Challenges with heterogeneity of acupuncture
There has been a substantial growth in research and interest regarding the field of acupuncture and its relation to physiotherapy. Up until now, there has been a poor effort to differentiate the various forms of interventions and techniques in the literature. As a result, there is a tendency to equate different methods of needle stimulation.
The aim of the present study was to assess the validity of the assumption that electrical acupuncture (EA) and mechanical acupuncture (MA) show similar evidence within the basic and clinical studies, and therefore can be interchangeable in practice. It was found that there are endemic methodological limitations in the studies - thus, the comparability of the two modalities is limited.
Principally, it was shown that few studies directly compare EA to MA and that it has been difficult to match the frequency, intensity and duration of MA to EA. As a result of this pitfall in both the basic and clinic sciences, it would be naïve to interchangeably utilize EA and MA.
The authors carried out a literature review of systematic reviews and clinical trials, comparing EA and MA to determine if conclusions regarding possible similarities and differences can be gleaned from these two modalities. The literature was searched for both basic science studies and clinical trials.
Knowing that there is an inherent difference in the physiologic effect of acupuncture modalities, the literature was scoured for articles directly comparing EA to MA. When considering the basic sciences, studies have not yet shown whether the effects of EA result from afferent stimulation, fascial distortion and/or muscle fasiculations and if it can quantitatively and qualitatively be similar to EA.
Overall, very few studies directly compare EA to MA and those that do fail to match treatment parameters. Considering the results of this study, it is clear that more care needs to be taken when educating and selecting our treatment modalities as very little evidence exists to suggest that these two techniques are exchangeable clinically and physiologically.
> From: Langevin et al., J Altern Complement Med 21 (2016) 113-128. All rights reserved to Mary Ann Liebert, Inc. Click here for the Pubmed summary.