【Introduction】Thumbtack needles for skin stimulation are used in the field of sports medicine. Their primary therapeutic mechanism is believed to be the increase in regional blood flow mediated by the axon reflex. However, it is not clear at this time whether a medical device (acupuncture device) for skin stimulation significantly increases regional blood flow at the stimulation site. Furthermore, sterile acupuncture needles in which the acupuncture needle body is inserted into the skin with multiple needles (hereafter referred to as Multi-core thumbtack needle) have not been manufactured to date, and their usefulness and potential application for blinding is unknown.【Materials and Methods】A single-blind randomized crossover trial was conducted in 16 healthy adult males. A multi-core thumbtack needle (needle length 0.55 mm, needle base diameter 0.3 mm, number of needles 37, pitch 1.0 mm, made of biosafe resin) was placed in the center of the palmar side of the forearm for 30 seconds, and then one week later they were randomly assigned in a 1:1 ratio to one group to receive stimulation in the same way with a sham needle (a flat disk made of the same material), or one group to receive stimulation in the opposite order. The primary endpoints were the change in regional blood flow (5 min post-stimulation vs. pre-stimulation) and the rate of change at the stimulation site, which were measured using a laser perfusion meter. The secondary endpoint was heart rate. A linear mixed model was used as the statistical method, with a significance level of 5%.【Results】Regarding the amount of change in regional blood flow, sham needles showed a mean of -0.09 (95% confidence interval [CI]: -0.39 to 0.21) mL/min/100g, whereas multi-core thumbtack needles showed a mean of 8.83 (95% CI: 5.86 to 11.79) mL/min/100g, indicating a significant intervention effect (P < 0.001), with no significant period effect (P = 0.474) or carryover effect (P = 0.441). There was no intervention effect on heart rate (P = 0.95).【Conclusion】A significant increase in local blood flow was observed with the use of the multi-core thumbtack needle employed in this study. As this response was not accompanied by a significant increase in heart rate, it is speculated that the effect is primarily mediated by the axonal reflex and the involvement of nitric oxide, as well as somatic-autonomic reflex mechanisms.

[Objective]To investigate the effects of acupuncture on sports activities of athletes[Methods]A total of 1,804 athletes were targeted. The method used was a collective survey. Questionnaires were administered after obtaining consent from the participants; online questionnaires were also provided. The questionnaire evaluated profile (sex, age); sensation immediately after acupuncture treatment, duration of stimulus sensation, stimulus intensity, stimulus sensation, and therapeutic effect; timing of acupuncture treatment; and questions related to acupuncture as to whether the acupuncture caused any adverse effects on play (movement) or showed any positive effects.[Results]In total, 1,525 (84.5%) valid responses were obtained. The survey analyzed 841 subjects (55.1%) who underwent acupuncture. The most common response after acupuncture treatment was that the subjects felt lighter and were able to move more easily; 43.9% of subjects gave this response. In addition, 10.6% of respondents said that they continued to feel pain similar to the sensation during acupuncture treatment and 7.7% said they felt weak. The most common response at 59.8% was that the sensation felt during acupuncture disappeared quickly after treatment was ended, 58.6% of subjects said that the sensation felt after acupuncture was optimal, and 48.3% responded that the sensation from treatment remained and a positive effect was observed. The most common timing for receiving acupuncture for 21.8% of subjects was after practice or a match: [Discussion and Conclusion]Acupuncture for athletes should be performed according to the guidelines, taking into account the competition schedule and type of competition and the appropriate amount of acupuncture stimulation, thereby preventing problems during competition.

The purpose of this study was to investigate the injury patterns and risk factors of injuries among high school handball players in Japan. A total of 1299 (709 male and 590 female) subjects who played in the 2018 Japanese National High School Handball Championship participated in this study. The questionnaire on injury experience was distributed two weeks before the championship and was collected at the representation meeting the day before the championship. The main results were as follows: 1) The subjects (n=625, 48.1%) reported experiences of injuries in the previous year. Female had significantly more suffer injuries than male. 2) The main body parts of injuries were the ankle, knee, and finger in traumatic injuries and the lower leg, lumber spine/lower back, and knee in overuse injuries. The main types of injuries were sprain, ligamentous rupture, and fracture in traumatic injuries and stress fracture, other bone injuries, and lesion of meniscus or cartilage in overuse injuries. The main cause of injuries was “contact with another athlete”. 3) Age, female players, and back players were associated with increased the occurrences of injuries. Goalkeepers were associated with decreased the occurrences of injuries. These results indicated that a high prevalence of injuries in high school handball players, and it is important to take preventive measures based on age, gender, and player position.

[Objective] The purpose of this cross-sectional questionnaire-based study is to investigate the challenges of adverse events during treatment by acupuncture and moxibustion to an athlete. [Methods] In total, 1,804 subjects, including athletes who participated in marathons and university athletes were enrolled in this study. The survey was conducted by distributing the questionnaire or via online questionnaire to the athletes who fit the criteria for the study. The questionnaires were collected after consent was received from the participants; online questionnaires were also collected. The questionnaire was examined for age, sex, and type of competition, purpose of the acupuncture treatment and the actual effects, and treated area, content of adverse event, number of times the subjects received acupuncture, and informed consent, and free description of adverse events.[Results] In total, 1,525 (84.5%) valid responses to the questionnaires were received. The survey analyzed 841 subjects (55.1%) who experienced acupuncture and moxibustion. The following responses about adverse events of acupuncture were obtained: "pain at time of needle insertion"; 17.0%, "subcutaneous-bleeding"; 10.1% and "pain and feeling of heaviness due to the needle": 10.0%, among others. For moxibustion, responses included "burns"; 5.9% and "malaise"; 5.8%, among others. In the free description, there were 17 descriptions of discomfort due to excessive stimulation and difficulty in movement during exercise. Of the questions regarding whether or not they received informed consent, 215 were received orally (25.6%), 34 were received in written form (4.0%), 99 were received both orally and in written form (11.8%).[Discussion and Conclusion] Acupuncture for athletes causes a certain rate of adverse events. It was suggested that guidelines for athletes to receive acupuncture safely and training and education for practitioners are important.

[Background] Presenteeism, defined as the practice of sick workers who come to work, and whose work performance effectiveness has been reduced due to various signs and symptoms, causes a significant financial loss to companies. However, comprehensive and effective occupational health countermeasures have not yet been presented. Therefore, we report here the results of an interim analysis to determine whether an allowance for acupuncture treatment is beneficial for workers' presenteeism. [Methods] A four-week randomized intergroup comparative study was conducted on office workers who were aware of their presenteeism. Participants were allocated to either the control group, in which regular recommended presenteeism countermeasures for each workplace were implemented arbitrarily, or to the intervention group in which an allowance of up to 8,000 was given for acupuncture treatment, in addition to the usual arbitrary measures. The primary endpoint was the WHO-HPQ relative presenteeism score: a score lower than 1 indicates lower work performance; and it was analyzed with the "full analysis set" population.[Results] A total of 52 patients were assigned to the intervention group (n = 30) and the control group (n = 22). On average, the intervention group received acupuncture treatments 1.4 times for stiff neck and shoulders (67%), lower back pain (26%), depression (5%), and allergies (2%), and paid a total of 7,219; and 6,556 was paid as an expense allowance. As a result, the relative presenteeism score was 0.95 in the intervention group, compared to 0.91 in the control group, with a between-group difference of 0.04 (ES (r) = 0.22, P = 0.12).[Conclusions] With a total of up to 8,000 offered to office workers who were aware of their presenteeism, an acupuncture treatment allowance for a four-week period was provided 1.4 times on average. The results suggested that the treatment allowance would increase workers' performance efficiency by about 4% (equivalent to 19,691 per person) compared to those without it.