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M.Tech. / This study aimed to determine the difference between the standard dry needling technique versus the rapid dry needling technique with regards to which technique would provide quicker relief of symptoms, as measured by an increase in participant’s pressure tolerance and range of motion and a decrease in subjective pain. Subjectively it was seen that both groups had a statistical decrease in the participants perceived pain with the Oswestry Disability Index, the McGill’s Pain Questionnaire and the Numeral Pain Rating Scale. Both groups showed significant changes over the two time variables (pre-Treatment one and post-Treatment four) with regards to all the questionnaires. Group 2 showed the most significant change when comparing the two groups with regards to the Oswestry Disability Index and the Numeral Pain Rating Scale. From these results it is seen that subjectively all the participants felt relief with respect to their perceived pain. However, objectively the rapid dry needling technique proved to improve pain faster and more consistently throughout the treatment period over the standard intra-muscular dry needling technique. Therefore the rapid dry needling technique is more effective in treating active Gluteus medius muscle trigger points.

Orientador: Edson Rosa Pimentel / Tese (doutorado) - Universidade Estadual de Campinas, Instituto de Biologia / Made available in DSpace on 2018-08-26T20:21:48Z (GMT). No. of bitstreams: 1 Almeida_MarcosdosSantosde_D.pdf: 2549790 bytes, checksum: f7c5cf41c1fe21e8441475d830717187 (MD5) Previous issue date: 2015 / Resumo: Vários estudos indicam que a acupuntura (AC) tem efeito anti-inflamatório (AI) sistêmico e mecanotransdutor local. Estes efeitos podem potencialmente acelerar o processo de cicatrização. Portanto, o objetivo deste estudo foi analisar o efeito de diferentes protocolos de AC nas características bioquímicas, organizacionais e ultraestruturais de tendões de ratos durante o processo de cicatrização. Ratos Wistar machos com 60 dias de idade foram divididos nos seguintes grupos: grupo não tenotomizado ou normal (N), grupo tenotomizado (T), tenotomizado e submetido à AC no ponto E-36 (E36), tenotomizado e submetido à AC no B-57 (B57), tenotomizado e submetido à AC manual no ponto E-36 e B-57 (EB) e tenotomizado e submetido à eletroacupuntura (EA) nos dois pontos citados. Os animais foram submetidos à eutanásia nos dias 7, 14 e 21 após a lesão. Em seguida, os tendões calcâneos foram coletados, processados e analisados para quantificação de proteínas não colagênicas através do método de Bradford. Para a análise organizacional, foi utilizada a quantificação da birrefringência das fibras de colágeno através da microscopia de polarização. Na analise ultraestrutural foram mensurados os diâmetros das fibrilas de colágeno e em seguida foram construídos histogramas de distribuição destes diâmetros assim como foi calculado o diâmetro da massa-média - MAD - das fibrilas de colágeno. Os resultados mostraram que o uso associado dos pontos E-36 e B-57 aumenta tanto a birrefringência das fibras de colágeno nos dias 14 e 21 após a lesão quanto o MAD nos três períodos analisados. A reorganização das fibrilas de colágeno também aumentou no dia 21 após a lesão com a aplicação dos dois pontos citados. No entanto, a aplicação da EA não promoveu aumento da birrefringência ou da reorganização das fibrilas assim como diminuiu o MAD no dia 21 após a lesão. Desta forma, concluímos que o uso da AC manual nos pontos E-36 e B-57 tem efeito no restabelecimento das propriedades estruturais e ultraestruturais do colágeno de tendões durante o processo de cicatrização. Estes resultados sugerem o fortalecimento da estrutura tendínea com consequente aumento da resistência a re-ruptura e o potencial uso da AC em protocolos de reabilitação / Abstract: Several studies indicate that acupuncture (AC) has both local mechanotransductor and systemic anti-inflammatory (AI) effects. These effects could potentially accelerate the healing process. Therefore, the aim of this study was to analyze the effect of different protocols of AC on the biochemical, organizational and ultrastructural aspects of rat tendons during the healing process. Male Wistar rats at 60 days of age were divided into the following groups: not tenotomized or normal group (N), tenotomized group (T), tenotomized and submitted to AC at ST-36 point (ST36), tenotomized and submitted to AC at BL-57 point (BL57), tenotomized and submitted to manual AC at ST-36 and BL-57 points (SB) and tenotomized and submitted to electroacupuncture (EA) on the two points mentioned. The animals were euthanized on 7th, 14th and 21th days after injury. Thereafter, the Achilles tendons were collected, processed and analyzed to quantify non-collagenic proteins using the method of Bradford. For organizational analysis, it was quantified the collagen fibers birefringence by polarizing microscopy. In the ultrastructural analysis were measured the diameters of collagen fibrils and then histograms of distribution of these diameters were built as well as mass-average diameter - MAD - of collagen fibrils was calculated. The results showed that the associated use of ST-36 and BL-57 points increases both the birefringence of collagen fibers at 14th and 21th days and the MAD at the three periods analyzed. The reorganization of collagen fibrils also increased at 21th day with the application of the two points mentioned. However, the application of EA did not increase the birefringence or the reorganization of fibrils as well as decreased the MAD of fibrils at 21th after injury. Thus, we conclude that the use of manual AC at ST-36 and BL-57 points is effective in restoring the structural and ultrastructural properties of the collagen of tendons during the healing process. These results suggest strengthening the tendon structure with consequent increased resistance to re-rupture and the potential use of AC in rehabilitation protocols / Doutorado / Anatomia / Doutor em Biologia Celular e Estrutural

Bakgrund: Psykisk ohälsa ökar världen över. Ångestsymtom medför lidande och minskad funktion hos drabbade individer. Patienter med ångestsymtom erhåller sällan adekvat behandling och intresset för icke farmakologiska behandlingsmetoder mot ångestsymtom ökar. NADA-behandling har visat sig minska ångestsymtom hos patienter vid exempelvis operation och missbruk. Syfte: Syftet med studien var att beskriva upplevelser av NADA- akupunktur hos patienter med ångest i psykiatrisk öppenvård. Metod: Kvalitativ innehållsanalys med induktiv ansats valdes som metod. 14 studiedeltagare intervjuades efter 10 genomgångna NADA-behandlingar. Resultat: I resultatet framkom att studiedeltagare som erhållit NADA-behandling upplevde ett ökat välmående efter NADA-behandling vilka av studiedeltagarna beskrevs som en upplevelse av rogivande avslappning som kom gradvis, en upplevelse av ökad glädje och ökat välbefinnande, upplevd lindring av kroppsligt obehag och upplevd förbättrad sömnkvalitet. Informanter upplevde även obehagliga upplevelser såsom smärta vid insticksstället och huvudvärk eller utebliven effekt av NADA-behandlingen. Slutsats: Flera deltagare i studien hade positiva upplevelser av NADA- behandlingen. Resultatet visade att patienter efter NADA-behandling upplevde ångestlindring. Mer forskning behövs för att bekräfta studiens resultat. Ytterligare studier av hur patienter upplever NADA-behandling skulle kunna medföra att psykiatrisjuksköterskan får tillgång till ännu ett icke farmakologiskt omvårdnadsverktyg att använda inom psykiatrisk omvårdnad. / Background: Mental illness is increasing worldwide. Anxiety symptoms cause distress and diminished function in affected individuals. Patients with anxiety symptoms rarely receive adequate treatment and the interest in non-pharmacological treatment methods for anxiety symptoms is increasing. NADA treatment has been shown to reduce anxiety symptoms in patients during, for example, surgery and abuse. Objective: The aim of the study was to describe experiences of NADA acupuncture in patients with anxiety in psychiatric outpatient care. Method: Qualitative content analysis with inductive approach was chosen as the method. 14 study participants were interviewed after 10 completed NADA treatments. Results: The results showed that study participants who received NADA treatment experienced increased well-being after NADA treatment, which was described by the study participants as an experience of calming relaxation that came gradually, an experience of increased joy and increased well-being, a relief from bodily discomfort and perceived discomfort. Informants also experienced unpleasant experiences such as pain at the insertion site and headaches or no effect of NADA treatment. Conclusion: Several participants in the study had positive experiences of NADA treatment. The results showed that patients after NADA treatment experienced anxiety relief. More research is needed to confirm the study's results. Further studies regarding how patients experience NADA treatment could lead to psychiatric nurses being given yet another non-pharmacological nursing tool to use in psychiatric nursing.

Bakgrund: Fibromyalgi är en kronisk sjukdom där smärta är en stor del av sjukdomen. 3-5% av världens befolkning beräknas vara drabbade av sjukdomen. Sjuksköterskan ska i omvårdnaden hjälpa patienten att återfå eller förbättra sin hälsa. Smärtlindring är en del av denna process. Det finns inget läkemedel som botar sjukdomen, behandlingen är inriktad på att lindra symtomen. Idag vänder sig många patienter till alternativa behandlingsmetoder för att bli smärtlindrande. Syfte: Att undersöka om TENS och/eller akupunktur har smärtlindrande effekt vid fibromyalgi. Ger någon av metoderna en sänkning på VAS? Är minskningen större vid någon av metoderna?Metod: Studien utfördes som en litteraturstudie med kvantitativ ansats. Resultatet byggde på 11 artiklar som fanns på databaserna CINAHL och Pubmed. Artiklarna granskades och kvaliteten bedömdes med hjälp av en anpassad kvalitetsmall. Resultat: Åtta artiklar handlade om akupunktur och tre om TENS. Studien visade att akupunktur och TENS hade en viss sänkning på VAS. Sänkningen varierade beroende på interventionens längd och var inte signifikant efter 12 veckor. Sänkningen var inte alltid signifikant. Konklusion: Akupunktur hade en större sänkning på VAS än TENS. Det fanns fler artiklar som handlade om akupunktur och fler personer var med i studierna än TENS. Detta bidrar till att sjuksköterskan inte kan rekommendera akupunktur över TENS på grund av att det inte fanns lika många artiklar. / Background: Fibromyalgia is a chronic, widespread disease which mostly revolves around pain. 3-5 % of the world population is estimated to be suffering from the disease. The nurse’s mission is to help patients to recover and to improve their health. Pain relief is a vital part of this process. Since the disease has no cure, the treatment is instead focused to ease the symptoms. There are many patients that seek pain relief from non-pharmaceutical treatments. Aim: To study if TENS and/or acupuncture have pain relieving effects in patients suffering from fibromyalgia. Do any of the methods a reduction on VAS? Do any of the methods have a larger reduction?Method: The study was a quantitative literature review. 11 articles were found on literature databases (e.g. PubMed and CINAHL). The quality and nature of these articles were assessed through a template. Result: Eight of the chosen articles regarded acupuncture as a treatment option and the rest regarded TENS. The study showed that both acupuncture and TENS caused a reduction on the VAS. The decrease was dependent on the duration of the treatment and was proven to be nonsignificant if treated longer than 12 weeks.Conclusion: Acupuncture caused a larger reduction on the VAS than TENS. Though more articles regarding acupuncture as a treatment were used and these studies were performed on larger populations than the studies regarding TENS. Thus, the nurse may not recommend acupuncture over TENS as a treatment option for fibromyalgia.

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Introduktion: Smärta förekommer hos cirka 55 % av alla patienter med cancer, vilket gördet till ett vanligt problem. Smärtan påverkar patienternas liv på flera olika nivåer. Förutomdet fysiska lidandet påverkas även livskvaliteten negativt, därför är det viktigt attuppmärksamma problemet. Trots farmakologisk behandling underbehandlas cirka 30 % avpatienterna. Det finns ett flertal olika icke-farmakologiska behandlingsmetoder motcancersmärta som skulle kunna verka som komplement till farmakologisk behandling. Idagsläget finns det fortfarande brister gällande huruvida sjuksköterskor informerar ocherbjuder patienter komplement till farmakologisk behandling. Genom att öka medvetenhetenkan smärtproblematiken hos patienter med cancer minska, och vården bli merindividanpassad. Eftersom cancersmärta är komplext behöver även behandlingen vara det. Syfte: Syftet är att undersöka hur akupunktur, massage och avslappning påverkar smärta hospatienter med cancersmärta. Metod: I denna studie användes en allmän litteraturöversikt med beskrivande design sommetod. Totalt har 11 vetenskapliga originalartiklar valts ut och granskats. Samtliga artiklarvar randomiserade kontrollerade studier. Resultat: Resultatet av studien visade att akupunktur, massage och avslappning har ensmärtlindrande effekt, både långtidsverkande och direktverkande, hos patienter medcancersmärta. Likaså visade resultatet att smärtans påverkan på det dagliga livet minskade avdessa behandlingsmetoder. Akupunktur och massage kunde även bidra till ett minskatanvändande av analgetika. Slutsats: Akupunktur, massage och avslappning kan fungera som komplement tillfarmakologisk smärtbehandling hos patienter med cancer. Dessa metoder kan även ha enpositiv effekt på patientens välmående i helhet, då en minskad smärta kan öka livskvaliteten. / Introduction: Pain is very common among patients with cancer, approximately 55%experience it, making it a frequent problem. The pain affects the patients' lives in many ways.In addition to the physical suffering, the quality of life is negatively affected as well. Despitepharmacological treatment, about 30% are undertreated. There are several differentnon-pharmacological treatment methods for cancer pain, which could act as a complement topharmacological treatment. There are shortcomings regarding whether nurses inform andoffer patients complements to pharmacological treatment. By raising awareness, the carecould be more individualized. Since cancer pain is complex, the treatment has to be as well. Aim: The aim of this study is to examine how massage, acupuncture, and relaxation affectsthe pain in patients with cancer pain. Method: A general literature review with descriptive design. A total of 11 scientific articlesof origin have been selected and reviewed. All articles were randomized controlled trials. Result: The results showed that acupuncture, massage and relaxation therapy affect pain,both long- and short term, amongst patients with cancer pain. Furthermore, it showed that theeffect pain has on daily life decreased during the interventions. Acupuncture and massagecould decrease the daily use of analgesics. Conclusion: Acupuncture, massage and relaxation therapy can work as a complement topharmacological treatment among patients with cancer pain. These methods may have apositive effect on the general well being of the patients since reduced pain increases thequality of life.