PowerPoint 演示文稿 - Shiyan

PowerPoint 演示文稿 - Shiyan

1 1972 NIH97 2 183

3 4 5 6 7 8 2017-08-11 04:38:34

4000 SCI SPARCS 2000 USD

-- / WIKIPEDIA: The debated distinction between dry needling and acupuncture has become a controversy because it relates to an issue of scope of practice of various professions.

WIKIPEDIA: Controversy Many physical therapists and chiropractors have asserted that they are not practici ng acupuncture when dry needling.[28] They assert that much of the basic physiologi cal and biomechanical knowledge that dry needling utilizes is taught as part of thei r core physical therapy and chiropractic education and that the specific dry needlin g skills are supplemental to that knowledge and not exclusive to acupuncture. How ever, the originators and proponents of dry needling acknowledged that certain as pects of this techniques were inspired by acupuncture although they also acknowle dge that the medical basis for it is purely Western Medicine in nature and therefor

e is not validly a subset of acupuncture and is a separate medical process. Many ac upuncturists have argued that dry needling appears to be an acupuncture techniqu e requiring minimal training that has been re-branded under a new name ("dry nee dling"). Definition (Dry Needling)Dry Needling)) trig)g)er point Definition by WIKIPEDIA: Dry needling, also known as myofascial trigger point dry needling,[1][2][3][4] is

the use of either solid filiform needles (also referred to as acupuncture needles) or hollow-core hypodermic needles for therapy of muscle pain, including pain related to myofascial pain syndrome. Dry needling is sometimes also known as intramuscul ar stimulation (IMS). Orig)in and Development Janet G. Travell 1940 Simons Myofascial Pain and Dysfunction The Trig)g)er Point Manual WIKIPEDIA: The origin of the term dry needling is attributed to Janet G. Travell, M.

D. In her book, 'Myofascial Pain and Dysfunction: Trigger Point Manual', Dr. Travell us es the term "dry needling" to differentiate between two hypodermic needle techniqu es when performing trigger point therapy. However, Dr. Travell did not elaborate on t he details on the techniques of dry needling; the current techniques of dry needling were based on the traditional and western medical acupuncture. The two techniques Dr. Travell described are the injection of a local anesthetic and the mechanical use of a hypodermic needle without injecting a solution. Janet G. Travell, MD 1901-1997

WIKIPEDIA: Dry needling is a neurophysiological evidence-based treatment technique that requires effective manual assessment of the neuromuscular system. Physical therapists are well trained to utilize dry

needling in conjunction with manual physical therapy interventions. COCHRANE COLLABORATION REVIEW: Acupuncture was defined as "the diagnosis was made using traditional acupuncture theory." Dry-needling) was defined as "the cause of pain was diagnosed as 'myofascia pain syndrome, the points were chosen by palpation in the muscle."

WIKIPEDIA: Dr. Travell preferred a 22-gauge, 1.5-in hypodermic needle for trigger point therapy and used this needle for both injection therapy and dry needling. Dr. Travell never used an acupuncture needle. Dr. Travell had access to acupuncture needles but reasoned that they were far too thin for trigger point therapy. She preferred hypodermic needles because of their strength and tactile feed back: A 22-gauge, 3.8-cm (1.5-in) needle is usually suitable for most superficial muscles. In hypera lgesic patients, a 25-gauge, 3.8-cm (1.5-in) needle may cause less discomfort, but will not provide t he clear feel of the structures being penetrated by the needle and is more likely to be deflected by the dense contraction knots that are the target A 27-gauge needle, 3.8-cm (1.5-in) needle is e ven more flexible; the tip is more likely to be deflected by the contraction knots and it provides les s tactile feedback for precision injection (Travell, Simons, & Simons, 1999, p. 156).

COCHRANE COLLABORATION REVIEW: Acupuncture was defined as "the diagnosis was made using traditional acupuncture theory and needles were inserted in classic meridian points, extra points or ah-shi points (painful points)." Dry-needling) was defined as "the cause of pain was diagnosed as 'myofascia pain syndrome,' the points were chosen by palpation in the muscle, and needles were

inserted into these myofascial trigger points." myofascial pain syndrome Cochrane Collaboration Review: Dry needling is a technique that uses needles to treat myofascial pain in any body part, including the lower back region.

20-30 Cochrane Review: Dry needling uses the technique of local twitch response on the trigger points. According the Cochrane Review, the needles are not left in situ except in DiLorenzos report in which he left needles for 5 minutes and used the acupuncture twirling technique to create the Deqi response.

WIKIPEDIA: Many physical therapists and chiropractors have asserted that they are not practicing acupuncture when dry needling. [28] The Attorney General was asked for an opinion by the North Carolina Acupuncture Licensing Board which he gave date d Dec 1st, 2011 saying that "In our opinion, the Board of Physical Therapy Examiners may determine that dry needling i s within the scope of practice of physical therapy if it conducts rulemaking under the Administrative Procedure Act and adopts rules that relate dry needling to the statutory definition of practice of physical therapy." [33] But that is a matter of opinion and not a matter of law. The North Carolina Rules Review Committee of the legislative branch found that the N orth Carolina Physical Therapy Board had no statutory authority for the proposed rule. [33] The Physical Therapy board su

bsequently decided that they had the right to declare dry needling within scope anyway "the Board believes physical ther apists can continue to perform dry needling so long as they possess the requisite education and training required by N.C. G.S. 90-270.24(4), but there are no regulations to set the specific requirements for engaging in dry needling.". [34] WIKIPEDIA:

Dry needling is a neurophysiological evidence-based treatment technique that req uires effective manual assessment of the neuromuscular system. Physical therapist s are well trained to utilize dry needling in conjunction with manual physical therap y interventions. Research supports that dry needling improves pain control, reduce s muscle tension, normalizes biochemical and electrical dysfunction of motor end p lates, and facilitates an accelerated return to active rehabilitation.

Dry needling) versus acupuncture: the ong)oing) debate : The other argument lies in the training of PTs in DN. The practice of acupuncture by trained clinicians requires enhanced experience. In most states and countries, the practice of acupuncture requires hundreds and often thousands of hours of acupuncture education in specialised educational programmes. In the USA, the practice of acupuncture requires state licensure, which is based on passing national level examinations and maintaining good professional records. The practice of acupuncture is governed by the acupuncture or medical board of the state educationdepartment in most states across the USA. By contrast, current training of DN for PTs in the USA is done only through continuing education or certificate programmes, which are not strictly regulated and have few (if any) standards that need to be complied with. With these non-formal training programmes in DN, acupuncturists argue that PTs exposure, experience and skills in needling therapy are likely to be limited.6 Additionally, evaluation systems for the practice of DN by PTs are currently

unavailable, and standards for healthcare governing administrations and policymakers are not yet established. : - - - .

300 :

: .

WIKIPEDIA: Case in Oreg)on state and action done by AMA In January 2014, The Oreg)on Court of Appeals ruled that the Oregon Board of Chiropractic Examiners did not have the sta tutory authority to include dry needling in the scope of practice for chiropractors in that state. The ruling did not address whether chiropractors have the medical expertise to use dry needling or whether the training they were being given was a dequate.[27]Pending further discussion of training requirements the Oregon Physical Therapist Licensing Board has advised all Oregon physical therapists against practicing dry needling. They have not changed their ruling that dry needling is withi n the scope of practice for Oregon Physical Therapists. [38] The American Medical Association adopted a policy in 2016 that said physical therapists and other non-physicians practici ng dry needling should at a minimum have standards that are similar to the ones for training, certification, and continu

ing education that exist for acupuncture. AMA board member Russell W. H. Kridel, M.D. stated "Lax regulation and nonexi stent standards surround this invasive practice. For patients' safety, practitioners should meet standards required for licen sed acupuncturists and physicians." [39] Comparison of Acupuncture and Dry Needling for the Treatment of Pain Jennie Longbottom: Acupuncture In Manual Therapy published by Churchill Livingston Elservier, 2010 1

2 1985 10

1997 6 2002 8 2

2012 18 2016 8 (From the discussion on the definition of acupuncture held on May 10, 2017, Beijing)

3 1

2 3 3 1 2 3

WIKIPEDIA: Dry needling), also known as myofascial trigger point dry needl ing,[1][2][3][4] is the use of either solid filiform needles (also referr ed to as acupuncture needles) or hollow-core hypodermic nee dles for therapy of muscle pain, including pain related to myof

ascial pain syndrome. Dry needling is sometimes also known a s intramuscular stimulation (IMS). Acupuncture is a broad cate gory of needling practices with solid filiform needles. Modern acupuncture notably includes both traditional and Western m edical acupuncture; dry needling) is arg)uably one subcateg)ory of western medical acupuncture.[1] WILIPEDIA:

Acupuncture is a form of alternative medicine in which thin needles are inserted into the body . It is a key component of Traditional Chinese Medicine (TCM). TCM theory and practice are not based upon scientific knowledge, and acupuncture is a pseudoscience.

Conclusions: Sham acupuncture: JAMA 2005 BMJ 2005 JAMA 2014

Western Medical Acupuncture ---- Wikipedia - SPARC Stimulating) Peripheral Activities to Relieve Conditions

SPARC Stimulating) Peripheral Activities to Relieve Conditions

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