Feasibility Study of Laser Acupuncture on Static Balance in Healthy Elderly Women: Pilot Study

Transcription

1 , pp Feasibility Study of Laser Acupuncture on Static Balance in Healthy Elderly Women: Pilot Study Wonjae Choi 1, Sajin Tak 2, Jongeun Yim 2, Seungwon Lee 2 1 Institute of Rehabilitation Science, Hwarangro 815, Nowon-gu, Seoul , Republic of Korea. 2 Department of Physical Therapy, Sahmyook University, Hwarangro 815, Nowon-gu, Seoul , Republic of Korea. Abstract. The present study was designed to determine whether laser acupuncture improves balance in healthy elderly women immediately. Twenty five subjects screened to the welfare center were participated in laser acupuncture group. They were treated by laser acupuncture stimulation of equilibrium area on scalp acupoint. Needles were contacted at a 90-degree angle. So, hair net band was worn. Laser acupuncture was applied for 20 m in sitting posture with eye closed. Static balance was assessed before and after the intervention. After the intervention, the postural sway was increased, but no statistically significant differences were found at baseline. Only anterioposterior postural sway was significantly increased (p<0.05). In healthy elderly women, scalp laser acupuncture does not the effect in static balance. However, this study provides a plan for future research. Keywords: Laser, Acupuncture, Elderly, Postural Balance 1 Introduction The elderly show reduced volume of the cerebrum and the cerebellum compared to the young, which leads to decline of balance control [1]. As the average life span and life expectancy are extended, disorders caused by balance problems will be increased and more serious. Falling accidents, which account for 14% of emergency hospitalization of the elderly, become the cause of injury-related deaths and bring about loss of mobility, dysfunction, lowered quality of life and fear of falling [2]. Therefore, balance control for the elderly is one of the most important physical factors that directly affect their daily lives. Generally, acupuncture has been used to reduce pain and to treat musculoskeletal system disorders [3], but its application is now being expanded to various fields. 1 Please note that the LNCS Editorial assumes that all authors have used the western naming convention, with given names preceding surnames. This determines the structure of the names in the running heads and the author index. ISSN: ASTL Copyright 2015 SERSC

2 Laser acupuncture is suggested as an effective method that substitutes the effect of acupuncture therapy with metal needle [4, 5]. Because laser acupuncture is easy to use and non-invasive, it can be applied to patients who have needle phobia [6, 7]. Laser acupuncture provides physiological effect in cytological level by supplying sufficient energy based on photobiomodulation by laser as well as stimulation by needles [8]. In a recent study, seniors' postural control was improved with the application of laser acupuncture and Auriculotherapy [9]. 2 Method 2.1 Participants Elderly women over 65 years old were recruited through an ad-poster in M welfare center of Seoul. The inclusion criteria were those who are able to stand independently and stably without help of aids and who have had no falling accidents. Those with vestibular, cerebellum, and musculoskeletal disorders, which could affect balance and those with neurological medical history such as stroke and Parkinson's disease were excluded. 2.2 Apparatus & Procedure In this study, laser needles (Laserneedel GmbH, Original Laserneedle, Berlin, Germany) were applied as scalp acupuncture that stimulates the cerebellum to improve the balance of participants. This laser device, the 3B class, is laser wavelength 658nm, distal output 40mW, frequency 1~10,000 Hz and power density 20 W/cm 2. As an early evaluation, Good balance system was used to estimate static balance. Laser needle was applied for 20 minutes in equilibrium area on scalp acupoint, and then static balance was estimated again after 1 minute of break. The subjects who received the treatment sat on the chair comfortably with their eyes closed during laser needle application. It is difficult to apply laser needle vertically due to the hair, so the subjects wore hair nets to fix their laser needle while assistants were continuously supervising. Static balance was estimated 3 times per each eye open and eye closed condition, and then the average values were recorded. The procedure of the study went through deliberation of Sahmyook University Institutional Review Board. 2.3 Data analysis All statistical analysis was performed using SPSS 19.0 software (SPSS Inc., Chicago, IL, USA). Data are presented as mean and standard deviation as indicated in the text and tables. The general characteristics of the subjects were displayed by descriptive statistics, and Shapiro-Wilk test was performed for test of normality of a dependent 20 Copyright 2015 SERSC

3 variable. To check changes by arbitration, repeated ANOVA was used. Significance level was Results This cohort study was performed with 25 elderly women average age Their man BMI was kg/cm2, and the falling was experienced 0~2 times (mean 0.56 times). The characteristics of subjects are presented in Table 1. There was no significant improve in static balance after laserneedle intervention. Only anterioposterior postural sway was statistically significant in eye opened condition (p<0.05) (Table 2) Table 1. Baseline demographic characteristics of subjects Laserneedle acupuncture (n=25) Sex (male/female) 0 / 25 Age (year) ± 5.41 Body weight (kg) ± 6.49 Height (cm) ± 5.52 Body mass index (kg/cm 2 ) ± 2.57 Experience of falls (time) 0.56 ± 0.58 Values are presented as mean ± SD Table 2. Change of static balance in according to laser radiation Laserneedle acupuncture F(p) Eye open X Y Pre-test 5.51 ± 2.67 Post-test 5.92 ± 3.00 Changes 0.41 ± (0.239) Pre-test 7.61 ± 2.52 Post-test 8.48 ± 2.92 Changes 0.87 ± (0.018) Copyright 2015 SERSC 21

4 Eye closed V (mm 2 /s) X Y V (mm 2 /s) Pre-test ± Post-test ± Changes 1.10 ± (0.559) Pre-test 6.48 ± 4.26 Post-test 6.91 ± 4.25 Changes 0.44 ± (0.239) Pre-test ± 5.58 Post-test ± 5.04 Changes 0.77 ± (0.274) Pre-test ± Post-test ± Changes 4.60 ± (0.361) 4 Discussion In this study, there was no significance in the result of applying laser acupuncture to acupuncture point for elderly people's balance. Acupuncture has been practiced in China based on the existence of meridians and energy flow, and currently it is a part of alternative medicine in many countries. Since 1970, many researches have been performed to find the base of acupuncture's pain relief effect, and now it is broadly applied to treatment of various diseases [10]. Neurophysiological mechanisms of acupuncture are not yet unclear, but stimulation on the cerebrum and the cerebellum was confirmed in human and animal studies [1]. In China or global, acupuncture is widely used, but it does not give any benefit instantly to elderly women as shown in this study. One potential limitation of this study is that all the subjects are healthy enough, which is why there might not be large changes of postural sway. There are several researches that report the result that there is no significant difference between real acupuncture and sham acupuncture [11-13]. In the precedent study, laser acupuncture with long treatment time and strong laser showed effective result [14]. In this study, strong energy of laser acupuncture was used. However, the duration time was short and the session was only one time, so the effect was insufficient in that the suitable laser wavelength wasn't found. Therefore, Whittaker mentioned that in laser acupuncture, effective application of laser is not easy due to the variety of wavelength, irradiance and beam profile [5]. It is thought that in the future researches of scalp acupuncture, the strength of laser should be adjusted in consideration of energy loss caused by hair, and application time should be divided by stages to confirm effective duration. Besides, it should be 22 Copyright 2015 SERSC

5 applied to treatment of not only elderly women but also those with other sex or balance disorder, and the effect of long term application should also be checked. References 1. Jernigan TL, Archibald SL, Fennema-Notestine C, Gamst AC, Stout JC, Bonner J, et al.: Effects of age on tissues and regions of the cerebrum and cerebellum. Neurobiology of aging.22, (2001) 2. Tinetti ME, Williams CS.: The effect of falls and fall injuries on functioning in community-dwelling older persons. The journals of gerontology Series A, Biological sciences and medical sciences.53, M (1998) 3. Lu TW, Wei IP, Liu YH, Hsu WC, Wang TM, Chang CF, et al.: Immediate effects of acupuncture on gait patterns in patients with knee osteoarthritis. Chinese medical journal.123, (2010) 4. Al Rashoud A, Abboud R, Wang W, Wigderowitz C.: Efficacy of low-level laser therapy applied at acupuncture points in knee osteoarthritis: a randomised double-blind comparative trial. Physiotherapy.100, (2014) 5. Whittaker P.: Laser acupuncture: past, present, and future. Lasers in medical science.19, (2004) 6. Lin ML, Wu HC, Hsieh YH, Su CT, Shih YS, Lin CW, et al.: Evaluation of the effect of laser acupuncture and cupping with ryodoraku and visual analog scale on low back pain. Evidence-based complementary and alternative medicine : ecam.2012, (2012) 7. Litscher G.: High-tech laser acupuncture is Chinese medicine. Medical Acupuncture.20, (2008) 8. Peplow PV, Chung TY, Baxter GD.: Laser photobiomodulation of proliferation of cells in culture: a review of human and animal studies. Photomedicine and laser surgery.28 Suppl 1, S3-40 (2010) 9. Bergamaschi M, Ferrari G, Gallamini M, Scoppa F.: Laser acupuncture and auriculotherapy in postural instability--a preliminary report. Journal of acupuncture and meridian studies.4, (2011) 10. Wu MT, Hsieh JC, Xiong J, Yang CF, Pan HB, Chen YC, et al.: Central nervous pathway for acupuncture stimulation: localization of processing with functional MR imaging of the brain--preliminary experience. Radiology.212, (1999) 11. Moffet HH.: Sham acupuncture may be as efficacious as true acupuncture: a systematic review of clinical trials. Journal of alternative and complementary medicine (New York, NY).15, (2009) 12. Park J, White AR, James MA, Hemsley AG, Johnson P, Chambers J, et al.: Acupuncture for subacute stroke rehabilitation: a Sham-controlled, subject- and assessor-blind, randomized trial. Archives of internal medicine.165, (2005) 13. Tough L.: Lack of effect of acupuncture on electromyographic (EMG) activity--a randomised controlled trial in healthy volunteers. Acupuncture in medicine : journal of the British Medical Acupuncture Society.24, (2006) 14. Schlager A, Offer T, Baldissera I.: Laser stimulation of acupuncture point P6 reduces postoperative vomiting in children undergoing strabismus surgery. British journal of anaesthesia.81, (1998) Copyright 2015 SERSC 23