Objective To observe the surface electromyography (sEMG) characteristics of upper limbs during one-finger pushing manipulation under different operating forces, so as to find out the muscle coordination movement pattern for key operating technology. Methods sEMG data of performing one-finger pushing manipulation by the expert, skilled and novice groups were collected. The manipulation force was divided into three different types, namely mild, moderate and severe. The continuous, stable data were adopted for analysis on Myo-Research software. Results Significant differences were found in the upper limb muscle integrated electromyography (iEMG) values (P<0.05). Under the three different forces, there were no significant differences in iEMG ratio of muscles between the expert and skilled groups (P>0.05), with the flexor carpi ulnaris, deltoid, wrist flexors and extensors ranking the top three of iEMG ratio. The expert and skilled groups had the same core muscles in the same movement pattern during their manipulation operation, while the novice group had different core muscles under different forces. There were significant differences in co-contraction ratio among the expert, skilled and novice groups (P<0.01). The novice and expert groups had the highest and lowest co-contraction ratio, respectively, and the co-contraction ratio was gradually decreased with force increasing. During 6-minute manipulation operation, deltoid median frequency(MF) slope of the expert group was declined more slowly than that in the other two groups (P<0.05), which indicated that the expert group were better at resisting to fatigue. Conclusions The expert and skilled groups have the same sEMG characteristics during one-finger pushing manipulation operation with the same core muscles. The movement pattern of upper limb muscles is of regularity. The iEMG ratio, MF slope and co-contraction ratio can be used as reference standard for evaluating the durability, and homogeneity of the manipulation operation and normalization of force application.

The standardization of Chinese Tuina therapy is one of the most popular research topics in Chinese medicine. By reviewing the literatures contributed by Chinese investigators between 1982 and 2010, the authors summarized the progress on Chinese Tuina manipulation techniques, in particular, focusing on the data on several key parameters (i.e., frequency, duration, and force). This summarization will benefit the standardization of Chinese Tuina.
Biomedical Research ; methods ; trends ; China ; Female ; Humans ; Male ; Massage ; methods ; Medicine, Chinese Traditional ; methods ; trends ; Musculoskeletal Manipulations ; methods ; Quality Improvement

OBJECTIVE: To observe the analgesic effect of manipulation loading on chronic low back pain (CLBP) model rats and the expression of inflammatory factors in psoas major muscle tissue, and to explore the improvement of manipulation on local inflammatory microenvironment. METHODS: Thirty two SPF male SD rats weighing 340-360g were randomly divided into blank group, sham operation group, chronic low back pain model group and treatment group, with 8 rats in each group. In the model group, L RESULTS: There was no significant difference in PWT and PWL between the blank group and the sham operation group after modeling ( CONCLUSION Local massage loading has analgesic effect on CLBP rats, at the same time, it can inhibit the content of CGRP and NGF in psoas muscle tissue of CLBP rats, and improve the local inflammatory microenvironment.
Animals ; Calcitonin ; Calcitonin Gene-Related Peptide ; Low Back Pain/therapy* ; Male ; Nerve Growth Factor/genetics* ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo study the effects of tuina on the mechanical properties of skeletal muscles of four limbs in patients with chronic fatigue syndrome (CFS).

METHODSThirty CFS patients were recruited as the test group, while another 30 healthy volunteers were recruited as the healthy control group. Patients in the test group received tuina therapy, 30 min each time, once every other day, for totally 10 times. Isokinetic testing technology was used to compare peak torque (PT), total watt (TW), average power (AP), and flexor/extensor (F/E) ratio in the elbow and knee muscles of CFS patients before and after treatment. The Functional Assessment of Chronic Illness Therapy (FACIT) fatigue scale was used to evaluate the fatigue degree before and after treatment, and compared with the healthy control group.

RESULTSAfter treatment the FACIT fatigue scale score decreased significantly in the test group when compared with before treatment (27.5 +/- 9.1 vs 42.5 +/- 11.2), showing statistical difference (P < 0.05). The pre-treatment PT, TW, AP, and F/E ratio in the skeletal muscle were all lower in the test group than in the healthy control group. Compared with before treatment in the test group, patients' elbow 60 degrees/s angular velocity values during exercise extensor PT and TW, knee 60 degrees/s and 180 degrees/s angular velocity values during exercise flexor PT and TW increased significantly; elbow extensor and knee extensor, flexor AP was significantly elevated; knee in 180 degrees/s angular velocity of movement F/E ratio significantly increased, and all the differences were statistically significant (P < 0.05). The improvement of the fatigue degree in CFS patients and elbow in 60 degrees/s angular velocity values under the flexor and extensor TW, and flexor AP value of the degree of improvement were negatively correlated (r = -0.282, -0.482, -0.285, P < 0.05, P < 0.01). Meanwhile, the muscles with the knee in 180 degrees/s angular velocity was negatively correlated with the F/E ratio of the degree of improvement (r = -0. 330, P < 0.05).

CONCLUSIONSCFS patients have lowered mechanical properties of four limbs. Tuina therapy can improve the biomechanical properties of limb skeletal muscle and reduce the overall degree of fatigue in patients. The changes of limb skeletal muscle and mechanical properties can provide objective reference for the clinical diagnosis and assessment of CFS.

Adult ; Case-Control Studies ; Fatigue Syndrome, Chronic ; physiopathology ; therapy ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Muscle, Skeletal ; physiopathology

OBJECTIVETo assess the effectiveness of acupuncture for treatment of herpes zoster.

METHODSAccording to the requirement of evidence-based medicine, acupuncture, body acupuncture, electroacupuncture, head acupuncture, three edged needle, plum-blossom needle, fire needle, elongated needle, encircling needling, herpes zoster, etc. were selected as subject words to retrieve the relative medical database at home, and clinically randomized controlled trials were used as enrolled criteria, the treatment group were treated with acupuncture or acupuncture plus other therapies, and the control group with medicine, the cured rate and the time of killing pain for herpes zoster were used as assessment indexes. Altogether 43 papers were enrolled. Among them 10 papers were conducted for Meta-analysis by RevMan 4.2.9.

RESULTSThe total OR was 4.27 with 95% CI [2.90, 6.29] of the clinically cured rate in the 10 studies, and the total OR was -7.64 with 95% CI [-8.12, -7.15] of the time of killing pain in the 4 studies. The therapeutic effect in the treatment group on herpes zoster was superior to that of the western medicine (P < 0.01).

CONCLUSIONAcupuncture therapy for herpes zoster is effective, but more high-quality studies are required to prove this view point.

Acupuncture Therapy ; methods ; Herpes Zoster ; therapy ; Humans

"Subluxation" is the core of pathological conception of spinal injuries treated by spinal manipulation. The conception of "Subluxation" not only includes changes of joint anatomy,but also emphasizes on joint dysfunction which is caused by changes of the anatomical position. The name of "Subluxation" in manual medicine is the same as modern medicine,but the content is obviously different. Nonetheless, it would be confused and not reflect the characteristics of manual practices. So we can consider changing the name of "Subluxation" in manual medicine into "Yatuowei".
Animals ; Humans ; Manipulation, Spinal ; Models, Animal ; Spinal Injuries ; therapy ; Terminology as Topic

Spinal "Gucuofeng" mainly is considered as abnormalities of joint function. Manipulative maneuver have obviously effect in adjustment of spinal "Gucuofeng", and the technical key point is utilization of principle of lever to achieve safe, effective and labor-saving purpose. After clinical practice, the general principle of manipulative maneuver in adjustment of spinal "Gucuofeng" can be summed up as pull stretch traction, first-induced instability, reverse adjustment,withdraw along situation.
Adaptation, Psychological ; Exercise Therapy ; Humans ; Low Back Pain ; surgery ; Manipulation, Spinal ; methods ; Social Adjustment ; Spine ; physiopathology

OBJECTIVETo study the effects of Tuina on muscular tension of flexor and extensor in patients with knee osteoarthritis (KOA).

METHODSFrom June 2009 to March 2010, 20 patients with KOA were observed, including 7 males and 13 females, the age ranged from 42 to 72 years with an average of 61 years. Eight patients were ailed with single knee, 12 patients were ailed with double knee. The maneuver of Tuina were Gun maneuvers (120 to 140 times per minute), An maneuvers, Na maneuvers and Ca maneuvers. The patients were treated 3 times every week,and 10 times were 1 course of treatment. The muscular tension of flexor and extensor were measured before and after treatment, and the press force of the point reached largest of L 500 g when the press was 500 g. The therapeutic effects were assessed by WOMAC (including pain, stiffness, functional activity and overall score) scale before and after treatment.

RESULTSThere was significant increase in the ill knee on L 500 g (P<0.01). There was significant decrease after treatment in WOMAC (P<0.01). There was significant positive correlation between the improvement rate of extensor and the improvement rate of therapeutic effects (P<0.01, r=0.764). There was significant positive correlation between the improvement rate of flexor and the improvement rate of therapeutic effects (P<0.01, r2=0.533).

CONCLUSIONTuina can improve muscular tension of flexor and extensor in patients with knee osteoarthritis, thus can improve the therapeutic effects.

Adult ; Aged ; Female ; Humans ; Male ; Manipulation, Orthopedic ; Middle Aged ; Muscle Tonus ; Muscle, Skeletal ; physiopathology ; Osteoarthritis, Knee ; physiopathology ; therapy

Abstract Previous epidemiological studies indicated that weight of schoolbag in most countries is far higher than that recommended guidelines. Heavy schoolbags seriously affect the healthy development of the musculoskeletal system of adolescents, which not only leads to abnormal posture e.g. rounded shoulders, hunchback and head forward, but also is one of the main causes of adolescent musculoskeletal diseases such as cervical spondylosis, low back pain and scoliosis. However, adolescents and their parents do not fully understand the harm of heavy schoolbags, let alone the health knowledge regarding the choice and use of schoolbags. Therefore, the review introduces current evidence regarding the association between schoolbag and adolescent musculoskeletal system diseases, as well as schoolbag selection and use, with the aim to arouse the attention of teenagers and their parents and relevant health education departments.

ObjectiveTo evaluate the clinical efficacy and adverse effects of Shugan Hewei prescription combined with vonoprazan in the treatment of refractory gastroesophageal reflux disease （RGERD） due to qi depression and phlegm obstruction. MethodEighty RGERD patients who met the inclusion criteria underwent 24-hour pH impedance and high-resolution esophageal manometry and electronic gastroscopy. The 80 patients were randomly assigned to an observation group （Shugan Hewei prescription， one bag each time， twice a day + vonoprazan， 20 mg each time， once a day） and a control group （vonoprazan， 20 mg each time， once a day） by the random number table method. The treatment in both groups lasted for 4 weeks. The clinical efficacy was examined. The scores of TCM symptoms （pharyngeal discomforts such as phlegm obstruction， retrosternal discomfort， and belching）， somatic symptoms， quality of life， and improvement of esophageal mucosa under gastroscopy were observed in both groups before treatment and after treatment for 2 and 4 weeks. ResultSeventy-five patients completed the trial were included in this study， including 38 patients in the observation group and 37 patients in the control group. The total response rate in the observation group was 89.47%（34/38）， which was higher than that （62.16%，23/37） in the control group （χ²=13.014， P<0.01）. After treatment， the scores of esophageal mucous membrane， reflux disease symptoms， TCM symptoms， gastroesophageal reflux disease health-related quality of life scale （GERD-HRQL）， and somatic self-rating scale （SSS） decreased in both groups（P<0.05）. Moreover， the observation group outperformed the control group in alleviating heartburn， acid reflux， throat discomforts， midnight coughing， nausea and dry vomiting， mucousy mouth， and insomnia in the patients with GERD （P<0.05，P<0.01）. However， the two groups showed no statistically significant differences in the improvement of esophageal mucosa after treatment. ConclusionThe combination of Shugan Hewei prescription with vonoprazan was superior to vonoprazan alone in treating RGERD regarding clinical symptoms， physical signs， quality of life， and somatic symptoms， without causing obvious adverse effects.