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Acupuncture needle grasp: Ultrasound analysis and clinical implications

Helene M Langevin, Junru Wu, David L Churchill, Gary J Badger and Jason A

Yandow

Department of Neurology, University of Vermont, Burlington, VT

The insertion and manipulation of acupuncture needles is associated with a

measurable biomechanical phenomenon termed " needle grasp " , characterized by

an increase in the force necessary to pull the acupuncture needle out of the

skin (pullout force). Needle grasp is not due to a muscle contraction, and

histological observations in rat tissue explants suggest that needle grasp

involves connective tissue. We used high frequency (50 MHz) ultrasound

scanning acoustic microscopy to further confirm quantitatively that changes

in connective tissue architecture occur as a result of acupuncture needle

rotation. Using this technique, we obtained high-resolution images of viable

rat abdominal wall tissue explants into which an acupuncture needle had been

inserted and either rotated for 32 revolutions, or not rotated. We

hypothesized that the acoustic pattern generated by the main components of

connective tissue (collagen, elastic fibers, fat, extracellular matrix) is

more ordered after acupuncture needle rotation, compared with needle

insertion alone without rotation.

A Fourier Transform analysis was performed on standardized polar coordinate

lines (using the center of the needle as the origin) from the bitmap gray

scale images created by the scanning acoustic microscope. For each line,

this analysis yielded spatial frequency peaks corresponding to spatial

periodicity in the image. The maximum peak gray level at a significantly low

spatial periodicity (0.3-1.4 mm) was significantly higher with needle

rotation (vs. p<) compared with acupuncture needle insertion alone without

rotation (mean ± SE: 28.7 ± 2.2 vs. 21.9 ± 1.4, p=0.02). This indicates that

connective tissue architectural order increased with acupuncture needle

rotation. The images also suggest that this increased order is due to tissue

winding around the needle and reorganization of tissue structures relative

to the needle. Changes in connective tissue architecture may be perceived by

the acupuncturist holding the needle, and therefore may be important

clinically. This perception may constitute important feedback affecting how

the acupuncturist chooses to further move (or not move) the needle.

During their training, acupuncturists learn to apply needle stimulation that

is quantitatively and qualitatively appropriate to each clinical situation.

Before needling, the acupuncturist will usually decide roughly what type of

manipulation will be used (e.g. reducing method, reinforcing method, deep or

shallow needling). Once the needle is inserted, the acupuncturist will

carefully observe and feel for changes in the patient, and modify his/her

behavior accordingly. This response to the feedback provided by the patient

during needling is a key component of the acupuncturist’s skills. This

feedback includes verbal communication of sensations experienced by the

patient during needling, and also includes direct observation of changes

such as skin color, facial expression, as well as local changes in the area

of the needle. Local changes in the area of the needle can be perceived by

acupuncturists with extremely small amounts of needle movement (less than

one revolution of the needle, or up-and-down movements of a few millimeters)

These changes can be very subtle, leading some authors to suggest that they

occur on an " energetic " plane. Another possibility is that subtle material

changes in the tissues are taking place, perhaps accompanied by related

energetic phenomena.

In this study, we describe pronounced tissue architectural changes occurring

as a result of a relatively large amount of acupuncture needle rotation

(corresponding to pullout forces of the order of 500 grams in related

experiments). Smaller amounts of needle manipulation are likely to be

associated with more subtle tissue architectural changes. Whether large or

small in magnitude, these changes in connective tissue architecture may have

profound downstream effects. Mounting evidence suggests that mechanical

deformation of tissue can lead to mechanical signal transduction into cells,

polymerization of cellular actin cytoskeleton, activation of intracellular

signaling pathways, changes in gene expression and cell contraction. These

biochemical events may further contribute to the sensation perceived by the

acupuncturist, and also may be components of acupuncture’s therapeutic

effect. Modification of the acupuncturist’s skilled behavior in response to

tissue changes caused by needle manipulation therefore may be a key to the

treatment’s outcome.

 

 

Centro de Medicina Oriental

Acupunctura,Laserterapia,Shiatsu,

Drenagem Linfatica,El-Terapia.

Dr.H.Peter Nussbaumer

351 269 827272 +351 967 044284

medoriental

Santiago do Cacém / Portugal

 

 

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>skin (pullout force). Needle grasp is not due to a muscle contraction, and

>histological observations in rat tissue explants suggest that needle grasp

>nvolves connective tissue.

 

Many thanks for the info. I have long suspected that needle insertion

affects the myofascial layer directly but had no proof.

 

salvador

 

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