTS: Total time required by research staff on treatment days was 90 minutes; total cost, $1500; temperature range, -13.9°C to -2.8°C, and largest participant to acupuncturist ratio, 7:1. No major side effects occurred. The majority (73%) of participants reported minimal side effects; most common was treatment site pain. The overall pre- to posttreatment effect on muscle soreness (average over 5 days) demonstrated significantly improved posttreatment scores (P = .04). The effect of the day (average over pre- and posttreatment values) demonstrated significantly higher muscle soreness scores on day 3 versus day 1 (P = .03). At study completion, all participants indicated that they would consider acupuncture in the future and would recommend treatments to friends or teammates. CONCLUSION: Providing acupuncture to adolescent Nordic ski athletes in the practice field under extreme temperatures is feasible with the appropriate resources. Despite mild side effects, acupuncture was well received by the athletes. Lessons learned from this trial can provide a framework for delivering acupuncture to other athletes in their training environment. LEVEL OF EVIDENCE: IV.


Assuntos
Terapia por Acupuntura/métodos , Mialgia/reabilitação , Esqui/fisiologia , Adolescente , Estudos de Viabilidade , Feminino , Humanos , Masculino , Manejo da Dor , Medição da Dor , Estudos Prospectivos , Medição de Risco , Países Escandinavos e Nórdicos
7.
J Integr Med ; 14(5): 311-4, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27641603

RESUMO

Acupuncture is a widely practiced system of medicine that has been in place for thousands of years. Consumer interest and use of acupuncture are becoming increasingly popular in the United States, as it is used to treat a multitude of symptoms and disease processes as well as to maintain health and prevent illness. A growing body of evidence increasingly validates the practice of acupuncture. Further developing scientific data will play an important role in the future of acupuncture and other complementary and alternative medicines in public health. Acupuncture is commonly used concurrently with conventional medicine. Although acupuncture is embraced by consumers and medical professionals, misconceptions abound. We have explored and dispelled ten misconceptions common to the practice of acupuncture, utilizing an evidence-based approach. As the trend of merging conventional medical care with acupuncture treatment grows, it is important to develop a conceptual model of integrative medicine. Using a scientific evidence approach will create a structure from which to begin and grow confidence among conventional medical providers. Acupuncture is a safe and effective modality when performed properly by trained professionals. Educating both the consumer and medical community is important to enable appropriate and evidence-based applications of acupuncture and integration with conventional medicine for high-quality patient care.


Assuntos
Terapia por Acupuntura , Acupuntura/educação , Terapia por Acupuntura/efeitos adversos , Humanos
8.
Am J Chin Med ; 43(8): 1503-13, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26621439

RESUMO

Complementary and alternative medicine (CAM) has gained acceptance throughout the industrialized world. The present study was performed to provide information about the use of CAM at Mayo Clinic, an academic medical center in Northern Midwest of the US. We retrospectively reviewed the electronic medical records of 2680 patients visiting the CAM program at Mayo Clinic, Rochester, between 1 July 2006 and 31 March 2011. Services provided included acupuncture, massage, integrative medical consultations and executive stress management training. Data including age, gender, race, diagnosis and the number of treatment/consultation sessions were collected to describe the use of CAM in our institute over the last several years. It was found that the mean (standard deviation) age of patient was 52.6 (15.5) years. Of those, 73.1% were female and 26.9% were male. Most patients were white. The number of patients referred to CAM increased significantly from 2007 to 2010. The three most common diagnostic categories were back pain (12.9%), psychological disorders (11.8%), and joint pain (9.6%). Back pain was the most common diagnosis for patients receiving acupuncture, and fibromyalgia was the most common for patients receiving massage therapy. Psychological disorders (i.e., stress) were the major diagnosis referred to both integrative medical consults and executive stress management training. These results suggest that the diseases related to pain and psychological disorders are the main fields of CAM use. It also shows the increasing trend of the use of CAM at an academic medical center in the US.


Assuntos
Dor nas Costas/terapia , Terapias Complementares/estatística & dados numéricos , Estresse Psicológico/terapia , Terapia por Acupuntura , Adulto , Idoso , Artralgia/epidemiologia , Artralgia/terapia , Dor nas Costas/epidemiologia , Grupos de Populações Continentais , Feminino , Fibromialgia/epidemiologia , Fibromialgia/terapia , Humanos , Medicina Integrativa , Masculino , Massagem , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Fatores Sexuais , Estresse Psicológico/epidemiologia , Estados Unidos/epidemiologia
9.
Complement Ther Clin Pract ; 21(4): 211-6, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26573445

RESUMO

An increased focus has been given to improving the patient experience in health care. This focus has included placing value in a patient-centric, holistic approach to patient care. In the past decade, the Healing Enhancement Program was developed at 1 large medical center to address this focus through implementation of such integrative medicine services as massage, acupuncture, and music therapy to holistically address the pain, anxiety, and tension that hospitalized patients often experience. We describe the development and growth of this program over the past decade.


Assuntos
Centros Médicos Acadêmicos , Terapias Complementares , Medicina Integrativa , Pesquisa sobre Serviços de Saúde , Humanos , Minnesota , Assistência Centrada no Paciente
10.
Glob Adv Health Med ; 3(4): 32-4, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25105074

RESUMO

Abducens palsy (ie, sixth nerve palsy) is the most common single extraocular muscle palsy. The primary symptom is double vision. The treatment goal is to correct the underlying cause. If no cause is identified or the palsy is related to a well-managed chronic disease, treatment consists of patching one eye or applying a temporary prism. We report a patient whose abducens palsy resolved with four acupuncture treatments. The patient, a 58-year-old Vietnamese man with diabetes mellitus, presented to our institution's ophthalmology department with sudden onset of double vision. Ophthalmologic examination resulted in diagnosis of isolated left abducens palsy. The patient received a temporary prism for symptomatic relief. With no improvement after 2 months, he presented to our integrative medicine program inquiring about acupuncture. He received four acupuncture treatments over 11 weeks with complete resolution of his diplopia. This case is suggestive that acupuncture may be helpful treatment of patients with abducens palsy.

11.
Am J Chin Med ; 41(4): 717-42, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23895148

RESUMO

This study was to evaluate the efficacy and safety of acupuncture for chronic functional constipation. Randomized controlled trials were searched in several databases. The primary outcome was a change in the number of weekly spontaneous bowel movements. The secondary outcomes included colonic transit activity, effective rate, Cleveland Clinic Score, and health-related quality of life score. Meta-analysis was done by using RevMan 5.1. After strict screening, 15 RCTs were included, containing 1256 participants. All of them were conducted in China and published in Chinese journals. Meta-analysis indicated that acupuncture for chronic functional constipation was probably as effective as conventional medical therapy in the change of bowel movements. For the colonic transit activity, acupuncture might be the same as conventional medical therapy and could be better than sham acupuncture. For the Cleveland Clinic Score, acupuncture was unlikely inferior to conventional medical therapy and the deep acupuncture was better than normal depth acupuncture in abdominal region. No obvious adverse event was associated with acupuncture for constipation. In conclusion, acupuncture for chronic functional constipation is safe and may improve weekly spontaneous bowel movements, quality of life, and relevant symptoms. However, the evidence was limited by the small sample size and the methodological quality.


Assuntos
Terapia por Acupuntura , Constipação Intestinal/terapia , Doença Crônica , Humanos , Resultado do Tratamento
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