The effects of acupuncture on muscle tissue oxygenation
Kaneko Y.1),2) , Kime R.1) , Takagi S.1) , Murase N.1), Osada T.1) , Katsumura T.1) , Kihira A.2) , Uehara A. 2) , Furuya E.2) , Sakamoto A.2)
1)Tokyo Medical University, Department of Sports Medicine for Health Promotion, Tokyo, Japan2) Kuretake College of Medical Arts & Sciences, Tokyo, Japan

Background
Acupuncture is widely used for musculoskeletal disorders such as low back pain or
osteoarthritis in complementary and alternative medicine. Acupuncture is recognized as one of
the reasonable referral options for chronic pain (Vickers, 2012). One of physiological effects ofacupuncture is that it increases tissue blood circulation, and it may help to ease pain or hasten
recovery from injuries (Kubo, 2011). Acupuncture stimulation with DeQi sensation, ormanipulation increased skin and muscle blood flow in the local area (Sandberg, 2003, Ohkubo,2009). Kubo showed the changes in blood circulation of the contralateral achilles tendon during
and after acupuncture (Kubo, 2011). However, there are no previous studies of the change ofblood circulation in both local and distant areas at the same time.

(n=10 mean ± S.D.)RL4LS1oxy-HbRS1

Needle insertion

RS1LS1
RL4Pre39.8 ± 11.7
30.6 ± 9.6
36.1 ± 7.8

Post
43.9±12.8**
32.7 ± 10.5*
41.0 ± 9.2**

deoxy-HbPre
Post
8.0 ± 4.1
7.9 ± 4.5
7.6 ± 3.7
7.6 ± 3.9
8.5 ± 4.4
8.9 ± 3.6

RG

77.7 ± 34.2

80.7 ± 36.6*

27.4 ± 7.7

The aim of this study was to examine the effects of acupuncture on muscle tissue oxygenationin both local and distant areas at the same time.

Table 1: The change of oxy-Hb, deoxy-Hb, and total-Hb at Pre and Post. There were significant
changes in oxy-Hb and total-Hb at all areas. At gastrocnemius, deoxy-Hb was also increased
after the intervention while no changes were observed in other areas.

Fig.3 : Probes were attachedon both sides of erector
spinae at S1 level , the rightside of erector spinae at L4
level, and the belly ofgastrocnemius on the rightRight
lowerleg(n=10 mean;+/- S.D.)

Methods[%]
95

[μM]

Fig.4 : Needle was inserted between LEDand detector at 15mm depth.

8Intervention

Rest6Ten healthy males (29±4.1yrs, 173.7±2.7cm, 69.0±5.2kg) participated in this study. NearInfrared Spectroscopy (NIRS, HB-14, ASTEM Co.,Ltd.) (Fig. 1, 2) was used to detect
oxygenated hemoglobin (oxy-Hb), deoxygenated hemoglobin (deoxy-Hb), total hemoglobin(total-Hb), and tissue-oxygen saturation (StO2). The probes of NIRS were placed on the rightand left side of erector spinae at S1 level (RS1, LS1), the right side of erector spinae at L4 level(RL4), and the belly of gastrocnemius on the right (RG) (Fig.3). Subjects lay on their belly andrested. The acupuncture needle (0.25*50mm, SEIRIN Co. ltd.) was inserted into the right side oferector spinae at S1 level, then manipulated for 1 min and left for 9 min (Fig.4). Subjects
continued to rest for 10 min after removal of the needle. oxy-Hb, deoxy-Hb, total-Hb, and StO2
were evaluated at rest (Pre) and after acupuncture stimulation (Post) (Fig. 5).

LEDDetector

105.2 ± 40.3 109.2 ± 42.3***: p<0.05 vs. Pre, **: p<0.01 vs. Pre by paired student-t test

RG

Objective

28.7 ± 7.4*

total-HbPrePost
47.8 ± 14.1 51.8 ± 15.5*
38.2 ± 13.0 40.3 ± 14.1*
44.1 ± 11.0 49.8 ± 12.3**

Fig.5 : Schematic protocol describing theexperimental design and procedure.
Subjects had a needle inserted on theright side of erector spinae at S1 level, thenreceived pecking sparrow manipulation for
1 min at 15mm depth and the needle wasleft at 15mm depth for 9 min. Recording ofoxygenation was started from 10min prior
to the intervention and continued to 10minafter the removal of the needle.

Intervention
10 minRest
10 minOxygenation
Recorded asPrePeckingSparrow
1 min

Rest
10 min1min

1min

LeavingNeedle
9 min

42TimeOxygenation
Recorded as
Post

Results90**(n=10 mean;+/- S.D.)

n.s.

85

*n.s.

80
**
*
*

**
**
**
**
** ** ** **

Pre
Post

75
70
65

060-255-450

RS1p<0.01 at main effect by repeat measures ANOVA*: p<0.05 vs. Pre, **: p<0.01 vs. Pre by Tukey multipule comparisonFig. 6 :This graph shows the increase of oxyHb from Pre to Post at RS1. There are
significant differences at the end ofintervention and in the whole period of resting
after the intervention compared to Pre.

LS1RL4Gastro*: p<0.05 vs. Pre **: p<0.01 vs. Pre by paired student-t test

Fig. 7 :The changes in StO2 at Pre and Post.
StO2 was increased after the intervention at
RS1 and RL4 while no change was observed
at gastrocnemius.

30mm

Acupuncture
Stimulation

Fig.2 : Shematic probe of Near
Infrared Spectroscopy
Fig.1 : Near Infrared Spectroscopy( HB-14, ASTEM Co.,Ltd. Japan)

At RS1, where the needle was inserted, oxy-Hb was increased from 39.8 ± 11.7 μM to 43.9± 12.8 μM (p<0.01). No change was observed in deoxy-Hb (8.0 ± 4.1 μM to 7.9 ± 4.5 μM).
Total-Hb was increased from 47.8 ± 14.1 μM to 51.8 ± 15.5 μM (p<0.05). StO2 was increased
from 83.8 ± 6.0 % to 85.4 ± 6.1 % (p<0.01). At LS1 oxy-Hb was increased from 30.6 ± 9.6
μM to 32.7 ± 10.5 μM (p<0.05). No change was observed in deoxy-Hb (7.6 ± 3.7 μM to 7.6 ±3.9 μM). Total-Hb was increased from 38.2 ± 13.0 μM to 40.3 ± 14.1 μM (p<0.05). No change
waas observed at StO2 (80.9 ± 5.2 % to 82.0 ± 5.1 %). At RL4 oxy-Hb was increased from36.1 ± 7.8 μM to 41.0 ± 9.2 μM (p<0.01). No change was observed in deoxy-Hb (8.5 ± 4.4μM to 8.9 ± 3.6 μM). Total-Hb was increased from 44.1 ± 11.0 μM to 49.8 ± 12.3 μM(p<0.01). StO2 was increased from 81.2 ± 5.1 % to 82.8 ± 4.2 % (p<0.05). At RG oxy-Hb wasincreased from 77.7 ± 34.2 μM to 80.7 ± 36.6 μM (p<0.05). deoxy-Hb was increased from27.4 ± 7.7 μM to 28.7 ± 7.4 μM (p<0.05). Total-Hb was increased from 105.2 ± 40.3 μM to109.2 ± 42.3 μM (p<0.01). There was no change in StO2 (72.8 ± 4.9 % to 72.4 ± 5.5 %)(Table. 1, Fig. 6,7).

Conclusions
Different effects of acupuncture on muscle tissue oxygenation were observed where theacupuncture needle was inserted in local area and distant areas. These results indicate that
acupuncture stimulation may differently affect local and distant areas, such as by axon reflex
and by segmental effects via sympathetic nervous system.

References: Vickers et al., Arch Intern Med. 2012; 172(19):1444-1453.
Sandberg et al., Eur J Appl Physiol 2003; 90:114-9.
Ohkubo et. al., Dynamic Medicine 2009; 8:2.
Kubo et al., Int J Sports Med. 2011 Oct; 32(10): 807-13.