The relevance of needling parameters and participant experience for acupuncture research
- Publication Type:
- Thesis
- Issue Date:
- 2006
Closed Access
| Filename | Description | Size | |||
|---|---|---|---|---|---|
| 01Front.pdf | contents and abstract | 968 kB | |||
| 02Whole.pdf | thesis | 11.91 MB |
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NO FULL TEXT AVAILABLE. Access is restricted indefinitely. ----- Although acupuncture has been practiced for over 2,000 years, it is only in the last four
decades that Western medical science has begun to investigate its mode of action and
clinical efficacy. Since the mid 1960s, there has been a steadily increasing number of
acupuncture clinical trials published in the Western scientific literature. However the
quality of research has generally been poor. This has been partly due to general
methodological problems such as small sample size and partly due to problems that
specifically relate to the nature of practice of acupuncture. The present research involves
two studies that were designed to clarify three specific problems associated with
acupuncture research: a questionnaire designed to compare the beliefs and expectations
of both naive and experienced subjects concerning the 'acupuncture experience' and the
implications for acupuncture research methodology; and an experimental needling study
whose aims were to determine the optimal needling parameters for eliciting analgesia in
acupuncture pain studies and the use of an appropriate control placebo intervention in
acupuncture clinical trials. The survey (called study one) found that naive and
experienced acupuncture subjects hold different beliefs and expectations of what
constitutes an acupuncture experience. These differences related to the credibility of laser
as an alternative to needling, the expectation of feeling needle insertion and a dull ache
during treatment, the appearance of the needle while in situ, the number of acupoints
needled, the placement of the needles and the likelihood of using the same acupoints over
a course of treatment.
Study two, the needling study, compared the effect of six needling parameters
combinations, as well as laser stimulation, on pressure pain threshold. A visual analogue
scale (VAS) was also used to assess levels of pain, needling sensation, level of tension
during, and anxiety prior to, the intervention period. The study found that the optimum
needling parameters to elicit an analgesic response involve deep needling with
manipulation at an acupoint. Difference in VAS scores were found for: pain, (both
interventions to Large Intestine 4 (LI4) that involved manipulation were reported as
significantly more painful than both the non acupoint (NAP) interventions and the two
LI4 interventions without manipulation); needling sensation, (all the LI4 needling
interventions produced similar scores except for the LI4 intervention that involved
shallow needling and no manipulation, which was significantly lower); and tension
(subjects reported higher scores for the LI4 intervention that involved shallow needling
and manipulation than for the LI4 that involved shallow needling and no manipulation,
and the two NAP and laser interventions). No significant differences were found for
subjects reporting levels of anxiety prior to receiving acupuncture and the behaviour of
the acupuncturist during the study.
The study also supports the concept that an invasive sham needling technique may
function as a feasible control intervention for pain conditions provided that manipulation
is not applied to the inserted needle.
It is hoped that the results of the two studies are incorporated into the design of future
acupuncture clinical trials and that this will ensure a better understanding of acupuncture
and facilitate the development of the evidence based practice of acupuncture.
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