Lately, many people from children to elderly people are playing sports. Society is in need of safer and more comfortable sporting environment, not only for competitive sports, but also for recreational sports. The themes of acupuncture and moxibustion of the field of sports are treatments of sports injuries, keeping the physical condition of the athlete, preventing life-style related diseases and competition performance improvement of the athletes. At this symposium, we reported the present conditions of the study of sports acupuncture and moxibustion. It is summarized as follows:
1) Press tack needles relieve muscle fatigue that occurs during a long-term training camp,
2) Acupuncture inhibits the fall of the immune function resulting from high extreme exercise,
3) Electroacupuncture can relieve disused muscle atrophy of mice,
4) Press tack needles are effective in acute muscle fatigue and delayed onset muscle soreness, and
5) The M-Test is effective in estimating performance improvement and preventing sports injuries.

Backgrounds : The one of the leading factors of deteriorating condition is upper respiratory tract infections (URTI) in athletes. Athletes who are forced in regularly intensive training often decrease salivary secretory immunoglobulin A (SIgA) which has important role of immune function in the buccal cavity. It causes increase of morbidity risk in URTI. Acupuncture treatment is one of the conditioning methods in the competition field and mainly treated for orthopedic injuries. On the other hands, acupuncture treatment induced increase of natural healing ability which involved immune response, and prevent and treat some diseases. It has been reported acupuncture increase SIgA level. However, the relationship between time course and diagnostic of cold by the acupuncture stimulation effect is still unclear. Thus, the purpose of this measurement is to investigate the effect of acupuncture stimulation on the SIgA during training camp. Furthermore, it is important to investigate questionnaire about diagnostic of cold during and 1 week after training camp, it leads to clear the effect of acupuncture stimulation on the URTI.
Methods : Eighty subjects men who have auditory difficulties (26.7±0.9 yr[±SE]) participated in this study. The subjects were randomly assigned two groups; acupuncture group and control group. The training camp conducted 3 days and training performed 3 hours each in the morning and afternoon. Acupuncture stimulation was applied at LU 6 (Kongzui), LI 4 (Hegu), ST 36 (Zusanli), and ST 6 (Jiache), for 30 min after dinner. To measure SIgA level, saliva samples were taken 7 times; daytime and evening of first day (Day1(D), Day1(E)), morning, daytime and evening of the second day (Day2(M), Day2(D), Day2(E)), morning and daytime in the third day (Day3(M), Day3(D)). The questionnaire about diagnostic of cold was conducted Day1(D), Day2(M), Day3(M) and 1 week after training camp.
Results : The secretion rate of SIgA in the control was not significantly changed during training camp. However, the acupuncture group was significantly higher level in the Day2(M) and Day3(M) compared to the Day1(D) (P<0.05). Both control and acupuncture group was significantly higher SIgA concentration in Day2(M) and Day3(M) compared to the Day1(D) (P<0.05), but acupuncture group was significantly higher in the Day3(M) compared to the control. The frequency of diagnostic cold was 1 in the acupuncture group and 4 in the control group. Moreover, 1 week after training camp, 6 in the acupuncture group and 6 in the control.
Conclusion : Acupuncture stimulation induced significant increase SIgA level during training camp. Moreover, the diagnostic of cold was lower during training camp in the acupuncture group. Therefore, acupuncture stimulation might reduce the risk of the morbidity of the URTI.

[Objective]The purpose of this study was the analysis of factors that are connected with acupuncturists'hand hygiene, and suggestions for improvement of hand hygiene inclinical practice of acupuncture.
[Design]A cross-sectional study.
[Methods]Subjects were 122 acupuncturists. Using a questionnaire, we investigated the difference in years of experience, daily number of patients, therapy policy, method of needle insertion, education, gender and age according to the difference in hand hygiene behavior. Furthermore, each items relation to hand hygiene behavior was examined.
[Results]The number of valid responses was 109 (89.3%). The group that does not wash its hands had a younger average age (P<0.01), shortness of clinical experience (P<0.01), and much higher number of patients per day (P<0.05) as compared with the group that washes its hands. The group with the behavior of using tools to prevent bare hands from touching needles (tools such as individual finger stalls) had a high ratio of a policy of contemporary medicine (P<0.05) and experience of education (P<0.05) as compared with the group using bare hands. Neglectfulness of hand washing was associated with younger age [odds ratio (OR) = 1.10, 95%confidence interval (CI) = 1.01-1.20]and higher daily number of patients (OR = 0.90, 95%CI = 0.83-0.98). Furthermore, behaviors of the use of tools such as individual finger stalls was related to experience of education (OR = 3.45, 95%CI = 1.27-9.36).
[Conclusion]Performance of hand washing before therapy is related with youth and greater numbers of patients per day, which cause hygiene neglect. Educational experience promotes the use of tools such as individual finger stalls.

We have developed a new educational program directed at young people who have never undergone acupuncture therapy. The objective of this program is to provide them with useful information related to acupuncture therapy. We examined whether this program had managed to motivate participants to receive therapy and whether or not it had caused a change in their attitude toward it. Forty-four young people participated in the program. We divided them into two main groups; one whose members knew someone close to them who had received acupuncture therapy, and one whose members did not, in consideration of the images that each might have of therapy. In addition, some members of these were selected at random of receive visual aids, making a total of four groups. In order to investigate the efficacy of the program with regard to each group, we compared the average of each evaluation at before and after the program. All groups showed an increase in scores in all criteria after the implementation of the program. These results indicate that the educational program used in this study was effective.

The purpose of this study is to evaluate physical characteristics of boxing players with/without low back pain (LBP). Materials and methods : 18 college boxing players were divided into two groups ; The first group consisted of eight subjects with LBP (LBP group), the other one consisted of ten subjects without LBP (no LBP group). The evaluation items were as follows : muscular strength of trunk extension/ flexion/ rotation, cross-sectional areas of the muscles of the lumber region, X ray photograph of lumber spine, MRI, general joint laxity test, muscle tightness test, muscle hardness, tenderness and moiré topography. Results : 9 out of 18 subjects showed lumber region abnormalities in their X ray photograph and MRI. The following evaluation items of LBP group read significant differences compared to those of no LBP group ; The trunk rotator peak torque was weaker at the angular velocity of 120 deg/sec, the laterality of SLR was significantly larger, while the finger floor distance value indicated significantly lower. Discussion : In LBP group, it is suggested that the decline of trunk flexion muscle strength possibly preceded the fall of trunk extension muscle strength which, however, was not observed.

[Objective]Skeletal Muscle atrophy is induced in response to unloading by Hindlimb Suspension (HS). Numerous studies have been performed to prevent Skeletal Muscle atrophy. However, the molecular mechanisms underlying Electro-acupuncture (EA) on skeletal muscle have not been identified, and the effect of EA to prevent skeletal muscle atrophy is unknown. Therefore, we aimed to determine the effect of EA and Chishin (where the needles are kept in muscle for thirty minutes) on skeletal muscle atrophy in an animal experiment.
[Methods]Twenty mice (8 week, C57BL6) were randomly grouped into 4 groups;Normal group (N group), Hindlimb Suspension Group (HS group), HS +Chishin group (Chishin group), and HS +EA 1Hz group (1Hz group) (n = 5/group, respectively). Acupuncture interventions were conducted on the gastrocnemius of the Chishin and 1Hz groups. We measured the muscle mass, the cross sectional area, the percentage of Antrogin-1 and MuRF1 (Atrophy related E3ubiquitin ligases) expressions of the soleus 0f each mouse at 2 weeks after acupuncture interventions.
[Result]The weight and Cross sectional area of the soleus of the 1Hz group were significantly greater than the HS group (P<0.01, P<0.01, respectively). On the contrary, the percentage of Atrogin-1 and MuRF1 expressions of the 1Hz group was significantly less than the HS groups (P<0.01, P<0.05, respectively).
[Conclusion]These results suggest that EA and Chishin may influence the activity of Atrogin-1 &MuRF1 expression.

 The purpose of this study was to clarify the change in symptoms, behavior, and feeling with acupuncture and the relationship between the changes and physical activity level in middle-aged and elderly people with musculoskeletal pain.
 The Subjects were 55 (26 males and 29 females, aged 65.0±12.2 years) middle-aged and elderly people with musculoskeletal pain who have been treated with acupuncture. We investigated the change in their symptoms, behavior, and feeling (symptoms, frequency of other treatments, exercise, frequency of going out and taking trips, general feeling, confidence in physical fitness, and coping with the prospects for the symptoms) with acupuncture using an unsigned self-administered question naire. In addition, the health-related quality-of-life was evaluated with SF-8 and the physical activity level was assessed with the Short Version of the International Physical Activity Questionnaire.
 The subjects mostly recognized that their symptoms, behavior, and feeling had a tendency to improve or remain unchanged with acupuncture. Evaluation of the relationship between the changes with acupuncture and walking physical activity showed that the subjects who felt their frequency of exercise or of going out or taking trips tended to increase with acupuncture treatment showed a significantly higher physical activity level than those who stated there was no change or a decreasing tendency (p<0.05). Similarly, the subjects whose assessment for the general feeling or coping with the prospects for symptoms was a tendency to irnprove with acupuncture showed a significantly higher physical activity level than those whose assessment was no change or deleterious change (p<0.05).
 These results indicate that acupuncture might have a positive affect on their symptoms, behavior, and feeling, and also provide opportunities to increase walking physical activity in middle-aged and elderly people with skeletai and muscular disorders.

 Acupuncture treatment is one of the conditioning methods in the competition field. Athletes who are forced in regularly intensive training often induced deteriorating of condition. Good conditions are adjusted by interaction of immune system, nervous system and endocrine system. Neutrophils and lymphocytes which are blood components prevent infections of the human body in various ways. Intensive training causes an increase of neutrophils, a decrease of lymphocytes and a negative impact on the immune functions. It has been reported that acupuncture stimulation could be involved in the coordination of the immune system. Therefore, acupuncture treatment could be important to keep physical condition and participate physical activity according to the plan without deteriorating of condition. It may be useful not only for athletes but also for the general public who train for the purpose of health and sports enthusiasts. The purpose of this study was to examine the effect of acupuncture stimulation on fluctuation of neutrophils and lymphocytes by the transient high-intensity exercise.
Method : Twelve healthy men (23.6±O.3 yr [±SE]) participated in this study. Subjects exercised on bicycle ergometer for 60 minutes at 75% of their VO₂max. Acupuncture treatment was applied at LU6 (Kongzui), LI 4 (Hegu), ST 36 (Zusanli), and ST 6 (Jiache), for 30 min after the exercise. Blood samples were taken before exercise, immediately after exercise, hourly after exercise until 4 hours and 24 hours after exercise. Leukocyte, neutrophils, lymphocytes, Th cells and Tc cells were measured from the blood samples.
Result : The neutrophils significantly increased from Post 1h to Post 4h in the both trials (P < 0.05). However the neutrophils was significantly lower in the acupuncture group than in the control group at Post 1h and Post 3h (P < 0.05). The lymphocytes significantly increased from immediately after exercise to Post 24h in the control trial, and increased significantly only at Post 1h to Post 3h in the acupuncture trail (P<0.05). The Th cells significantly decreased from Post 1h to Post 24h in the control trial and decreased significantly only at Post 1h, 2h and 24h in the acupuncture trail (P < 0.05).
Conclusion : These results suggested that acupuncture stimulation may reduce the increase of neutrophils and the decrease of lymphocyte and Th cells caused by high-intensity exercise. These results indicated that acupuncture stimulation may promote the recovery from high-intensity exercise.

Sports Acupuncture is used for alleviating physical disorders of athletes and it helps them to keep up the quality of their performance. Acupuncture has been used for sports injuries to relieve the pain, and lately, is also applied for preventing injuries, conditioning, or health maintenance. However, the definition of "Sports Acupuncture"is still unclear and there is no guideline to apply acupuncture for athletes.
As Tokyo Olympic and Paralympic will be held in Tokyo in 2020, we decided to review past researches related with sports acupuncture. These researches examine the effects of acupuncture for muscle pain, muscle fatigue, muscle atrophy, and sports injuries. Moreover, we invite one former athlete and she speaks how she used acupuncture when she was a player. After this panel discussion we will be able to make a step to next level, so that we re-create "Sports Acupuncture"on athletes'demand.

[Objective] In this study, the pain of receiving acupuncture was evaluated with or without individual finger stalls.
[Design] In a randomized, subject- and operating person-blind, controlled study.
[Methods] Sixteen acupuncturists and same number of normal volunteers participated in this study. Two needles were inserted into each side of the lumbar muscles. The trials were carried out twice using finger stalls and with bare fingers. These trials were performed in random order. Right after the insertion of needles and at the beginning of electrical stimulation, the subjects were asked to answer a questionnaire about the severity and quality of pain on receiving acupuncture. Durations of procedures were measured. We asked the acupuncturists whether they felt any difficulty in performing acupuncture using finger stalls.
[Result] The majority of acupuncturists reported that using the finger stalls during treatment was inconvenient. Although the severity of pain of acupuncture did not significantly differ between that with and that without finger stalls, the average value was slightly higher with finger stalls. The qualities of pain on receiving acupuncture did not significantly differ between the two methods, however, the numbers of selected words differed on some items. The subjects could not recognize the use of individual finger stalls. The use of finger stalls did not influence the duration of the procedure.
[Conclusion] In this study, the qualities of pain on receiving acupuncture did not significantly differ between that with and that without finger stalls. The subjects could not recognize the use of individual finger stalls.