Made available in DSpace on 2014-10-09T12:54:12Z (GMT). No. of bitstreams: 0 / Made available in DSpace on 2014-10-09T14:07:44Z (GMT). No. of bitstreams: 1 12697.pdf: 655472 bytes, checksum: 17722971c9d58d20dbb9095955c414c4 (MD5) / Dissertacao (Mestrado Profissionalizante em Lasers em Odontologia) / IPEN/D-MPLO / Instituto de Pesquisas Energeticas e Nucleares - IPEN/CNEN-SP; Faculdade de Odontologia, Universidade de Sao Paulo , Sao Paulo

Orientador: Evanisi Teresa Palomari / Tese (doutorado) - Universidade Estadual de Campinas, Instituto de Biologia / Made available in DSpace on 2018-08-10T18:15:43Z (GMT). No. of bitstreams: 1 Politti_Fabiano_D.pdf: 862982 bytes, checksum: e7f128f64db3385d3565211be8cbaf2e (MD5) Previous issue date: 2007 / Resumo: Os avanços nos conhecimentos em neurofisiologia permitiram definir que a acupuntura é um método de estimulação neural periférica, que provoca respostas reflexas, locais e sistêmicas. Portanto, o objetivo deste trabalho foi verificar se a eletromiografia de superfície pode ser utilizada como ferramenta de estudo da ação da acupuntura auricular (AA) sobre o músculo estriado esquelético e se a AA interfere na freqüência do sinal eletromiográfico (EMG) do músculo. Assim, foi analisado a amplitude sinal EMG normalizado das porções clavicular, acromial e escapular do músculo deltóide e da porção descendente do músculo trapézio com 20%, 40% e 60% da contração voluntária máxima, em 15 indivíduos voluntários saudáveis, após o tratamento com AA. A freqüência média do sinal EMG foi obtida do músculo trapézio descendente. Na coleta dos dados foi utilizado um eletromiógrafo de 8 canais com freqüência de amostragem de 1.33 kHz. Para verificar a diferenças entre os valores em RMS (root mean square) obtidos por meio de janela móvel de 200 ms, foi utilizado o teste de Friedman. Nos casos em que os resultados se apresentaram significantes o teste de Wilcoxon foi utilizado para comparações múltiplas. O nível de significância adotado foi de p < 0,05 e para as comparações Nesse estudo concluiu-se que a eletromiografia de superfície pode ser utilizada como ferramenta na análise dos efeitos da AA sobre a atividade do músculo e que o método utilizado para gravar o sinal EMG pode influenciar os resultados. Além disso, a AA pode atuar como mecanismo modulador da atividade do músculo, determinando o numero de unidades motoras recrutadas e a sua média da freqüência de disparo de acordo com o nível de força adotada durante uma tarefa realizada com contração isométrica / Abstract: The advancement of knowledge in neurophysiology has demonstrated that acupuncture is a method of peripheral neural stimulation that promotes local and systemic reflexive responses. The purpose of this study was to determine if surface electromyography can be used as a tool to study the action of auricular acupuncture (AA) on the striated skeletal muscle and if auricular acupuncture interferes with the frequency of the EMG signal of the muscle. The EMG amplitudes of the anterior, middle and posterior deltoid muscle and the upper trapezium muscle with 20%, 40% and 60% of maximal voluntary contraction (MVC) of 15 healthy volunteers, were analyzed after the individuals were submitted to the AA treatment. The median frequency (MF) surface electromyography (EMG) recordings were obtained from the upper trapezius muscle. The nonparametric Friedman test was used to compare Root Mean Square (RMS) values estimated by using a 200 ms moving window. Significant results were further analysed using the Wilcoxon signed rank test. In this exploratory study, the level of significance of each comparison was set to p < 0,05. It was concluded in this study that a surface EMG can be used as a tool to investigate possible alterations of electrical activity in muscles after AA, however there is still a lack of adequate methodology for its use in this type of study, being that the method used to record the EMG signal can also influence the results. The AA peripheral stimulus can act as a modulator mechanism of muscle activity, as a result of the number of motor units recruited and their mean discharge frequency of excitation according to the level of force adopted during a task carried out with isometric contraction / Doutorado / Anatomia / Doutor em Biologia Celular e Estrutural

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / As mulheres sÃo acometidas por sintomas de ansiedade generalizada no climatÃrio/menopausa, gerando um sofrimento psÃquico que influencia negativamente sua qualidade de vida. Destarte, surge uma demanda por abordagens naturais, como a acupuntura, que minimizem os efeitos adversos provocados pelas medicaÃÃes convencionais e que funcionem como fonte de autoconhecimento e responsabilidade na saÃde individual e coletiva. Os objetivos deste estudo foram avaliar a acupuntura como terapÃutica complementar em mulheres de um Centro de AtenÃÃo Psicossocial (CAPS), bem como identificar a intensidade das suas queixas difusas antes e depois da aplicaÃÃo da acupuntura e relacionar a intensidade das mesmas com fatores sÃcio-demogrÃficos. Estudo do tipo experimental, misto (uni-cego e aberto), randomizado e prospectivo, que teve como instrumentos para a coleta de dados a Escala de Ansiedade de Hamilton - HAMA adaptada por Souza (2004), realizado no Centro de AtenÃÃo Psicossocial Prof. Frota Pinto (CAPS III). Foram observados os procedimentos Ãticos exigidos para a realizaÃÃo da pesquisa e selecionadas 30 mulheres obedecendo os critÃrios de inclusÃo e exclusÃo, avaliando a HAMA-ANTES e divididas aleatoriamente em dois grupos com acupuntura verdadeira (GT) e acupuntura placebo (CP), as quais foram submetidas a 10 aplicaÃÃes, uma vez por semana, quando avaliamos a HAMA-DEPOIS. Quatorze mulheres em tratamento no CAPSIII formaram outro grupo controle com medicaÃÃo (CM) e tiveram a HAMA-DEPOIS avaliada. Os dados foram processados pelo programa Statistical Package for Social Science - SPSS, versÃo 11.0. Os grÃficos foram gerados no programa GraphPad Prism, versÃo 4). Os resultados mostraram que as participantes tÃm idade entre 41 e 60 anos (81,8 %), sÃo casadas (47,7%), com escolaridades de 1 (47,7%) e 2 (36,3%) graus, praticam o catolicismo (77,7%), trabalham em casa (50,0%), sem filhos (36,3%) ou poucos filhos (43,2%) e com renda familiar de 1 a 2 salÃrios mÃnimos (65,9%), tÃm baixo sedentarismo (31,8%), sÃo insatisfeitas profissionalmente (61,4%), tiveram puberdade conturbada (63,6%), tÃm experiÃncia de vida marcada por traumas emocionais e/ou fÃsicos (75,0%), apresentam sintomas psicofÃsicos manifestados no climatÃrio/menopausa (52,3%) e alto Ãndice de procedimentos cirÃrgicos (59,1%),as relaÃÃes conjugais insatisfatÃrias afetam a vida psicossomÃtica das mulheres (r= 6,363; p=0,012; n=30), e as que trabalham em casa tÃm maior probabilidade em desencadear sintomas de ansiedade, apesar de nÃo ser significante estatisticamente (r=6,356; p=0,096; n=30); nÃo houve correlaÃÃo significativa entre HAMA e as demais variÃveis sÃcio-demogrÃficas. Concluiu-se que a acupuntura reduziu significativamente os nÃveis de HAMA no CP e no GT; a acupuntura verdadeira foi mais segura e confiÃvel clinicamente; a acupuntura verdadeira e a medicaÃÃo reduziram os nÃveis de ansiedade das mulheres, podendo uma ou outra ser adotada isoladamente ou em combinaÃÃo; à necessÃrio que outros estudos com acupuntura sejam realizados envolvendo amostras maiores, alÃm de controlar melhor as variÃveis influenciadoras da ansiedade. à relevante mencionar que o conhecimento apreendido e produzido na sistematizaÃÃo da acupuntura como recurso viÃvel da assistÃncia à saÃde, pode integrar-se nas instituiÃÃes pÃblicas ou privadas, em nÃvel ambulatorial ou hospitalar, nas mais diversas especialidades / Women are disturbed with symptoms of general anxiety in climacteric years/ menopause, creating a mental suffering that adversely affects their life quality. Thus, arising a demand for natural approaches such as acupuncture, which reduces the adverse effects caused by conventional drugs working as a source of self-knowledge and responsibility for individual and collective health. The aims of this study were to assess the acupuncture method as a complementary therapy in women from the Center for Psychosocial Care (CAPS - Centro de IntegraÃÃo Psicossocial) and to identify the intensity of their diffused complaints before and after application of acupuncture and to relate their intensity with socio-demographic factors. Experimental, mixed (single-blind and open), randomized, prospective study, which had as instruments for collecting data the Hamilton Anxiety Scale - HAMA adapted by Souza (2004), held at the Center for Psychosocial Care Prof. Frota Pinto (CAPS III). We complied with the ethical guidelines required for making this research and selected 30 women obeying the criteria of inclusion and exclusion, evaluating the HAMA-BEFORE, randomly distributed into two groups with real acupuncture (GT) and placebo acupuncture (CP), which were subjected to 10 applications once a week, moment in which we assessed the HAMA-AFTER. Fourteen women in treatment at CAPS III completed another control-group making use of medication (CM) whom also received the HAMA AFTER. The Statistical Package Social Science Program was used to process the data - SPSS, version 11.0. We used GraphPad Prism program, version 4) to generate the graphics. The results indicated that the participants between 41 and 60 years old (81.8%) are married (47.7%), concluded Junior School Elementary (47.7%) and High School grades (36.3%), are catholic (77.7%), work at home (50.0%), have no children (36.3%) or few children (43.2%) and which family incomes vary from 1 to 2 living wages (65.9%), low inactivity (31.8%), professionally unfulfilled (61.4%), careworn puberty (63.6%) life experience marked by emotional and/or physical trauma (75.0%), present the climacteric symptoms, psychophysical / menopause (52.3%) and high rate of surgical procedures (59.1%), unsatisfactory conjugal relations affect their psychosomatic lives (r = 6363, p = 0012 n = 30), and those who work at home are liable to present symptoms of anxiety, although not statistically significant (r = 6356, p = 0096 n = 30) There was no significant correlation between HAMA and other socioâdemographic variables. We concluded that acupuncture reduced significantly the levels of HAMA on CP and GT groups. The effective acupuncture was lager and clinically reliable. The effective acupuncture and medication reduced the levels of anxiety among women, thence, both can be used singly or joinly. Further studies are needed involving larger, samples with regard to acupuncture, providing a better control of the most imported variables of anxiety. The knowledge acquired and produced during the systematization of acupuncture as of a viable use of health care, can be integrated in public or private institutions, at hospitals or policlinics and in a wide range of specialties

CoordenaÃÃo de AperfeiÃoamento de NÃvel Superior / A Acupuntura (Ac) e a Eletroacupuntura (EAc) tem sido amplamente utilizadas na prÃtica clÃnica para o tratamento de vÃrias doenÃas. A Medicina Tradicional Chinesa (MTC) preconiza o uso dos acupontos Zusanli (E-36) e Zhongwan (RM-12) para alÃvio dos sintomas de diabetes mellitus. Por aÃÃo da Ac e EAc, ocorre liberaÃÃo de opiÃides endÃgenos, incluindo &#946;-endorfinas, que comprovadamente estimulam a secreÃÃo de insulina. O objetivo desse estudo foi avaliar os efeitos da Ac e EAc nos acupontos E-36 e RM-12 sobre as concentraÃÃes de glicose e lactato no sangue, fÃgado e rim de ratos sadios. No presente estudo, 48 ratos foram divididos em 4 grupos (Valores Basais, Ac, EAc10Hz e EAc100Hz) e subdivididos em 2 subgrupos de acordo com os tempos de coleta dos substratos (T-30: imediatamente apÃs o tÃrmino da sessÃo de Ac ou EAc e T-60: 30 minutos apÃs o tÃrmino da sessÃo). Todos os ratos foram anestesiados e os grupos experimentais (Ac, EAc10Hz e EAc100Hz) foram submetidos, respectivamente, à Ac e à EAc (10 Hz e 100 Hz) nos acupontos E-36 e RM-12, durante 30 minutos. Foram dosadas as concentraÃÃes de glicose, lactato e LDH no sangue, fÃgado e rim dos animais nos tempos T-30 e T-60. A estimulaÃÃo dos acupontos E-36 e RM-12 por EAc de 10Hz reduziu significativamente a glicemia em ratos sadios, ao tÃrmino da estimulaÃÃo elÃtrica (190,80Â24,88 vs. 138,50Â21,09, p>0,001) e 30 minutos mais tarde (186,30Â23,76 vs. 134,10Â25,65, p>0,001). Utilizando-se uma freqÃÃncia 10 vezes maior (100Hz) demonstrou-se resultado semelhante (T-30, 186,30Â23,76 vs. 99,17Â8,79, p>0,001; e T-60, 190,80Â24,88 vs. 113,40Â7,37, p>0,001). A Ac nÃo alterou significativamente a glicemia. Houve tambÃm reduÃÃo significante das concentraÃÃes de LDH imediatamente apÃs o tÃrmino da sessÃo de acupuntura e 30 minutos depois, tanto nos animais submetidos à AC (T-30, 518,20 43,31 vs. 354,80Â44,66, p<0,001; T-60, 637,80Â61,01 vs. 325,70Â10,54, p<0,001) quanto à EA (10Hz: T-30, 518,20 43,31 vs. 286,50Â59,86, p<0,001; T-60, 637,80Â61,01 vs 268,80Â43,51, p<0,001 e 100Hz: T-30, 518,20 43,31 vs. 213,80Â24,85, p<0,001; T-60, 637,80Â61,01 vs 188,20Â24,00, p<0,001), sugerindo um menor metabolismo anaerÃbio. No presente estudo, a reduÃÃo significante do lactato sÃrico 30 minutos apÃs o inÃcio do estudo em ratos submetidos à EAc com 100 Hz sugere prevalÃncia da glicÃlise aerÃbica (2,10Â0,23 vs. 1,19Â1,02, p<0,001). Resultado semelhante foi observado nos nÃveis de lactato no fÃgado (T-60, 10 Hz: 1,92Â0,42 vs. 0,69Â0,29, p<0,001 e 100 Hz: 1,92Â0,42 vs. 0,44Â0,21, p<0,001) e rim (T-30, 100 Hz: 1,86Â0,87 vs. 0,91Â0,38, p<0,05). Os resultados deste estudo mostram que a Ac e a EAc nos animais hiperglicÃmicos podem reduzir as concentraÃÃes de glicose no sangue. FreqÃÃncias maiores tem maior efeito hipoglicemiante. A reduÃÃo da glicemia deve ser conseqÃÃncia da aÃÃo de opiÃides endÃgenos e da &#946;-endorfina, como sugerido em estudos anteriores. O mecanismo e reduÃÃo das concentraÃÃes de lactato e LDH parece estar relacionado a uma prevalÃncia da glicÃlise aerÃbica. / Acupuncture (Ac) and electroacupuncture (EAc) have been widely used in clinical practice for the treatment of various diseases. Traditional Chinese medicine (TCM) recommends the use of acupoints Zusanli (E-36) and Zhongwan (RM-12) for relief of symptoms of diabetes mellitus. Ac and EAc stimulation may release some endogenous opioids, including &#61666;- endorphins, enhancing insulin secretion. The aim of this study was to evaluate the effects of Ac and EAc on acupoints ST-36 and RM-12 on glycemia, lactacemia and liver and kidneys lactate concentrations in healthy rats. In this study, 48 rats were divided into 4 groups (baseline [GVB] , Ac, EAc10Hz and EAc100Hz) and subdivided into 2 subgroups according to the time of samples collection (T-30, immediately after the end of the session or Ac or EAc and T-60: 30 minutes after the end of the session). All rats were anesthetized and experimental groups (Ac, EAc10Hz and EAc100Hz) were submitted respectively to the EAc and Ac (10 Hz and 100 Hz) on acupoints ST-36 and RM-12 for 30 minutes. Glucose, lactate and LDH were assayed in the blood. Tissue lactate concentration was assayed in liver and kidney of rats at T-30 and T-60 timepoints. Stimulation of acupoints ST-36 and RM-12 by EAc 10Hz significantly reduced blood glucose levels in healthy rats, at the end of electrical stimulation (190.80  24.88 vs. 138.50  21.09, p> 0.001) and 30 minutes later (186.30  23.76 vs. 134.10  25.65 , p> 0.001). Using a frequency 10 times higher (100Hz) similar results were obtained (T-30, 186.30  23.76 vs. 99.17  8.79, p> 0.001, and T-60, 190.80  24.88 vs. 113.40  7.37, p> 0.001). Ac stimulation did not significantly alter blood glucose. There was also a significant reduction in the concentrations of LDH immediately after the acupuncture session and 30 minutes later, both in animals subjected to Ac (T-30, 518.20  43.31 vs. 354.80  44.66, p <0.001, T-60, 637.80  61.01 vs. 325.70  10.54, p <0.001) and EAc (10Hz: T-30, 518.20  43.31 vs. 286.50  59.86, p <0.001, T-60, 637.80  61.01 vs 268.80  43.51, p <0.001 and 100Hz: T-30, 518.20  43.31 vs. 213, 80  24.85, p <0.001, T- 60, 637.80  61.01 vs 188.20  24.00, p <0.001), suggesting a lower anaerobic metabolism. In this study, a significant decrease in serum lactate 30 minutes after the start of the study in rats subjected to EAc 100 Hz suggests the prevalence of aerobic glycolysis (2.10  0.23 vs. 1.19  1.02, p < 0.001). Similar result was observed in the levels of lactate in the liver (T-60, 10 Hz: 1.92  0.42 vs. 0.69  0.29, p <0.001 and 100 Hz: 1.92  0.42 vs. 0.44  0.21, p <0.001) and kidney (T-30, 100 Hz: 1.86  0.87 vs. 0.91  0.38, p <0.05). The results of this study show that the Ac and EAc, can reduce the concentrations of blood glucose in hyperglycemic animals. Higher frequencies have greater hypoglycemic effect. The reduction of blood glucose should be a consequence of the action of endogenous opioids and &#61666;- endorphin, as suggested in previous studies. The mechanism of reduction of lactate and LDH appears to be related to a prevalence of aerobic glycolysis.

O objetivo deste estudo é avaliar a eficácia de duas técnicas de acupuntura no controle da náusea e vômito em pacientes portadoras de Carcinoma Invasivo de mama, submetidas à quimioterapia anti-neoplásica. Foram incluídas no estudo 64 pacientes no período de março de 2003 a fevereiro de 2007, do Hospital A.C. Camargo com diagnóstico anatomopatológico de carcinoma invasivo da mama, candidatas à quimioterapia adjuvante com esquemas que incluem doxorrubicina e ciclofosfamida. O estudo foi realizado no primeiro ciclo de quimioterapia. As pacientes foram randomizados em 3 grupos: As pacientes do grupo A, receberam tratamento antiemético convencional com medicamentos. As pacientes do grupo B, receberam o tratamento antiemético convencional e aplicação de acupuntura clássica. As pacientes do grupo C, receberam tratamento convencional e aplicação de acupuntura auricular. As pacientes foram submetidas à auto-avaliação nos primeiros 21 dias após o início da quimioterapia, e conforme os critérios da Common toxicity criteria of the National Cancer Institute (NCI CTC), preencheram a ficha de coleta de dados em relação à náusea e vômito neste período. Quanto à náusea do primeiro ao sétimo dia, encontramos pelo teste de Kruskal-Wallis diferença significativa (p=0.040), sugerindo que a acupuntura diminui a intensidade de náusea deste período, e quanto à duração de dias de pior intensidade também foi significativo (p=0,037) ou seja a acupuntura diminui os dias de pior intensidade.Quando utilizamos o teste de Mann-Whitney encontramos diferença significativa da intensidade de náusea somente entre os grupos A e B (p=0,013), significando que a acupuntura clássica diminui a intensidade de náusea em relação ao grupo controle. Em relação aos dias de pior intensidade de náusea encontramos diferença entre os grupos A e B (p=0,043) e entre grupos B e C (p=0,010) ou seja, a acupuntura clássica diminui os dias de pior intensidade de náusea em relação aos grupos controle e acupuntura auricular. Quanto à gravidade do vômito, do primeiro ao sétimo dia, encontramos pelo teste de Kruskal-Wallis diferença significativa (p=0,036) entre os grupos, sugerindo que a acupuntura diminui a gravidade de vômitos. Pelo teste de Mann-Whitney entre os grupos A e B encontrou-se diferença significativa (p=0,017), ou seja, a acupuntura clássica diminui a gravidade de vômitos comparado ao grupo controle. Quanto ao número de dias de vômito de pior grau entre o primeiro e o sétimo dia encontramos ao aplicar o teste ANOVA diferença significativa entre os grupos (p=0,029), sendo que a acupuntura diminui o número de dias com vômito. O teste t aplicado para os grupos em pares revelou entre grupos A e B (p=0,035), portanto, a acupuntura clássica diminui o número de dias de vômito comparado ao grupo controle. Ao estudarmos a intensidade de náusea entre oitavo e vigésimo primeiro dia encontramos pelo teste de Kruskal-Wallis entre os grupos diferença significativa (p=0,022), sendo que a acupuntura diminui a náusea entre oitavo e vigésimo primeiro dia. Pelo teste de Mann-Whitney entre grupos aos pares encontrou-se diferença significativa entre os grupos A e B (p=0,016), houve diferença entre grupos A e C (p=0,049). Portanto, há diferença significativa entre grupos B e C em relação ao grupo A, ou seja, a acupuntura clássica e auricular diminuem a náusea entre oitavo e vigésimo primeiro dias em relação ao grupo controle. Conclusão: A acupuntura clássica diminui a intensidade e duração de náusea e vômito do primeiro ao sétimo dia pós-quimioterapia. A acupuntura clássica e auricular diminuem a intensidade de náusea do oitavo ao vigésimo primeiro dia pós-quimioterapia. / The purpose of this study is to evaluate the efficacy of two acupuncture techniques in the control of the nausea and vomiting in patients diagnosed of Invasive Breast Carcinoma submitted to chemotherapy. Sixty four patients with pathological diagnosis of Invasive Breast Carcinoma were included in the study during the period of March 2003 to February 2007 at Hospital A.C. Camargo. The patients received adjuvant chemotherapy including doxorubicin and ciclophosphamide. The study was developed during the first chemotherapy cycle. The patients were randomized in 3 groups: Patients of the group A received conventional antiemetic treatment with drug administration. Patients of the group B received conventional antiemetic treatment with drug administration and application of classic acupuncture. Patients of the group C received conventional antiemetic treatment with drug administration and application of auricular acupuncture. During the first 21 days, the patients performed self-reports after receiving the chemotherapy shot, according to the Common toxicity criteria of the National Cancer Institute (NCI CTC). They filled out the data collection instrument related to the nausea and vomiting in this period. As for the nausea from the first to the seventh day, we found statistical significancy (p=0.040) using the Kruskal - Wallis test, suggesting that acupuncture reduces the intensity of nausea in this period. Regarding length of days having worse intensity of nausea in this period, results were statistically significant by ANOVA test (p=0.037) with acupuncture decreasing the number of days of worse intensity. Through the Mann Whitney test, we also found significant difference regarding the intensity of nausea among the groups A and B (p=0.013), showing that classic acupuncture reduces the intensity of nausea when compared to the control group. In relation to the days of worse intensity of nausea we found difference among the groups A and B (p=0.043) and among groups B and C (p=0.010) meaning that classic acupuncture decreases the days of worse intensity of nausea when compared to control group and auricular acupuncture group. As for the severity of the vomit, from the first to the seventh day, we found through Kruskal - Wallis test a significant difference (p=0.036) among the groups, suggesting that acupuncture reduces the severity of the vomits. Using the Mann - Whitney test among the groups A and B a significant difference was found (p=0.017) meaning that classic acupuncture reduces the severity of vomits compared to the control group. As for the number of days of vomit in worse degree between the first and the seventh day, we used the ANOVA test and found significant difference among the groups (p=0.029) with acupuncture reducing the number of days with vomit. The t test applied for the groups in pairs revealed statistical significance among groups A and B (p=0.035) and therefore, classic acupuncture reduces the number of days of vomit compared to the control group. We have analysed the intensity of nausea between eighth and twentieth first day. Through the Kruskal - Wallis test, we found significant difference among the groups (p=0.022) showing that acupuncture also reduces the nausea between eighth and twentieth first day. Analyzing the groups in pairs with the Mann - Whitney test, we found significant difference among the groups A and B (p=0.016) and among groups A and C (p=0.049). Therefore, there is significant difference among groups B and C in relation to the group A. Classic acupuncture and auricular acupuncture reduce the nausea between eighth and twentieth first days when compared to control group. Conclusion: Classic acupuncture reduces the intensity and duration of nausea and vomit from the first to the seventh day after chemotherapy. Classic acupuncture and auricular acupuncture reduce the intensity of nausea from the eighth to the twentieth first day after chemotherapy.

M. Tech. / OBJECTIVE: The aim of the study was to explore whether dry needle therapy delivered to latent myofascial trigger points of the biceps brachii muscle had an immediate effect on muscle activity and strength . DESIGN: One hundred participants with latent myofascial trigger points of the biceps brachii muscle and who were suitable for the study were drawn from the community. They were al located in to either a controlor treatment group so that each group contained fifty participants . The control and treatment group were divided in such a way to ensure that the two groups were comparable with one another un terms of age and gender. The International Physical Activity Questionnaire was completed by each participant to ensure that the two groups were also comparable with one another in terms of the total amount of physical activity performed per week. The results of this study were statistically analysed by STATKON at the University of Johannesburg.

M.Tech. / Purpose: This study was undertaken in order to demonstrate the effects of static magnetic field therapy on acupuncture points in the treatment of those suffering from mechanical neck pain. Isolated spinal manipulative therapy of the cervical spine was compared to spinal manipulative therapy of the cervical spine in conjunction with magnetic field therapy on acupuncture points using both objective and subjective measurements. Before the execution of this study, it was hypothesised that both treatment protocols would be effective in the treatment of mechanical neck pain, although the combined therapy would be more effective. Method: Patients were recruited by way of advertisements placed in and around the University of Johannesburg, Doornfontein campus and their health clinic. Thirty patients with mechanical neck pain were recruited and randomly divided into two groups. Group one received manipulation to the affected joints of the cervical spine and group two received manipulation to the cervical spine combined with magnetic field therapy on acupuncture points. Procedure: Each patient in each group attended six treatment sessions; three in the first week and three in the second week. The Vernon Mior Neck Pain and Disability Index and the Numerical Pain Rating Scale (subjective measurements) were completed by each patient and the Cervical Range of Motion instrument (objective measurements) was used to collect readings from each patient in both the control and experimental groups, subjective and objective measurements were taken before treatment one, three and six. Specific treatment protocols were then adhered to. Results: The results indicated that both treatment protocols were effective in reducing mechanical neck pain although not one group was more effective than VI the other. Both groups improved subjectively and objectively as they had cervical spinal manipulation directed at joint dysfunction. Conclusion: The experimental group who received spinal manipulative therapy to correct joint dysfunction in conjunction with magnetic field therapy on acupuncture points was not more effective than the control group who received spinal manipulation only, in the treatment of mechanical neck pain.

M.Tech. / Purpose: Acupuncture has been a controversial issue in the medical world for many years before the sceptic western medicine slowly adopted its idea. Some mechanisms for pain relief were clinically researched and proven to be valid as well as effective in treating tension-type headaches (Stux, Berman and Pomerantz, 2003) The purpose of this study was to assess and compare the effects of cervical spine manipulation and needling of acupuncture points in those patients with tension-type headache and suggest another complimentary treatment to the chiropractic manipulation, especially in those patients where manipulation is contraindicated to manipulation. If found to be effective, various mechanisms have been suggested in the formation of tension headache episodes. Those mechanisms may be alterations within the spinal cord and/or brainstem gating mechanisms as a result of facet joint dysfunction, sensitization of nociceptors in the peripheral structures of the body and psychological factors. Method: This study consisted of two groups, consisting of 16 subjects in each group. All participants were screened for tension-type headaches and accepted based on the inclusion and exclusion criteria. The subjects were between the ages of eighteen and thirty-five. Group 1 received chiropractic manipulation treatment to the most restricted levels in their cervical spine. Group 2 received treatment consisting of needling of acupuncture points to specific predetermined points. Procedure: Each successful candidate was treated six times over a 3 week period which included a total of seven sessions. Before the beginning of the treatment, the successful candidate completed the Vernon-Mior Neck Pain and Disability Index Questionnaire and the Numerical Pain Rating Scale. Readings for cervical spine ranges of motion were then taken with a CROM device. In group 1, chiropractic manipulation was then delivered to the most restricted segments in the cervical spine. In group 2, needling of six predetermined acupuncture points for relieving tension-type headache was performed bilaterally. The same treatment procedure was administered at sessions one through six, the CROM readings and questionnaires were taken in sessions one, three, five and seven. Results: The results were obtained by using the Mann-Whitney U and t-test. No statistically significant differences were identified between the groups, when comparing the 2 treatment methods at the visits. However, both groups showed a statistically significant improvement over time within each group individually for subjective measurements and for right lateral flexion in the objective measurements. Conclusion: The results were inconclusive with regards to the prolonged effects of chiropractic manipulation and needling of acupuncture points on cervical spine range of motion in patients with tension-type headache. However, it was concluded that both methods of treatment had beneficial effects on how the participants perceived their pain and disability. Due to the small group of subjects and relatively short duration of the study, accurate conclusions could not be formulated. The findings obtained were insignificant and further research needs to be performed on the effects of cervical spine manipulation and needling of acupuncture points on those suffering with tension-type headache.

M.Tech. / Problem Statement: Myofascial Pain Syndrome (MPS) is a painful and prevalent muscular condition that is characterized by the development of myofascial trigger points (TrP’s). These are locally tender when active and are able to refer pain through specific patterns to other areas of the body distal from the trigger point (Manga, 2008). Myofascial trigger points are a frequently overlooked and misunderstood source of the distressingly ever-present musculoskeletal aches and pains of mankind and many authors have found that the trapezius muscle is most often the muscle that has frequent myofascial trigger points (Travell and Simons, 1999). Much debate and discussion has arisen on the merits of the fanning dry needling technique compared to that of the static dry needling technique, but research evidence is very limited. Some practitioners prefer the static technique over the fanning technique as it reduces the presence and amount of post-needling soreness, as well as reduces the possibility of penetrating a blood vessel resulting in hemorrhaging. Other practitioners prefer the fanning technique as it increases the chances of locating the loci of the TrP, as well as increasing the chances of eliciting a local twitch response and possibly making this method more effective in deactivating a TrP than the static technique. Aim of Study: The aim of this study was to compare the effects of static myofascial dry needling to the effects of fanning myofascial dry needling of an active trigger point (TrP1) in the upper trapezius muscle in order to determine which of the two treatments is more effective with regards to decreasing neck pain and disability as well as increasing pressure pain threshold in patients with neck pain due to Trapezius Myofascial Pain Syndrome. Method: Forty participants underwent a general screening to determine whether they had active myofascial trigger points in the upper fibers of the trapezius muscle.

M.Tech. / The aim of this study was to compare the effectiveness of cervical adjustment therapy, dry needling of the levator scapulae muscle and a combination of the two in the treatment of chronic mechanical neck pain. Forty-five patients were recruited via posters and advertisements from in and around the University of Johannesburg. The participants had to present with bilateral neck pain, decreased range of motion and an active levator scapulae muscles trigger point, which was diagnosed using range of motion and trigger point examination. The participants were randomly allocated into three groups of fifteen participants each. Prior to treatment a full case history, physical examination and cervical regional examination were performed to ensure that the patients were eligible to partake in the clinical trial. Group 1 was the adjusting group; group 2 was the combination group while group 3 was the needling group. Participants were treated five times over a period of three weeks. The objective measurements used in this clinical trial involved a cervical range of motion instrument (C.R.O.M., Performance Attainment Associates) and an algometer (Wagner Instruments). Subjective measurements were achieved using the Neck Pain and Disability Index (Appendix G) and the Numerical Pain Rating Scale (Appendix H). Each measurement was taken prior to treatment on the first and third visits and after treatment on the fifth visit with three measurements per participant overall. The statistical analysis was conducted using the Kruskal-Wallis, Friedman and Wilcoxon tests to compare data. The results indicated that the three groups responded favourably to their respective treatments. Overall, this study has indicated that dry needling of the Levator scapulae muscle provides no statistically significant contribution to the conservative treatment of mechanical neck pain caused by levator scapulae trigger points.