Acupuncture Effective For Parkinsons Symptoms
Acupuncture and herbs have been employed for thousands of years by Asian traditional doctors for nervous disorders. The benefits for the use of the acupoints LR3, GB34 and GV20 for nerve and motor conditions have been well-documented in Asian medical literature.
In a 2017 study, researchers from the College of Medicine at South Koreas Kyung Hee University investigated the research evidence for acupuncture for treating Parkinsons disease. After a deep search, the researchers found 25 randomized clinical trials that tested acupuncture treatment for Parkinsons.
In this meta-analysis, the researchers scored for high-quality. And 19 of the 25 studies were found to be of high quality. This means they had enough strength to significantly remove bias and the placebo effect.
The clinical trials included 1,616 Parkinsons disease patients. They were conducted between 2000 and 2014. Some of the studies compared acupuncture to no or sham treatment. Other studies compared acupuncture with conventional treatment to conventional treatment without acupuncture.
The meta-analysis of these studies found that acupuncture can significantly improve symptoms of Parkinsons in all these cases: Whether being treated with drugs or not.
Some of the studies utilized Unified Parkinson Disease Rating Scales to gauge any improvements. The rating scales are:
Effective rates also found acupuncture treatment was more effective.
Massage Therapy For Parkinsons
While data analyzing the role of acupuncture in treatment of PD symptoms is fairly limited, the data on the role of massage in the treatment of PD symptoms is even more so. One clinical trial was done assessing the effects of a 40-minute massage session, with some participants then continuing to receive seven weekly sessions. The control group was not blinded to their status . Despite these limitations, the study showed that massage was helpful in improving quality of life for people with PD.
All of the above begs the question should a person with PD try acupuncture or massage to help their PD symptoms? The bottom line is that there is little formal evidence that either treatment is truly effective. Larger and better designed clinical trials are necessary before these treatments will be routinely recommended.
For now, people with PD can choose to make their own assessments about whether these practices improve their well-being and whether to incorporate acupuncture or massage into their weekly routine. In general there is minimal risk in trying acupuncture or massage, aside from perhaps disappointment if they do not work for you. If you plan to try acupuncture and/or massage, be sure to go to reputable practitioners, preferably ones with experience in treating people with PD.
Inclusion And Exclusion Criteria
The inclusion criteria were as follows: study types: SRs/MAs in which the participants were patients with PD and were diagnosed according to any internationally recognized clinical guidelines; intervention: acupuncture therapy vs. conventional medication or acupuncture therapy combined with conventional medication vs. conventional medication alone; outcomes: reviews that assessed the motor and non-motor symptoms of PD as the main outcome measures were considered eligible. Measures of quality of life and activities of daily living were included if they were relevant to the assessment of PD symptoms. Studies were excluded if they used acupuncture alone or combined with other drugs in the control group.
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What Should I Expect At An Appointment
Acupuncture is not regulated in many countries.;It is therefore a good idea to ask your doctor or other healthcare professional for recommendations. Friends, family, other people with Parkinsons or your national Parkinsons association may also be able to advise based on personal experience.
It is advisable to see a therapist who has experience of Parkinsons so do ask about their experience of the condition as well as their qualifications.
How Might The Alexander Technique Help
Theres evidence from one scientific study of fewer than 100 people that the Alexander technique may help to relieve symptoms of Parkinsons, including pain, speech, tremor, depression and balance.
NICE clinical guidelines recommend that people with Parkinsons consider the Alexander technique to help with balance or motor problems.
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Quality Assessment Of Included Studies
We assessed the quality of the included studies with a Jadad scale and an Overview Quality Assessment Questionnaire .
The primary limitations of the included RCTs were small sample size and unreported adverse events. One progress compared with previous acupuncture studies was that placebo acupuncture was performed in four studies and objective behavioral assessment tool was used in one study Figure 1B.
Is Herbal Medicine Safe
You should always talk to your GP, specialist or Parkinsons nurse before taking herbal medicines or supplements in case they have serious side effects or interfere with your usual medication.
Some herbal medicines shouldnt be taken during pregnancy again, check with your GP.
Make sure your herbal medicine comes from a reliable source. In the past the UK;Medicines and Healthcare products Regulatory Agency has found supplies of contaminated herbs. .
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Improvements/characters In Acupuncture Studies During The Past 5 Years
RCTs and Meta-Analysis Studies Based on RCTs Are Increasing
More rigorously designed RCTs and meta-analyses following PRISMA rules were used to evaluate the efficacy of acupuncture. This will provide more convincing evidence for the efficacy of acupuncture. Increasing numbers of acupuncture investigators have accepted the principles of evidence-based medicine and recognized that only well-designed RCTs can provide powerful and convincing evidence for the efficacy of acupuncture, which is the only way for acupuncture to step into mainstream medical academia. In the present study, seven recent RCTs and four meta-analysis studies evaluated the efficacy of acupuncture. Although some studies did not reach a satisfactory quality , the data obtained from RCTs cannot be ignored.
Non-motor Symptoms Are Increasingly Emphasized
In addition to the motor symptoms of PD, more clinicians are paying attention to the non-motor symptoms . We found several studies that evaluated the efficacy of acupuncture for non-motor symptoms. Noh et al. found that acupuncture was effective against PD-related stress ; Kluger reported that acupuncture could relieve PD-related fatigue ; studies by Liang et al. and Wang et al. showed that acupuncture could relieve PD-related sleepiness; and QOL in PD patients could be improved by acupuncture . The non-motor symptoms of PD are quite complex. More investigations can be expected to verify the efficacy of acupuncture for various non-motor symptoms in PD.
Is Massage Therapy Safe
Massage therapy shouldnt hurt, although there may be some discomfort if pressure is applied to injured areas, or where your body is very tense.
Massage may not be suitable for people with certain medical conditions, a history of blood clots, or weak or broken bones.
If you have wounds or bruises you should wait until these are healed before booking a massage appointment.
Massage therapists arent regulated by law, but they may register with the Complementary and Natural Healthcare Council.
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Efficacy Of Acupuncture For Motor Symptoms
UPDRS III is the most commonly used score for measuring motor performance. An RCT with 15 participants conducted by Lei et al. evaluated improvement in motor performance due to electroacupuncture in 15 participants . They found that electroacupuncture significantly decreased UPDRS scores and improved gait speed. To the best of our knowledge, this is the first experiment using an objective task for evaluating the effects of acupuncture, which may provide rigorous evidence for evaluation of the efficacy of acupuncture. These results were in accordance with those of other studies by Cho et al. and Lee et al. . Only one study found no efficacy. A meta-analysis by Liu et al. that analyzed two RCTs with 240 participants did not found any efficacy of acupuncture in improving UPDRS scores . Their explanation was that the high heterogeneity influenced the reliability of the results .
Frontiers In Aging Neuroscience
Long Island School of Medicine, New York University, United States
Reviewed by
Shandong University of Traditional Chinese Medicine, China
The editor and reviewers’ affiliations are the latest provided on their Loop research profiles and may not reflect their situation at the time of review.
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What Are The Main Complementary Therapies Used By People With Parkinsons
The rest of this information looks at some complementary therapies you may find helpful. Please remember that although weve included them here, we cant recommend any particular therapy. ;
Our forum is also a great place to find out what people are trying and how they feel about different therapies.;
Acupuncture is a form of ancient Chinese medicine. It involves a therapist inserting thin needles at particular points on your body.;
Traditional practitioners believe that energy flows round the body through channels which, when blocked, can cause illness. The role of acupuncture is to unblock the channels.
Some scientists believe the needles act to stimulate muscles and nerves, which is what causes the effects.
Acupuncture needles are very fine so shouldnt cause a lot of pain. Your therapist will stimulate them manually using heat, pressure, electrical currents or laser light.;
How Might Music Therapy Help
Its been suggested that music can improve movement and speech and help people to relax or talk about their feelings or ideas.
Some people with Parkinsons find that listening to strong rhythmic music can improve their walking, prevent hesitations and overcome freezing episodes.
In general, research indicates that music seems to help people with conditions such as Parkinsons improve their emotional sense of wellbeing.
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Search Methods For Identification Of Studies
The search was performed without restrictions in the language or year of publication. We searched Medline, EMBASE, and the Cochrane Central Register of Controlled Trials from the database inception through August 2015. For Korean publications, we searched 3 Korean medical databases . For Chinese articles, we searched the China National Knowledge Infrastructure . A manual search of relevant references from previous systematic reviews was conducted. The keywords used for the search were Parkinsonism or Parkinson’s disease AND acupuncture in each database language. The search strategy was adjusted for each database.
Characteristics Of Included Literature
A total of 11 studies were included, comprising 4 meta-analysis studies and 7 RCTs. The characteristics of the included studies are shown in Table 1. Subjective behavioral assessments employed in this study include the Unified Parkinson’s Disease Rating Scale , the Webster Scale , the Tension Assessment Scale , the Parkinson’s Disease Sleep Scale , the Postural Instability Gait Disorder , the Parkinson’s Disease Quality of Life Questionnaire , the Beck Depression Inventory , the Modified Fatigue Impact Scale , the 39-Item Parkinson’s Disease Questionnaire , and the Pittsburgh Sleep Quality Index . One RCT used gait speed as an objective assessment . Besides motor symptoms, non-motor symptoms, such as sleep , quality of life , and fatigue , were also evaluated. Objective evaluation and evaluation of non-motor symptoms are increasingly emphasized for evaluation of the efficacy and safety of acupuncture for PD. No serious adverse events were reported.
Table 1. Efficacy and safety in the current acupuncture study.
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Recommendations For Future Studies
Based on the recent acupuncture studies summarized here, we make several recommendations for future studies.
1. The quality assessments suggested that some studies were of low quality and some items provided inconsistent results in different studies. Thus, it is time to organize large, multicenter, well-designed RCTs to evaluate the efficacy of acupuncture. Although many RCTs have provided evidence for the efficacy of acupuncture, flaws of methodology have reduced the value of the evidence. Acupuncture needs authoritative evidence to step into the mainstream of medical academia. Once acupuncture has been authoritatively proved to be efficacious and accepted by clinicians, it should be considered as a method of peripheral stimulation to treat PD . Peripheral stimulation has no surgical risks, which will greatly benefit PD patients in the world.
2. Objective assessments using novel computerized technologies, such as wearable devices, virtual reality, and augmented reality technologies and robot assistant technology, which can realize real-time, programmable, and safe measurements of the motor fluctuations in PD, should be developed and used in future acupuncture studies to provide more powerful evidence for the efficacy of acupuncture, since it may bring great revolutionary in the behavioral assessments in PD .
How Might Homeopathy Help
Homeopaths believe homeopathy can help with any condition in which the body has the potential to self-repair. As a result, they suggest homeopathy can be used to treat a wide range of acute and chronic medical conditions.
Homeopathy is popular. However, despite extensive research, there’s no good quality evidence that homeopathy is effective as a treatment for any health condition.;There are no studies on homeopathy for Parkinsons.
Homeopathy isn’t widely available on the NHS. In 2017, NHS England recommended that GPs and other prescribers should stop providing it.;It is available privately.
Practitioners
Some health professionals, including doctors, nurses and pharmacists, are trained in homeopathy and use it alongside conventional medical treatment. Theyre all regulated by their relevant professional body for example, GPs are regulated by the General Medical Council.
Some homeopaths arent medically qualified. Currently, there are no national standards of training and accreditation for these practitioners. If you decide to see a homeopath who isnt medically qualified, you should check theyre insured and registered with a professional body.
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Study Shows Acupuncture Is Effective For Treating Parkinsons Disease
Lee, S.-H., & Lim, S. . Clinical effectiveness of acupuncture on Parkinson disease: A PRISMA-compliant systematic review and meta-analysis. Medicine, 96, e5836. http://doi.org/10.1097/MD.0000000000005836 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5279085/
Find an Acupuncturist to learn more about acupuncture and Oriental medicine!
About the Author: Vanessa Vogel Batt, L.Ac., MSTOM, studied at the Pacific College of Oriental Medicine, and practiced acupuncture and Oriental medicine in New York for several years. Vanessa enjoys traveling the world, and has published articles on acupuncture and Oriental medicine and related health topics for websites and publications in both the U.S. and abroad.
How Might Massage Therapy Help
Research suggests that massage may help to reduce pain;and anxiety and depression,;although theres no conclusive evidence. Abdominal massage may also help with constipation.
Many people with Parkinsons and their carers have told us they find massage therapy useful as a way to relax and to have time to themselves.
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How Might Feldenkrais Help
Studies show that Feldenkrais helps with balance and mobility. People also use it to find relief from tension and pain, to improve breathing and performance, and for general wellbeing.;As yet, there have been few studies of the method specifically for the treatment of Parkinsons, but there are some indications that the method improves quality of life.
Effect Of Acupuncture On Dopamine Content Alteration
DA neuronal deficit leads to decreases in dopamine content in striatal projections. The above analysis indicated that DA neurons in PD model rodents were recovered by acupuncture; thus, it was explored how dopamine content was changed by acupuncture in the studies . Twelve studies reported the effect of acupuncture on improving dopamine content in PD models compared with the control PD group. There was no remarkable increase in dopamine content, except in three studies with high increase . While three studies reported large increases in the striatal dopamine by acupuncture, overall, studies showed that dopamine content was not significantly altered by acupuncture . In the subgroup analysis of dopamine content, there was a significant effect of acupuncture was observed in MPTP models , MFB models , but no significant difference was found in the 6-OHDA models .
Figure 4. Comparison of dopamine content in striatum with PD animal and acupuncture-treated PD animal.
Figure 5. Analysis of difference in dopamine content level between PD rodent and acupuncture treatment group throughout studies. Each dopamine content level of all the PD animal models group and acupuncture-treated PD animal models group. Lines indicates the mean value and error. Dashed arrows mean the slope of difference from PD models to PD models plus acupuncture group in each study.
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Dopamine Content And Possible Mechanisms For Improvements In Motor Function
Studies have shown that dopamine content is recovered, although not as much as neuronal deficits, by acupuncture treatment . These results were unexpected because most studies reported that motor dysfunctions in PD animals were significantly altered after acupuncture . Studies have reported that partial recovery of DA neurons is not sufficient to rescue neuronal function completely in terms of dopamine secretion. Instead, studies have suggested that acupuncture treatment has another effect on PD animals, which is improvement of synaptic function in addition to neuronal protection . Notably, single-photon emission computed tomography imaging has demonstrated that neurotransmission was increased by acupuncture . Moreover, analysis of synaptic changes showed that dopamine use was enhanced via regulating the D1 dopamine receptor and dopamine transporter . Additionally, in vivo microdialysis results have shown that dopamine availability and other neurotransmitters, such as acetylcholine and glutamate, were mitigated by acupuncture . Furthermore, postsynaptic cortico-striatal pathway alteration was found after acupuncture . Based on these results, it is possible to hypothesize that acupuncture can modulate DA synaptic pathways via alteration of neuronal plasticity; however, it rescues less striatal dopamine content itself in PD animal models.
How Might Osteopathy Help
Osteopathy is commonly used for conditions caused by problems with the nerves, joints and muscles, such as back and neck problems, joint pain or injuries.;NICE guidelines recommend that osteopathy be considered as a treatment for back pain.
Some osteopaths believe they can also help relieve general health problems such as asthma, jaw problems and painful periods. However there is no good evidence that this is true.
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Possible Mechanism Of Neuroprotective Effects
Several mechanisms of acupuncture have been suggested to be involved in recovering DA neuronal deficits. First, the neurotrophic factor-induced cell proliferation pathway was suggested as a potential mechanism to explain the neuroprotective effect of acupuncture. For example, it was found that acupuncture increased brain-derived neurotrophic factor levels, followed by activation of TrkB-related cell proliferation cascade . Glial cell-derived neurotrophic factor was also upregulated by acupuncture , and there was remarkable increase in cyclophilin A levels . Additionally, it was found that acupuncture activates hypothalamic melanin-concentrating hormone , which is involved in neuronal protection by upregulating a downstream pathway related to neuroprotection in the SN of MPTP-induced and A53T -syn mutant PD mice . Moreover, various researchers have suggested possibilities that acupuncture helps PD patients recover from PD through biological processes such as anti-oxidant , anti-inflammation , and regulation of autophagy . Although all of these processes need to be clinically verified, the scientific evidence revealed strong possibilities of a neuroprotective effect of acupuncture on PD.