【Purpose】 To investigate effects of physiotherapy on delayed onset muscle soreness (DOMS), DOMS was induced in the elbow flexors of the non-dominant arm. We selected transcutaneous electrical nerve stimulation (TENS) to examine effects of physiotherapy to the recovery process.【Methods】 Fifteen human volunteers were recruited. DOMS was induced by eccentric exercise. Subjects were assigned randomly to one of three groups (Control, 110 Hz TENS, 4 Hz TENS). TENS was applied for 20 min over the biceps brachii on 1 day only after exercise. Measurements of Mechanical Pain Threshold (MPT) and Visual Analogue Scale (VAS) were performed as evaluation of pain. Measurements were taken before and after exercise.【Results】 There was no significant improvement in MPT and VAS among all three groups.【Conclusion】 It was suggested application of TENS on DOMS at the parameters used here had no beneficial effect.

[Purpose] Elderly patients with chronic low back pain have often been treated by acupuncture andmoxibustion therapy, using the traditional acupoints for low back pain. But there are some patients who do not get a clinical effect. Therefore, we tried to treat three such patients with three sessions of trigger point acupuncture therapy, instead of using the traditional acupoints for low back pain.
[Methods] The patients were aged 74, 71 and 66, and had low back pain for at least 6 months. They hadround backs, but there were no extraordinary findings in their neurological examinations.
[Results] During and after the previous therapy using the traditional acupoints for low back pain, there wereno remarkable clinical effects on low back pain. But during and after the present therapy using trigger points, there were remarkable clinical effects on low back pain, as evaluated by the visual analogue scale (VAS) and the pain disability assessment scale (PDAS).
[Conclusion] These results suggest that the trigger point acupuncture therapy may be more effective on lowback pain in elderly patients than acupuncture therapy which uses the traditional acupoints.

Treatment of tender points has widely been used for diagnosis and treatment, but there are few studies elucidating the usefulness of this approach to diagnosing knee pain. This study investigated the diagnostic importance of tender points. The symptoms and the pressure pain threshold (PPT) in osteoarthritis of the knee (pain and motion of knee joint) were measured in 45 patients being treated at the Acupuncture Center of Meiji University of Oriental Medicine. The change in PPT was related to symptoms of knee pain (staircase and flexion pain). It is suggested that changes in PPT around the knee joints are a useful indicator for evaluating knee pain.

[Objective] To compare the effectiveness of electro-acupuncture with that of transcutaneous electrical nerve stimulation (TENS) in the treatment of lower back pain and to investigate problems with conducting rigorous trials in Japan. [Design] A multi-center, randomized, observer-blinded, controlled trial with two parallel arms. [Setting] Four medical facilities affiliated with universities or colleges in Japan. [Subjects and methods] Low back pain patients without sciatica suffering for at least two weeks were randomly assigned to either an acupuncture with electro stimulation group (Group A) or a TENS group (Group T). Plans called to recruit 80 patients in the protocol. Patients in both groups were treated twice a week for 2 weeks with 1 Hz electro-stimulation for 15 minutes. Visual analogue scale (VAS) of pain relief and the scores recommended by the Japanese Orthopaedic Association (JOA Score) were measured. Primary endpoint was improvement of pain that was assessed from the changes in VAS. [Results] Three patients were withdrawn after one-week run-in period and one patient was withdrawn from Group A during treatment the period. Consequently, 31 in group A and 33 in group T completed the trials and were available for evaluation. There was no difference between the groups in primary endpoint and JOA scores. [Discussion] Problem of patient recruitment should be resolved by strategically selecting facilities or by advertising for participants. Future investigation with attentive trials using adequate intervention is required to conclude whether or not acupuncture exceeds TENS in efficacy. [Conclusion] There was no statistical difference between electro-acupuncture and TENS for lumbago in this study.

The tender points treatment has been widely used for both treatment and diagnosis, but there have been very few studies that have examined its diagnostic usefulness. Thus, the purpose of this study was to clarify the diagnostic importance of tender points. The subject was a patient who had osteoarthritis of the knee of Meiji University of Oriental Medicine Hospital. The relationship between pressure pain thresholds (PPTs) and symptoms in osteoarthritis of the knee (painful knee motion) were evaluated with the Japanese Orthopaedic Association scale (JOA scale), a knee scale and the subject's knee pain diary (starting pain, flexion pain, walking pain and total pain Wong-Baker faces pain rating scale). After 40 acupuncture treatments, improvement was noted in the symptoms and PPTs. The changes in PPTs were related to the symptoms of the knee (flexion and walking pain). This suggests that changes in PPTs (around the knee) are a useful indicator for evaluating knee pain.

We studied the clincal effect of the electrical acupuncture at pudendal nerve in four cases of lumbar spinal canal stenosis. The experimental effect of the direct electrical stimulation to the pudendal nerve on the blood flow of the sciatic nerve evaluated by Laser-Doppler flowmetry in anesthetized rats. Electrical acupuncture at pudendal nerve resulted in the improvement of the gait distance of all four cases. The specific effect of the electrical acupuncture at pudendal nerve was found in one case who did not show any improvement by the acupuncture at the intervertebral joint points. On one hand, the direct electrical stimulation to rats pudendal nerve resulted in the increase of the sciatic nerve blood flow, which were not evoked by administration of atropine. These results suggest that the electrical acupuncture at the pudensal nerve may be effective for the intermittent claudication of the lumbar spinal canal stenosis. The increased blood flow of the sciatic nerve may play one of the important roles in the effect via autonomic nervous system.

To determine the effect of moxibustion on blood flow in the gastric wall, gastric blood flow was measured seven times by H² clearance method at 30 minute intervals in 14 anesthetized female rabbits. Moxibustion stimulation was performed 3 times at one acupuncture point on the left hindleg (S 36 zusanli) just before the third measurement.
The level of gastric blood flow was high during the initial measurement after induction of anesthesia, and then gradually decreased in both groups. In the control group (without moxibustion: n=6) the blood flow showed a continuous decrease, but in the stimulation group (n=8) it tended to increase momentarily by about 1.5ml·min^-1·100g^-1 at the third measurement (just after moxibustion) and 2.0ml·min^-1·100g^-1 at the fourth measurement, amounting to 22.7±2.4ml·min^-1·100g^-1 at the third measurement (control group: 18.9±1.9) and 23.2±2.9ml·min^-1·100g^-1 at the fourth measurement (control group: 18.0±2.2). The increase in the blood flow was observed in 5 of 8 cases in the stimulation group. However, there was no increase observed in the control group. The increased blood flow in the stimulation group began to gradually decrease, but the values remained higher than the values in the control group until the last measurement. Significant difference, p<0.05, was found between the changes in the blood flow in the two groups.
Since the increment of the blood flow after moxibustion was supposed to be due to the vasodilation, it is suggested that moxibustion may cause the dilation of the gastric blood vessels owing to excitation of the vagal nerve and/or inhibition of the splanchnic nerve.

Epicodylitis humeri lateralis is common in indivisuals whose occupations require frequent rotatory motion of the forearm. An ache appears over the outer aspect of the elbow and is reffered into the forearm. The patients with epicodylitis humeri lateralis were often treated by acupuncture therapy. We treated the patients by means of acupuncture therapy with silver spike point therapy and streching of the extensors of the forearm, in Meiji College of Oriental Medicine Hospital. In order to clarify the effect of our therapy, we valuated clinical results by using pain scale score. We treated 13 patients (male 4, female 9, mean age 49.2 years). In our therpy, acupuncture points and SSP points, which were on the area from the lateral epicondyle to the extensors of the forearm, were used. And we made the patients to do streching of extensors of the forearm. The pain scale scale score improved from 10 points to 3.8 points after the treatments, 15% were excellent, 77% were good, and 8% fair. The results suggested that our therapy improves the symptoms of epicodylitis humeri lateralis.

The patients with the spondylosis deformans of the lumbar spine are often treated by acupuncture therapy. Forty patients (male 28, female 12, mean age 61.2 years old) with spondylosis deformans of lumbar spine were treated by the acupuncture therapy with therapeutic exercise and silver spike point (SSP) therapy in Meiji College of Oriental Medicine Hospital. The purpose of this study is to evaluate the clinical effect of our therapy using our painscale score. In our therapy, acupuncture points (Dachangshu-BL25, Shenshu-BL23, Ciliao-BL32, Baohuang-BL53 etc.) and SSP points on erector spinae muscle and gluteal muscle were used. As the result of this study, 22.5 % had excellent effect and 55.0 % had good effect by our therapy. It was concluded that our therapy is one of considerably effective therapy for the spondylosis deformans of the lumbar spine.