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Please identify the points on the Midline from Forehead to Upper Lip
- 1. Top of Face
- 2. Throat
- 3. LU
- 4. HT
- 5. LR
- 6. SP
- 7. Uterus and UB
Please identify the points on the Nose, Eye, Mouth, and Cheek
- 1. Breast
- 2. GB
- 3. ST
- 4. Medial Thigh
- 5. SI
- 6. LI
- 7. Shoulder
- 8. Arm
- 9. Hand
Please identify the points on the Cheek
- 1. KI
- 2. Umbilicus
- 3. Back
- 4. Thigh
- 5. Knee
- 6. Patella
- 7. Lower Leg
- 8. Foot
In ancient times, applying these as a means to electrically stimulate the body?
Who is the doctor that first coined the word, electro-acupuncture?
- Dr. Roger de la Fuye
- French acupuncturist in Paris
Stimulation of acupuncture needles, inserted into the body, by means of electrical current.
This indicates the relative electrical charge (positive, negative, neutral.
A unidirectional flow, used by positive or negative and needs a low voltage source. It can be used to stimulate de-nervated skletal muscle such as CVA and paralysis from injury.
Direct (Galvanic) Current (DC)
A bi-directional flow using positive and negative simultaneously. Most ESU's (electro stim units) work on AC. Used only for muscle contraction and pain management.
Alternating Current (AC)
Very similar to AC except the amperage is much lower. This lower strength flow does not stimulated muscle or nerve tissue as AC and DC does. This is more consistent with the predominant human frequency and is therefore said to increase the body's natural healing processes. This heals more systemically.
Micro Current (MC)
What is the predominant human frequency?
What is the frequency range for tonification?
- 1 Hz - 5 Hz
- Optimal range: 2 Hz
What is the frequency range for auricular tonification?
2 Hz - 5 Hz
What is the frequency range for sedation?
- 20 Hz - 200 Hz
- Optimal range: 80 Hz - 150 Hz
Nerve stimulation can be given without needles.
Flexible pads adhere to skin over site of pain.
Higher currents / voltages are used over EA because the resistance is greater through the pads to skin than needles and pads spread over a wider surface than needles.
Transcutaneous Electrical Nerve Stimulation (TENS)
What are the advantages of TENS?
- No needles
- Ease of use
- Precise location is not needed as the surface area is greater
- Home / Self use is possible
- 30 mins / day > twice a week sessions
What are the disadvantages of TENS?
- Most TENS cannot achieve De Qi (not the proper kind of current)
- De Qi can only be achieved by very strong stimulation (the sensation of tenderness during manipulation on points such as LI-4; most patients don't like this)
- Difficulty applying points to face, ears, scalp and nose
High frequency, low intensity using th gate theory.
Low intensity activates large muscle and large skin nerves.
High frequency (50-200 Hz) produces best presynaptic inhibition at low intensity but when high intensity is used this could cause spasms.
De Qi is not obtained from muscle.
Paps are placed near the site of pain.
Analgesia treatment throughout the day.
Tolerance to the stimulation can develop over a period of time.
- Characteristics of Conventional TENS
Low frequency, high intensity and does produce De Qi.
The stronger intensity releases endorphins.
The pads are placed on acupuncture points.
The frequency used (2-4 Hz) produces no muscle spasm.
Analgesia has a slow onset and long duration.
Thirty minutes is all that is needed for analgesia.
Continous treatment throughout the day is not needed for acupuncture like TENS.
- Characteristics of acupuncture like TENS
What are the indicaitons for Electo Stim?
- 1. Pain management
- 2. Improving muscle tone
- 3. Regulation of physiological functions
- 4. Analgesic
- 5. Treatment for addiction using auricular acupuncture
What are the contraindications of Electro Stim?
- 1. Patient with implanted electrical devices (pacemaker)
- 2. Sacral and Lower abdomen, SP-6, LI-4 on Pregnant women
- 3. Pregnancy
- 4. FDA - head and neck, heart conditions, epilepsy
- 5. No crossing the heart
- 6. No crossing spinal cord
- 7. Never use different currents at once, may harm Nervous System
What are the different wave length ranges for Infrared Rays?
- Infrared: 0.75-10,000 μm
- Near Infrared: 0.75-3 μm
- *(some indicate the >3 μm is considered Far)
- Medium Infrared: 3-30 μm
- Far Infrared: 30-1,000 μm
The human body is a natural biologic infrared radiation source and is the best absorber. What is the range in which the human body can absorb infrared?
3-50 μm (esp. 7-14 μm)
Infrared radiates to the skin, 34% of it will be absense of reflex and the rest will permeate the skin and directly act on different layers. It has the effect of removing EPF wind and eliminate cold due to wind, cold and damp.
Radiates acupoints or tender points, in lesion areas; causes warm and heat effect. Can replace moxibustion.
Infrared Radiation Therapy / TDP Lamp
What are the clinical effects of Infrared Therapy?
- Heat causes expansion of the microvascular, promote circulation to eliminate blood stasis and promote absorption of the product of pathometabolism
- Inhibit abnormal excitement or sensory nerves to relieve pain
- Regulate vegatative nerves to relieve spasm of smooth muscles
- Increase tissue's regenerative powers and promote the healing of trauma
What are the precautions for using Infrared Radiation Therapy?
- To prevent burns, patient should not move during treatment
- Leave 10"-20" b/w lamp and patient to prevent burns
- Stop if patient is hot, has palpitations, is dizzy during radiation
- Cover eyes if treatment is near eye, occiput is not allowed
- Caution for hypoalgesia (decrease sensitivity of painful stimuli), decrease feeling of warmth, new scars should not be radiated
- Metal needles or probe cannot touch infrared chip to prevent electrical shock
- Avoid TDPing a needle at the site of a replaced joint
Depending on the disease, what should be considered before using Acupoint Injection Therapy?
- Back and Chest: Palpation of Ashi points to find site of injection
- Ashi points found along related channels (Jia Ji points for heart may be injected)
- Traumatic injury: greatest Ashi point or origin / insertion of major muscle to help slipped disc; injection can also be made near spinal nerve roots
- Regular point may be used but should be used as little as possible
What are the indications for Acupoint Injection Therapy?
- Muscular-Skeletal issues
- Bronchitis, asthma, hypertension, peptic ulcer, ulcerative enteritis, impotence, neurasthenia, senile cerebral vascular dementia, sequelae of cerebral paralysis
- Other consideration:
- Let patient know that there may be local soreness / distention at the site with possible exacerbation of symptoms. Low-grade fever / side effects disappear after a few hours to a day.
- Take caution of any herbal interactions if more that one herb is injected
- Check patient for any allergies
- Lower amounts should be used on old / weak patients
- Injections should not be injected in the lumbosacral regions of pregnant women
- Medicine should not be injected joint capsules
- Glucose should not be injected in the superficial, but deep muscle tissue
What can you tell me about Laser Acupuncture?
- Can replace filiform needles to stimulate acupoints.
- Radiates Mono red beam diode laser: wavelength 6328 A (630 μm)
- Power: 1.5 mW
- Diameter of photo patch: 1-2 mm
- Can permeate 10-15 mm in depth
- Can directly reach most acupoints in the body
- Anti imflammation
- Promote metabolism
- Promote tissue growth
- Improve blood circulation
- Precautions: Avoid near eyes, cancerous growth, pregnant women, over-unclosed fontanelles in infants and children
What are the 5 Mechanisms of Energy (Heat) Transfer in the Body?
- Conduction: transfer through direct contact (ice massage, hydrocollator, ice pack)
- Convection: transfers through fluid (whirlpool)
- Conversion: energy change for one to another (Electrical to heat, Sount to heat, ultrasound)
- Radiation: emitted from anything above absolute zero (Sun, TDP, LASER, UV light)
- Evaporation: liquid to gas removing thermal energy from body
What can you tell me about Cryotherapy?
- Temp range: 32oF to 65oF
- Skin must be lowered to ~57oF (normal skin temp 91oF; 57oF - decreases local blood flow, 58oF analgesia occurs)
- Cooler than: Skin > adipose > muscular
- Cold therapy thought to activate mechanism of heat conservation in the body's core.
- Sensation of therapy: cold, burning, aching, analgesia
- acute injury inflammation, pain, acute / chronic muscle spasm, restore range of motion (ROM), small superficial 1st degree burns
- Post surgical pain & edema
- Post exercise
- Cardiac or respiratory involvement
- Uncovered open wounds
- Circulatory insufficiency
- Cold allergy
- Anesthetic skin
- Advanced diabetes
- Peripheral Vascular Disease
- Local Effect: decrease metabolism leading to decrease need for oxygen, lower tissue temp, vasoconstriction, decrease production of cellular waste, prevents / limits swelling, increase pain threshold, decrease acute & chronic muscle spasms, limits area of orignial injury
- Precautions: Pain may occur during exercise after treatment, Cold pack over nerves may cause palsy, Uticaria (hives)
What are some applications of Cryotherapy?
- Ice Message: 5-15 mins, reduces pain desensitizes Ashi points (not for acute inflammatory stage)
- Ice Pack: beware of frostbite, use insulating layer in between
- Cryo-cuff / Polar Care: ~ 40 mm Hg
- Cold Water Immersion:
- Ice Bucket: 40o-50oF
- Whirlpool: 50o-60oF
- Vapocoolant Spray: superficial, rapid cooling through evaporation
What are some methods of Ice with Compression?
- Circumferential: compression around entire area (ace wrap)
- Collateral: compression on both sides (aircast, gelcast)
- Focal: direct pressure to soft tissue surrounded by bony structure (horseshoe)
What can you tell me about Thermotherapy?
- Used during sub acute and chronic stages
- Superficial: can increase skin temp to 104o-113oF; heat through conduction; depth of heating effect: <2cm
- Deep: Ultrasound & Shortwave Diathermy; depth of heating effect: >2cm
- Treatment Effects:
- First 5-6 mins: body absorbs heat faster than can dissipate
- After 7-9 mins: temp gradients begin to even out & slightly decline
- Body begins the counteract: blood comes to area to cool it down
- Rebound vasoconstriction
- Vasoconstriction occurs after 20 mins of treatment where vasodialation occurs
- Indications: sub acute and chronic phases, increased: range of motion, lymphatic drainage, blood flow, cellular metabolic rate, body temperature, pulse rate, respiratory rate; decreased: pain, muscle spasm
- Contraindications: Acute injury, open wounds, heat stress / illness, neurovascular deficits (loss of sensation & impaired circulation), thrombophlebitis (clots can be dislodged), neoplasm, adipose tissue (more fat, harder to heat)
- Precautions: burns, mottling (discoloration)
What are some applications of Thermotherapy?
- Parafin Bath (125o-127oF)
- Analgesic Balm
What can you tell me about Contrast Therapy?
- Alternating Cryo and Thermo therapies
- Results in vaso constriction / dialation in area
- Stimulates venous and lymphatic return
- If you heat up on body part, you can heat the system