Utvalgte forskningsartikler på akupunktur og triggerpunktbehandling

Forskningsartikler på triggerpunktbehandling

Triggerpunktbehandling ved nakkesmerter 


"Dry needling reduces pain and changes MTrP status. Change in trigger point status is associated with a statistically and clinically significant reduction in pain. Reduction in pain is associated with improved mood, function and level of disability."



Triggerpunkter og tenderpoints ved fibromyalgi


"Abstract: 
Fibromyalgia syndrome (FMS) and myofascial pain syndrome (MPS) belong to the group of chronic non-inflammatory pain syndromes affecting muscles and tendinous insertions. Important criteria in the diagnosis of both diseases are the presence of "tender points" and "trigger points". According to ACR criteria FMS is characterized by the presence of tender points whereas trigger points are typically found in MPS.The main difference is that until now tender points could only be defined in terms of their localization, whereas trigger points can be found upon palpation which may cause a specific referred pain pattern. In addition, analysis of trigger points by microdialysis demonstrated elevated levels of pro-inflammatory substances at these sites. Moreover, local treatment of trigger points either by manipulative therapy or injection appears to be most effective for prompt relief of symptoms."


Triggerpunktbehandling ved ryggsmerter 


"The results suggest that TrP-DN was effective for improving pain, disability, kinesiophobia and widespread pressure sensitivity in patients with mechanical LBP at short-term."



Triggerpunktbehandling af smerter i forskellige deler av kroppen 

"Conclusion: The majority of high-quality studies included in this review show measured benefit from TDN for MTrPs in multiple body areas, suggesting broad applicability of TDN treatment for multiple muscle groups. Further high-quality research is warranted to standardise TDN methods to determine clinical applicability."



Myofascielle smerter


"Summary: The myofascial trigger point phenomenon has good face validity and is clinically relevant. Clinicians are encouraged to consider the contribution of myofascial trigger points to the patient's pain and disability through a careful medical history and a specific manual examination. Patients with myofascial trigger points will benefit from a multimodal treatment plan including dry needling and manual therapy techniques. Internal and external validity of research within the field must be improved."



Triggerpunktbehandling ved kroniske smerter 

"The results suggest that TrP-DN was effective for improving pain, disability, kinesiophobia and widespread pressure sensitivity in patients with mechanical LBP at short-term."



Triggerpunktbehandling ved migrene og spenningshodepine


Triggerpunktbehandling ved bækkenløsning



Historisk og vitenskapelig perspektiv på triggerpunkbehandling




Forskningsartikler på akupunktur

Akupunktur ved kronisk træthed

"Conclusions: Body acupuncture for 4 weeks in addition to usual care may help improve fatigue in CFS and ICF patients."



Akupunktur ved menstruationssmerter

"Conclusion: The results of this study suggest that acupuncture might reduce menstrual pain and associated symptoms more effectively compared to no treatment or NSAIDs, and the efficacy could be maintained during a short-term follow-up period. Despite limitations due to the low quality and methodological restrictions of the included studies, acupuncture might be used as an effective and safe treatment for females with primary dysmenorrhea."


Akupunktur ved depression

"Conclusion: The efficacy of acupuncture for depression is superior to that of western medication with fluoxetine."


Akupunktur ved allergisk rhinit

"Summary: There are high-quality randomized controlled trials that demonstrate efficacy and effectiveness for acupuncture in the treatment of both seasonal and perennial allergic rhinitis. Smaller head-to-head studies also show some preliminary benefit of acupuncture when compared with antihistamines, but these had a variety of methodological limitations. Further studies of higher quality are needed, particularly with a focus on comparative effectiveness research."


Akupunktur ved tinnitus


"Conclusions: Acupuncture is effective in reducing the loudness and severity of tinnitus and can be a useful treatment for nonpulsatile chronic tinnitus."



Akupunktur ved svimmelhet


"Conclusion: Acupuncture demonstrates a significant immediate effect in reducing discomforts and VAS of both dizziness and vertigo. This study provides clinical evidence on the efficacy and safety of acupuncture to treat dizziness and vertigo in the emergency department."



Akupunktur reducerer behovet for opoider/morfinpræparater efter operation

"Those who had battlefield acupuncture consumed half as many opioids in the first 24 hours after surgery compared to the control group: 17.4 MME vs. 35 MME. Those who received battlefield acupuncture had significantly lower pain scores and higher patient satisfaction scores (a median of 8 vs. 6) compared to the control group."

Forskningsartikler på akupunktur, liste forts

Akupunktur ved kroniske smerter

"Perspective: Acupuncture is effective for the treatment of chronic musculoskeletal, headache, and osteoarthritis pain. Treatment effects of acupuncture persist over time and cannot be explained solely in terms of placebo effects. Referral for a course of acupuncture treatment is a reasonable option for a patient with chronic pain."


Kinesisk akupunktur ved ibs og mageproblemer

"Conclusion: Abdominal acupuncture is more effective for IBS-D than western medication and can relieve abdominal pain, abdominal distension, diarrhea, poor stool output, stool abnormality, with long-term effect."


Metastudie på akupunktur ved angst


"Conclusion: acupuncture seems to be a promising treatment for anxiety; however, there is a need for improving the methodological quality of the research on this field."


Engelsk artikkel om aupunktur ved bihuleproblemer 


"Acupuncture may help to relieve pain and congestion in people with sinusitis by

  • increasing endorphins (Ham 2004) and neuropeptide Y levels (Lee 2009), which can help to combat negative affective states
  • stimulating nerves located in muscles and other tissues, which leads to release of endorphins and other neurohumoral factors, and changes the processing of pain in the brain and spinal cord (Pomeranz, 1987; Zhao 2008; Cheng 2009);
  • reducing inflammation, by promoting release of vascular and immunomodulatory factors (Zijlstra 2003; Kavoussi 2007);
  • enhancing natural killer cell activities and modulating the number and ratio of immune cell types (Kawakita 2008);
  • increasing local microcirculation (Komori 2009), which aids dispersal of swelling.

In general, acupuncture is believed to stimulate the nervous system and cause the release of neurochemical messenger molecules. The resulting biochemical changes influence the body's homeostatic mechanisms, thus promoting physical and emotional well-being. Stimulation of certain acupuncture points has been shown to affect areas of the brain that are known to reduce sensitivity to pain and stress (Hui 2010)"



Akupunktur ved helvedesild 

"Evidence from a systematic review of studies assessing the treatment of herpes zoster with acupuncture suggests that acupuncture therapy is effective for the condition.(Yu 2007) In a randomised controlled trial, electroacupuncture in combination with surround needling was found to be effective in facilitating crust formation and pain relief in patients with herpes zoster, and the effect was superior to that of medication.(Li 2009) Another randomised controlled trial found that acupuncture (surround needling) had a positive effect on cure rate in patients with herpes zoster, and that adding moxibustion to acupuncture improved the cure rate, and reduced the time to crust formation and the incidence of residual neuralgia.(Zhang 2007) (see Table below)."


Akupunktur ved migrene 


"Conclusion: Acupuncture exhibits certain efficacy both in the treatment and prevention of migraines, which is superior to no treatment, sham acupuncture and medication. Further, acupuncture enhanced the quality of life more than did medication."


Akupunktur ved kvalme 

"Abstract: Two consecutive studies were undertaken to evaluate the effectiveness of acupuncture as an antiemetic used in addition to premedication with opioids in patients undergoing minor gynaecological operations. In the first study 25 of the 50 patients underwent acupuncture immediately after premedication with 100 mg meptazinol, the rest receiving the drug alone, and in the second 75 patients were allocated randomly to one of three groups: a group receiving 10 mg nalbuphine and acupuncture, a group receiving premedication and dummy acupuncture, and a group receiving premedication alone. Manual needling for five minutes at the P6 acupuncture point (Neiguan) resulted in a significant reduction in perioperative nausea and vomiting in the 50 patients who underwent acupuncture compared with the 75 patients who received no acupuncture. These findings cannot be explained, but it is recommended that the use of acupuncture as an antiemetic should be explored further."



Akupunktur ved stress 

"Abstract: This study is a randomized controlled clinical trial to study the effectiveness of acupuncture on the perception of stress in patients who study or work on a large, urban college campus. The hypothesis was that verum acupuncture would demonstrate a significant positive impact on perceived stress as compared to sham acupuncture. This study included 111 participants with high self-reported stress levels who either studied or worked at a large, urban public university in the southwestern United States. However, only 62 participants completed the study. The participants were randomized into a verum acupuncture or sham acupuncture group. Both the groups received treatment once a week for 12 weeks. The Cohen's global measure of perceived stress scale (PSS-14) was completed by each participant prior to treatment, at 6 weeks, at 12 weeks, and 6 weeks and 12 weeks post-treatment completion. While participants of both the groups showed a substantial initial decrease in perceived stress scores, at 12 weeks post treatment, the verum acupuncture group showed a significantly greater treatment effect than the sham acupuncture group. This study indicates that acupuncture may be successful in decreasing the perception of stress in students and staff at a large urban university, and this effect persists for at least 3 months after the completion of treatment."


Akupunktur ved søvnløshet 

"Conclusion: Acupuncture treatment is more effective than sham acupuncture treatment in increasing insomnia patients' sleep quality and improving their psychological health."


Oversikt over forskning på akupunktur generelt

Udvalgt forskning på Kraniosakralterapi

Direct Measurement of the Rhythmic Motions of the Human Head Identifies a Third Rhythm

Conclusion

The present study demonstrates the existence, and normative range of a third physical rhythm detected on the human head. Having developed an objective approach to studying this third rhythm might form the future basis for clinical and physiological studies of craniosacral function and dysfunction.


Metastudie Kraniosakralterapi

Conclusion
This meta-analysis suggests significant and robust effects of CST on pain and function, which are not exclusively explainable by placebo responses or effects due to non-specific treatment mechanisms. More RCTs strictly following CONSORT are needed to further corroborate the efficacy, comparative effectiveness, and safety of CST in patients with chronic pain conditions.



Studie der kortlægger kraniets bevægelser med MR

Conclusion 
The possible shortcomings notwithstanding, the data presented in the present study suggest that calvarial structures have motion characteristics that can be identified by MRI technology. It may be just a matter of time until increased resolution of MRI technology and image analysis provide the ability to examine more detailed areas of specific cranial bone motion and provide a reliable means for cranial bone motion research.



Studie der undersøger hjernevæskens bevægelse ved søvn

Abstract
Sleep is essential for both cognition and maintenance of healthy brain function. Slow waves in neural activity contribute to memory consolidation, whereas cerebrospinal fluid (CSF) clears metabolic waste products from the brain. Whether these two processes are related is not known. We used accelerated neuroimaging to measure physiological and neural dynamics in the human brain. We discovered a coherent pattern of oscillating electrophysiological, hemodynamic, and CSF dynamics that appears during non–rapid eye movement sleep. Neural slow waves are followed by hemodynamic oscillations, which in turn are coupled to CSF flow. These results demonstrate that the sleeping brain exhibits waves of CSF flow on a macroscopic scale, and these CSF dynamics are interlinked with neural and hemodynamic rhythms.

En relativt letlæst oversigt

Studiet, publiceret i Science.



Studie om hvordan vejrtrækning påvirker rensningen af hjernen

"Lymfesystemet spiller en viktig rolle når kroppen skal kvitte seg med avfallsstoffer, som døde celler, vann eller nedbrytningsstoffer fra stoffskiftet. Også i hjernen dannes det avfallsstoffer som skadelige proteiner og overskuddsvann – men her finner vi ingen lymfeårer.
I stedet ser spinalvæsken ut til å fylle rollen som vaskemaskin. Hjerterytmen er en av faktorene som påvirker hvor godt denne væsken flyter gjennom hjernen.

The study, in english.

Studiet, på norsk.

Studiet, på nrk.no.

How unprocessed trauma is stored in the body

"The three parts of the brain responsible for processing stress can change when people suffer from PTSD:

  • The hippocampus shrinks — this is the centre for emotion and memory.
  • The amygdala function increases — the centre for creativity and rumination
  • The prefrontal/ anterior cingulate function decreases — the centre for more complex functions like planning and self-development


Like a virus in our encoding system, unprocessed traumatic memories can become sticking points that cause our mental and physical processes to malfunction."



Gennemgang af studie vedrørende Kraniosakralterapis effekt ved nakkesmerter

"The results? CST improved neck pain more than the sham treatment. In addition, physical function was also improved for the CST group. In essence, CST seemed to work well to help neck pain in this small, randomized, controlled placebo trial." 

En relativt letlæst oversigt.

Studiet, original artikkel. 


Læge Chris Centeno, MD, specialist i regenerativ medisin (arbejder i det nye feltet Interventional Orthopedics), opsummer på den her måde resultatet af et studie af kraniosakralterapis virkning på nakkesmerter:

"Kraniosakralterapi bedret nakkesmerter mere end placebo-behandling gjorde."



Studie der undersøger kraniosakralterapis effekt ved spædbørn kollik

Conclusion
Craniosacral therapy appears to be effective and safe for infantile colic by reducing the number of crying hours, the colic severity and increasing the total hours of sleep.




Upledger omtalt i Time magazine

Upledger Institute ble grundlagt efter mange års kliniks forskning på Kraniosacral behandling. I 2001 omtalte Time Magazine Dr. Upledger som en af de mest nyskabende behandlere i det nye årtusinde.

Vigdis Lysne er sertifiseret kraniosakralterapeut fra Upledger Institute.