Item
2a:
Number of needle insertions per subject per session (mean and range where
relevant)
Item
2b:
Names
(or location if no standard name) of points used (uni/bilateral)
Examples:
i) We based the acupuncture point selections on Traditional Chinese
Medicine meridian theory to treat knee joint pain, known as the “Bi”
syndrome. These points consisted of 5 local points (Yanglinquan [gall
bladder meridian point 34], Yinlinquan [spleen meridian point 9], Zhusanli
[stomach meridian point 36], Dubi [stomach meridian point 35], and extra
point Xiyan) and 4 distal points (Kunlun [urinary– bladder, meridian
point 60], Xuanzhong [gall bladder meridian point 39], Sanyinjiao [spleen
meridian point 6], and Taixi [kidney meridian point 3]) on meridians that
traverse the area of pain (refs). The same points were treated for each
affected leg. If both knees were affected, 9 needles were inserted in each
leg.
(5)
ii) The VA (verum acupuncture) group received acupuncture with a 0.25 X
40-mm stainless steel needle (Asia Med, Munich, Germany) at LI4, which is
situated between the first two metacarpal bones on the dorsal side of both
hands at the top of the muscle belly (figure provided).
(6)
iii) The most frequently treated local points were Bl 23, Bl 25, Gb 30, DU
4, Bl 26, and the extra point Huatuojiaji (table provided) ..….. The
most frequently treated distant points were Bl 40, Kid 3, Gb 34, Bl 60, SI
3, and DU 20. In most cases, 8 to 12 local points and 4 to 6 distant
points were used. Physicians used additional acupuncture points in 565 of
the treatment sessions. The most frequently used additional local points
were Li 4, St 40, Bl 17, Sp 6, and St 36.
(7)
Item
2c:
Depth
of insertion, based on a specified unit of measurement,
or on
a particular tissue
level.
Examples:
i) All needle placements were performed by an experienced acupuncturist at
a premarked depth of 4 mm from the tip of the needle.
(8)
ii) The depth of needle insertion varied with thickness of the skin and
subcutaneous fatty tissues at the site of the acupuncture points; it was
usually 1 to 1.5cm.
(9)
iii) Shallow and light needling stimulation (1–2 mm) using fine needles
(0.18–0.16 mm) inserted with the aid of insertion tubes was emphasized.
Points were needled at a 10°–20° angle with a 2-hand needling
technique, generally in the direction of the flow of the channel.
(10)
Item
2d:
Responses
sought
(e.g. de qi or muscle twitch response)
Examples:
i) The TRP (trigger point) group received treatment at trigger points. The
correct application of the technique requires experience in palpation and
localisation of taut muscle bands and myofascial trigger points. Precise
needling of myofascial trigger points provokes a brief contraction of the
muscle fibres. This local twitch response must be elicited for successful
therapy but it may be painful and post treatment soreness is frequent.
(2)
ii) In contrast with TCM style acupuncture, we did not employ vigorous
manipulation in order to elicit a strong de qi sensation (defined
as a feeling of heaviness around the acupuncture point).(ref)
Practitioners
focused instead on feeling the response to stimulation as an “echo”
sensation experienced on the receiving hand, while the active hand
performed the actual needling. Attention was placed on reactivity or
change in diagnostic areas, especially the pulse and abdomen. By carefully
assessing changes in palpatory findings, the treatment was adjusted
continuously based on the patient’s response. Before needling, the
“live” points were identified by palpation, that is, subtle changes at
the skin level, or upon touch or pressure, for that particular patient.
(10)
Item
2e:
Needle
stimulation (e.g. manual or electrical)
Examples:
i) This
mode of (manual) stimulation was provided via the acupuncture needles,
which were placed in the premarked depth at the marked sites. The needle
was rotated by an experienced acupuncturist with the index finger and
thumb in an alternating clockwise and counterclockwise fashion at the rate
of three to five rotations per second.
(8)
ii) Electrical stimulation was given to the anterior part of the knee for
10 minutes and then 10 minutes for the posterior part using a
battery-operated, four-channel, ‘AS Super 4’ Electrostimulator (RDG
Medical, Surrey UK) which generated low frequency, square-wave (2-10Hz)
pulses of 1 millisecond duration for 10 minutes.(ref) In both groups, the
apparatus was attached to needles at the two Xiyan points, SP9 and
GB34, and BL40 and BL57. Electrical stimulation was delivered at 6Hz at a
constant current. Voltage was set at a level just above the pain
threshold.
(9)
Item
2f:
Needle
retention time
Examples:
i) Each participant was treated bilaterally and had a total of six needles
inserted for the duration of the treatment. A draining technique was used
and the needles were left for a period of 30 minutes. The practitioner
returned to check on the participant at regular intervals during the
intervention.
(11)
ii) Needles were withdrawn immediately for tonification, and retained for
up to 20 minutes for the evens technique.
(12)
iii) Therapists allow 25 (min) to 35 (max) minutes between insertion of
the last needle and cessation of treatment and during that time they are
to revisit the needles as appropriate.
(13)
iv) The patients in group A were dry needled for a few seconds.
For trigger point inactivation by dry needling… it is especially
important not to apply too strong a stimulus because this may produce a
flare-up of the patient’s symptoms.
(14)
Item
2g:
Needle
type (diameter, length, and manufacturer or material)
Examples:
i) Seirin 36 gauge 2.5 inches long unused sterile L-type needles were used
for the study.
(8)
ii) The VA (verum acupuncture) group received acupuncture with a 0.25 X
40-mm stainless steel needle (Asia Med, Munich, Germany) at LI4.
(6)
References:
