Practising tai chi twice a week can help Parkinson’s patients improve their balance and walking ability, according to an American study. A randomised, controlled trial assigned 195 Parkinson’s patients with mild to moderate disease to one of three groups: tai chi, resistance training or stretching. The patients engaged in 60-minute exercise sessions twice weekly for 24 weeks. The tai chi group performed consistently better than the resistance-training and stretching groups in a number of postural stability tests. The tai chi group also performed better than the stretching group in all secondary outcomes (including measures of gait and strength, functional-reach and timed up-and-go tests) and outperformed the resistance-training group in stride length and functional reach. Tai chi lowered the incidence of falls compared with stretching, but not compared with resistance training. The effects of tai chi training were maintained at three months after the intervention. (Tai chi and postural stability in patients with Parkinson’s disease. N Engl J Med. 2012 Feb 9;366(6):511-9).

Seniors who practice tai chi regularly demonstrate improved arterial compliance (the ability of arteries to expand and contract with the pumping of the heart), as well as increased leg muscle strength, according to a Hong Kong study. Arterial compliance is an important predictor of cardiovascular health in the elderly and a therapeutic target for physical exercise in the prevention of cardiovascular disease. Twenty-nine elderly subjects, who had practised tai chi for at least 1.5 hours a week for three years, were compared with 36 age-matched subjects with no tai chi experience. The tai chi practitioners scored better than controls in almost all haemodynamic parameters, including blood pressure, vascular resistance and pulse pressure. Previous studies have shown that strength training, which improves muscle function, is accompanied by a decline in arterial compliance. The authors conclude that the combined beneficial effects of tai chi on vascular health and muscle strength make it a good exercise strategy for older adults. (Tai Chi, arterial compliance, and muscle strength in older adults. Eur J Prev Cardiolog. 2012 Apr 4. [Epub ahead of print]).

A discussion paper by a team of American authors argues that the ability of acupuncture to affect heart rate variability (HRV) might explain how it is able to regulate complex physiological systems. Heart rate variability (HRV), the beat-to-beat fluctuation in cardiac rhythm, results from the regulation of the heart by the autonomic nervous system (ANS). Low HRV is associated with increased risk of all-cause mortality and is a marker for a wide range of diseases. Coherent HRV
patterns are associated with increased synchronisation between the two branches of the ANS, and when sustained for long periods of time result in increased synchronisation and entrainment between multiple body systems. Then authors propose that acupuncture may function by mediating global physiological regulation through improvement of HRV and synchronisation of the two branches of the ANS. This view, which is in alignment with systems biology and complexity
theory, is also congruent with Chinese medical theory, which considers the Heart to be the ‘ruler’ of the internal organs. The authors suggest that future research into the mechanisms of acupuncture should focus on HRV and other systems-level markers of physiological function rather than on specific molecular markers that are more appropriate for investigating complex interventions. (Acupuncture and heart rate variability: a systems level approach to understanding mechanism. Explore(NY).2012 Mar-Apr;8(2):99-106).

Acupuncture at Taixi KID-3 can enhance activity in brain areas associated with memory in patients suffering from mild cognitive impairment (MCI). Chinese investigators performed fMRI while subjects received deep (DA) or superficial acupuncture (SA) at acupoint Taixi KID-3. The scans showed abnormal functional connectivity in the temporal regions (hippocampus, thalamus, fusiform gyrus), which are implicated in memory encoding and retrieval. Following DA there were significant, persistent enhancements functional connectivity in these regions compared with SA, suggesting that deep insertion of acupuncture needles is necessary to achieve a clinical effect. (FMRI connectivity analysis of acupuncture effects on the whole brain network in mild cognitive impairment patients. Magn Reson Imaging. 2012 Jun;30(5):672-82).

There are currently no recommended medical treatment options for threatened miscarriage. In a debate article, Australian authors discuss the physiological processes of early pregnancy loss, together with the possible benefits of providing supportive acupuncture care. Since acupuncture has demonstrated beneficial hormonal responses with decreased miscarriage rates in the context of fertility research, it may promote specific beneficial effects in early pregnancy and thus provide a much-needed therapeutic effect for women presenting with threatened miscarriage. (Acupuncture as a therapeutic treatment option for threatened miscarriage. BMC Complement Altern Med. 2012 Mar 22;12:20).

Acupuncture can reduce anxiety symptoms in women undergoing IVF, according to a team of Brazilian researchers.  Forty-three women undergoing IVF were randomly allocated to two groups: a test group who received verum acupuncture (at Shenmen HE-7, Neiguan P-6, Shanzhong REN-17, Baihui DU-20 and Yintang M-HN-3), and a control group who had needles inserted in areas near, but not corresponding to, acupuncture points. Treatment consisted of four weekly sessions. The mean anxiety score after the four-week experimental period was significantly lower in the test group compared with the control group (19.4 vs 24.4). (Effect of acupuncture on symptoms of anxiety in women undergoing in vitro fertilisation: a prospective randomised controlled study. Acupunct Med. 2012 Apr 12. [Epub ahead of print]).

A novel acupuncture treatment strategy called dense cranial electro-acupuncture stimulation (DCEAS) has been shown to enhance anti-depressant efficacy in the early phase of selective serotonin reuptake inhibitor (SSRI) treatment for major depressive disorder (MDD). DCEAS involves the electrical stimulation of acupuncture points on the head (including Baihui DU-20, Yintang M-HN3, Sishencong M-HN-1, Toulinqi GB-15, Taiyang M-HN-9, Shuaigu GB-8 and Touwei ST-8), with the rationale that this may stimulate the release of serotonin (5-HT) and other neurochemicals in the brain. In a single-blind, randomised controlled study carried out in Hong Kong, 73 patients were randomly assigned to DCEAS or a control non-invasive electro-acupuncture (n-EA) procedure, in combination with the drug fluoxetine (FLX, Prozac) for three weeks. Patients treated with DCEAS displayed a significantly greater reduction in depression scores at days three and 21 compared with patients receiving n-EA.  (Dense cranial electroacupuncture stimulation for major depressive disorder-a single-blind, randomized, controlled study. PLoS One. 2012;7(1):e29651).

A Chinese research group has found that acupuncture at Hegu L.I.-4 is significantly more effective for the treatment of chronic low back pain (CLBP) than standardised acupuncture, especially in the long term. A total of 187 patients with CLBP were randomised to ‘Hegu acupuncture’, standardised acupuncture or usual care. All received 18 treatments over seven weeks. The results showed that both acupuncture modes were beneficial compared with usual care. Disability scores at eight weeks were 5.3 for Hegu acupuncture, 4.2 for standardised acupuncture and 2.1 for usual care. At 48 weeks, the scores were 5.7 for Hegu acupuncture, 4.6 for standardised acupuncture and 3.3 for usual care. Differences in visual analogue pain scores showed a similar pattern. Statistical analysis showed a significant difference between the two acupuncture groups in favour of Hegu acupuncture, as well as between usual care and both acupuncture groups, in favour of acupuncture. (Hegu acupuncture for chronic low-back pain: a randomized controlled trial. J Altern Complement Med. 2012 Feb;18(2):130-6).

A major national survey of practitioners of acupuncture in the UK concludes that acupuncture provides a substantial contribution to the country’s healthcare. A team of UK authors conducted a cross-sectional survey of 800 practitioners randomly chosen from the four major national acupuncturists’ professional associations. Data collected included demographic details, association membership, statutorily regulated status, practice setting, style of acupuncture practised, diagnostic methods used and needle response sought. Practitioners additionally recorded details of their 10 most recent patients, including demographic details, primary reason for consulting and lifestyle advice provided. Of the 330 practitioners who responded, 29% were doctors, 29% physiotherapists, 15% nurses and 27% independent acupuncturists. Of these, 62% were women with a median age of 48 years. The majority (68%) practised in independent settings, while 42% practised within the National Health Service. Patients most commonly consulted for low back, neck, shoulder and knee pain, as well as headaches and migraine. Treatment for infertility by independent acupuncturists was found to have increased fivefold over a period of years. Based on the survey results, the authors estimate that four million acupuncture treatments were provided in the UK in 2009, of which approximately one-third were provided within the NHS. They conclude that the primary complaints for which patients consult acupuncturists reflect the growing evidence base on acupuncture for these conditions, and suggest that the survey data provides a basis for future decision-making regarding policy and practice. (Acupuncture in practice: mapping the providers, the patients and the settings in a national cross-sectional survey. BMJ Open. 2012 Jan 11;2(1):e000456. Print 2012).