5.Acupuncture treatment in a Parkinson's Disease patient with frozen gait
Tsuguo KUSAGAWA ; Tomomi SAKAI ; Norio OHKOSHI
Journal of the Japan Society of Acupuncture and Moxibustion 2010;60(2):216-224
[Objective]This case evaluates the effects of acupuncture for a Parkinson's Disease patient with frozen gait.
[Case]Patient:a 58-year-old male. Chief complaints were frozen gait and fatigue of legs. The gait disturbance was realized about three years ago, and has been gradually worsening. The Hoehn &Yahr stage is III. Treatment:The patient received medication and acupuncture treatment once a week or two for 18 months. Electric acupuncture treatment was adopted on arms and lower legs, and lone needles on the back and legs. Measurements:Outcome measures were timed in a 10 m walk and turn for frozen gait and Visual Analogue Scale (VAS) for fatigue of legs.
[Results]From a long term point of view, there were no significant changes for the outcomes measured. However just after the treatment VAS was statistically improved, and the patient reported a comfortable feeling.
[Conclusion]The effect of acupuncture for frozen gait was not seen, but the improvement in fatigue of legs was noted, and the patient felt comfortable after the treatment.
6.Effects of Acupuncture Therapy on Periarthritis Scapulohumeralis.
Tomomi SAKAI ; Yasushi MIZUIDE ; Daichi KASUYA ; Akira YOSIDA ; Fumiko YASUNO
The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine 1997;60(4):200-208
We examined the effects of acupuncture therapy on 41 patients with various levels of periarthritis scapulohumeralis. These patients were classified into two groups: one consisting of 20 patients having no contracture, those of freezing type (age 61.0±9.0; suffering period 3.0±5.1 months) and the other consisting of 21 patients having contracture, those of frozen type (age 53.8±7.3; suffering period 5.8±7.8 months).
As a result, we found that acupuncture therapy relieved pain more effectively in patients having no spontaneous pain than in those having spontaneous pain regardless of the presence or absence of contracture. We next investigated the effects of this therapy by the patient types. In the group of 20 freezing-type patients, which includes only six patients having spontaneous pain, pain relief was relatively easily obtained as indicated by the pain score after the therapy of 3.6±1.8. In the group of 21 frozen-type patients, which includes 13 patients having spontaneous pain, however, it was difficult to obtain sufficient pain relief as indicated by the pain score of 5.7±2.8. There was a statistically significant difference (P<0.002) between these scores. This shows that acupuncture therapy is more effective on freezing-type patients than on frozen-type patients.
Therapy also improved the range of motion. In many freezing-type patients, the range of motion was expanded due to pain relief. The abduction ROM expanded from 151.8±39.0° before therapy to 163.8±25.0° after acupuncture therapy. In frozen-type patients, however, the range of motion did not expanded significantly (87.6±24.1° before to 94.8±21.1° after therapy). The above results suggest that acupuncture therapy is effective for relieving the pain of periarthritis scapulohumeralis and that this therapy is particularly effective when applied to those patients having no spontaneous pain before they enter into the frozen phase.
7.A Clinical Study of Acupuncture Therapy for Lumbar Spinal Canal Stenosis.
Daichi KASUYA ; Fujio TAKEUCHI ; Kazuhiko YAMAMOTO ; Koji ITO ; Tomomi SAKAI
The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine 1999;62(4):201-206
We executed an acupuncture therapy to 62 lumbar spinal canal stenosis cases who were diagnosed by CT, MRI photo state and clinical symptom and examined the result.
The 36 men and 26 women in this study had a mean age of 67.3 years.
An acupuncture was executed by aiming to give an effect to the soft tissues and a blood circulation around the area where the stenosis was recognized then pierced facet joint closely and deeply and gave an electric acupuncture stimulus.
14 cases were very good and 17 cases had good results according to the JOA score. No cases worsened.
We concluded an acupuncture treatment was effective for treating lumbar spinal canal stenosis.
8.Relations of Stiff Shoulders with Deep Hemodynamics Values.
Tomomi SAKAI ; Noriko OSAKI ; Fumiko YASUNO ; Yoshihiro AIKAWA ; Tadashi YANO
The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine 2002;65(3):137-146
Poor circulation is considered to be a cause of stiff shoulders, but there have been no studies on deep hemodynamics and the subjective estimation/palpation of stiff shoulders. We evaluated the relationship between deep hemodynamics and the degree of the subjective estimation/palpation of stiff shoulders by near-infrared spectrophotometry.
The subjects were 146 patients who visited our center and 23 healthy volunteers. Deep hemodynamics (tissue oxygen saturation: StO2, total hemoglobin concentration: total Hb) was measured in the scapular region of the bilateral shoulders using a deep hemodynamics measurement system (PSA-IIIN, Biomedical Science), and its relationship with the severity of the subjective estimation of stiff shoulders (5-grade rating) and that of palpation (4-grade rating) was evaluated. Deep hemodynamic values were affected by the body mass index (BMI) that is highly correlated with subcutaneous fat thickness. Therefore, analysis was performed in 70 patients and 8 healthy volunteers with BMI of 20-24 that does not affect hemodynamic values. Compared with the healthy volunteers, patients who reported marked shoulder stiffness showed a significant decrease in total Hb, and that who reported shoulder stiffness showed a significant decrease in StO2. On the other hand, compared with the healthy volunteers, patients with marked shoulder stiffness observed by palpation showed significant decreases in both StO2 and total Hb; the decreases were more marked with more marked stiffness. These results suggested that deep hemodynamics is a diagnostic parameter of stiff shoulders.
9.Clinical Study of Electro-Acupuncture Therapy -(EAT)-Examination of muscle-EAT and nerve-EAT-
Tomomi SAKAI ; Fumiko YASUNO ; Munenori TAWA ; Tadashi YANO
The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine 2004;67(2):87-108
We investigated the difference between muscle-EAT and nerve-EAT basically and clinically. A basic study was performed on healthy adult males. The skin blood flow, deep-tissue temperature, deep hemodynamics, heart rate, and deep-pain threshold were adopted as indexes, and they were compared for a total of three groups: the muscle stimulation-EA group, nerve stimulation-EA group and control group (no stimulation). An acupuncture needle was inserted into the gastrocnemius muscle for muscle stimulation-EA and another needle into the tibial nerve in the femoral region for nerve stimulation-EA. Electric current was then applied at 1Hz for 15 minutes after the flexibility of the foot joint was conformed. Each index was measured after it became stable and was recorded from 10 minutes before starting stimulation until 20 minutes after ending stimulation.
A clinical study was performed on 41 patients with cervical radiculopathy. Muscle-EAT was applied to the patients as the first choice. Cases graded five points or less in pain score (10-point method) after one month were included in the muscle-EAT group. Cases graded six points or more were subjected to nerve-EAT and were included in the nerve-EAT group. The therapeutic results in these two groups were examined for a period of three months at intervals of one month based on the pain score and the evaluation criteria for the results of treatment of cervical radiculopathy.
As a result, we found that the skin blood flow significantly increased on the stimulated side in both the muscle stimulation-EA and nerve stimulation-EA group. The increase was greater in the nerve stimulation group than in the muscle stimulation group. The deep-tissue temperature rose significantly on the stimulated side in the nerve stimulation-EA group. Regarding the deep hemodynamics, deoxy Hb decreased significantly in the nerve stimulation-EA group. No difference was found in heart rate between the two groups. The deep-pain threshold was significantly raised by nerve stimulation.
Patients with cervical radiculopathy who did not respond to continuous muscle-EAT for one month were subjected to nerve-EAT. After three months (two months after changing to nerve-EAT), similar improvements were found in both groups. Significant improvement of paresthesia was obtained with nerve-EAT.
These results suggested that the nerve-EAT influences the peripheral circulation and the deep pain threshold more effectively, enhancing the clinical efficacy.
10.The Effects of Electroacupuncture Stimulation on Circulation in Human Ocular Fundus
Fumiko YASUNO ; Yoshihiro AIKAWA ; Tomomi SAKAI ; Tadashi YANO
The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine 2004;67(4):225-236
The effect of electroacupuncture (EA) stimulation on tissue circulation in the human ocular fundus (choroidal blood flow) was studied in 11 adult healthy volunteers (6 males and 5 females, age 31.5±5.7y) who had no physical or ocular disease. Using the laser speckle method, normalized blur (NB) values, a quantitative index for tissue blood flow, were measured over an area of choroid between the macula and the optic nerve papilla with no discrete visible vessel. The EA stimulation was applied between BL 10 and GB 20 and between GB 21 and SI 13 on the right side for 15 minutes at 1Hz with an intensity which cause slight muscle contraction. The NB value and intraocular pressure (IOP) in both side eyes, blood pressure (BP) and pulse rate (PR) were measured at baseline time, immediately after EA, and every 5 minutes after EA up to 15 minutes. These procedures were repeated on the same subjects as a control trial on another day. The NB value of choroid on the stimulated side significantly increased following EA stimulation compared with the control value, while that in the unstimulated side showed no significant change. No significant change was observed in BP, IOP or ocular perfusion pressure throughout the experimental period.