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Acupuncture in modern rehabilitation medicine


Authors: L. Hrehová Hanták
Authors place of work: Ústav všeobecného lékařství 1. LF UK v Praze
Published in the journal: Rehabil. fyz. Lék., 105, 2025, No. 2, pp. 81-87.
Category: Přehledový článek
doi: https://doi.org/10.48095/ccrhfl202581

Summary

Acupuncture represents a complementary approach in rehabilitation medicine, with its therapeutic potential and safety supported by a growing body of clinical evidence. It is applied for pain relief, modulation of spasticity, support of neuroplasticity, and regulation of autonomic and psychosomatic functions. This review article summarizes the main physiological mechanisms of acupuncture, its range of clinical indications, and the possibilities for practical application in rehabilitative care. The text includes up-to-date evidence from meta-analyses and international guidelines, as well as examples of clinical implementation. Acupuncture represents a valuable non-pharmacological tool, whose full potential depends on interdisciplinary collaboration, professional expertise, and systematic evaluation of effectiveness.

Keywords:

spasticity – Pain – Rehabilitation medicine – Acupuncture – non-pharmacological treatment – autonomic regulation


Zdroje
  1. White A, Ernst E. A brief history of acupuncture. Rheumatology (Oxford) 2004; 43(5): 662– 663. doi: 10.1093/rheumatology/keh192.
  2. Fiala P. Akupunktura v 21. století. 2. vyd. Praha: Mladá fronta 2018.
  3. Han JS. Acupuncture and endorphins. Neurosci Lett 2004; 361(1–3): 258–261. doi: 10.1016/j. neulet.2003.12.019.
  4. Zhao ZQ. Neural mechanism underlying acupuncture analgesia. Prog Neurobiol 2008; 85(4): 355–375. doi: 10.1016/j.pneurobio.2008.05.004.
  5. WHO. WHO Traditional Medicine Strategy 2014–2023. Geneva: WHO 2013.
  6. Brinkhaus B, Witt CM, Jena S et al. Acupuncture in patients with chronic low back pain: a randomized controlled trial. Arch Intern Med 2006; 166(4): 450–457. doi: 10.1001/ archinte.166.4.450.
  7. Tough EA, White AR, Cummings TM et al. Acupuncture and dry needling in the management of myofascial trigger point pain: a systematic review and meta-analysis of randomised controlled trials. Eur J Pain 2009; 13(1): 3–10. doi: 10.1016/j.ejpain.2008.01.006.
  8. Zhou W, Benharash P. Effects and mechanisms of acupuncture based on the principle of meridians. J Acupunct Meridian Stud 2014; 7(4): 190– 193. doi: 10.1016/j.jams.2014.02.007.
  9. Zijlstra FJ, van den Berg-de Lange I, Huygen FJPM et al. Anti-inflammatory actions of acupuncture. Mediators Inflamm 2003; 12(2): 59– 69. doi: 10.1080/0962935031000114943.
  10. Torres-Rosas R, Yehia G, Peña G et al. Dopamine mediates vagal modulation of the immune system by electroacupuncture. Nat Med 2014; 20(3): 291–295. doi: 10.1038/nm.3479.
  11. Kim MW, Chung YC, Jung HC et al. Electroacupuncture enhances motor recovery perfor- mance with brain-derived neurotrophic factor expression in rats with cerebral infarction. Acupuncture in Medicine 2012; 30(3): 222–226. doi: 10.1136/acupmed-2011-010126.
  12. Torres-Rosas R, Yehia G, Peña G et al. Dopamine mediates vagal modulation of the immune system by electroacupuncture. Nat Med 2014; 20(3): 291–295. doi: 10.1038/nm.3479.
  13. Kong J, Gollub RL, Rosman IS et al. Brain activity associated with expectancy-enhanced placebo analgesia as measured by functional magnetic resonance imaging. J Neurosci 2006; 26(2): 381–388. doi: 10.1523/ JNEUROSCI.3556-05.2006.
  14. Qin S, Zhang Z, Zhao Y et al. The impact of acupuncture on neuroplasticity after ischemic stroke: a literature review and perspectives. Front Cell Neurosci 2022; 16: 817732. doi: 10.3389/fncel.2022.817732.
  15. Hamvas S, Hegyi P, Kiss S et al. Acupuncture increases parasympathetic tone, modulating HRV – Systematic review and meta-analysis. Complement Ther Med 2023; 72: 102905. doi: 10.1016/j.ctim.2022.102905.
  16. Chung JW, Yan VC, Zhang H. Effect of acupuncture on heart rate variability: a systematic review. Evid Based Complement Alternat Med 2014; 2014: 819871. doi: 10.1155/2014/819871.
  17. Hui KK, Marina O, Liu J et al. Acupuncture, the limbic system, and the anticorrelated networks of the brain. Auton Neurosci 2010; 157(1– 2): 81–90. doi: 10.1016/j.autneu.2010.03.022.
  18. Vickers AJ, Cronin AM, Maschino AC et al. Acupuncture for chronic pain: individual patient data meta-analysis. Arch Intern Med 2012; 172(19): 1444–1453. doi: 10.1001/ archinternmed.2012.3654.
  19. Zhang J, Lu C, Wu X et al. Neuroplasticity of acupuncture for stroke: an evidence-based review of MRI. Neural Plast 2021; 2021: 2662585. doi: 10.1155/2021/2662585.
  20. Qin S, Zhang Z, Zhao Y et al. The impact of acupuncture on neuroplasticity after ischemic stroke. Front Cell Neurosci 2022; 16: 817732. doi: 10.3389/fncel.2022.817732.
  21. MacPherson H, Vertosick EA, Foster NE et al. The persistence of the effects of acupuncture after a course of treatment: a meta-analysis of patients with chronic pain. Pain 2017; 158(5): 784– 793. doi: 10.1097/j.pain.0000000000000747.
  22. Lee JH, Choi TY, Lee MS et al. Acupuncture for acute low back pain: a systematic review. Clin J Pain 2013; 29(2): 172–185. doi: 10.1097/ AJP.0b013e31824909f9.
  23. Mu J, Furlan AD, Lam WY et al. Acupuncture for chronic nonspecific low back pain. Cochrane Database Syst Rev 2020; 12(12): CD013814. doi: 10.1002/14651858.CD013814.
  24. Manheimer E, Cheng K, Linde K et al. Acupuncture for peripheral joint osteoarthritis. Cochrane Database Syst Rev 2010; 2010(1): CD001977. doi: 10.1002/14651858.
  25. Yang A, Wu HM, Tang JL et al. Acupuncture for stroke rehabilitation. Cochrane Data- base Syst Rev 2016; 2016(8): CD004131. doi: 10.1002/14651858.CD004131.pub3.
  26. Yuan QL, Wang P, Liu L et al. Acupuncture for musculoskeletal pain: A meta-analysis and meta-regression of sham-controlled randomized clinical trials. Sci Rep 2016; 6: 30675. doi: 10.1038/srep30675.
  27. Tough EA, White AR, Cummings TM et al. Acupuncture and dry needling in the management of myofascial trigger point pain: a systematic review and meta-analysis of randomized controlled trials. Eur J Pain 2009; 13(1): 3–10. doi: 10.1016/j.ejpain.2008.02.006.
  28. Linde K, Allais G, Brinkhaus B et al. Acupuncture for the prevention of episodic migraine. Cochrane Database Syst Rev 2016; 2016(6): CD001218. doi: 10.1002/14651858.CD001218. pub3.
  29. Chen P, Jin X, Yu D et al. Efficacy of acupuncture on lower limb motor dysfunction following stroke: A systematic review and meta-analysis of randomized controlled trials. PLoS One 2025; 20(5): e0312918. doi: 10.1371/journal. pone.0312918.
  30. Zhang XH, Feng CC, Pei LJ et al. Electroacupuncture Attenuates Neuropathic Pain and Comorbid Negative Behavior: The Involvement of the Dopamine System in the Amygdala. Front Neurosci 2021; 15: 657507. doi: 10.3389/ fnins.2021.657507.
  31. Wang SM, Kain ZN, White P. Acupuncture analgesia: I. The scientific basis. Anesth Analg 2008; 106(2): 602–610. doi: 10.1213/01. ane.0000277493.42335.7b.
  32. WHO. Acupuncture: Review and Analysis of Reports on Controlled Clinical Trials. Geneva: WHO 2002.
  33. Qaseem A, Wilt TJ, McLean RM et al. Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians. Ann Intern Med 2017; 166(7): 514–530. doi: 10.7326/M16-2367.
  34. Sateia MJ, Buysse DJ, Krystal AD et al. Clinical practice guideline for the pharmacologic treatment of chronic insomnia in adults: an American Academy of Sleep Medicine clinical practice guideline. J Clin Sleep Med 2017; 13(2): 307–349. doi: 10.5664/jcsm.6470.
  35. European Pain Federation. Position Paper: Acupuncture for Acute Pain. 2016. [online]. Dostupné z: https://www.europeanpainfederation.eu/wp-content/uploads/2017/01/12.-Acupuncture-for-Acute-Pain.pdf.
  36. Deutsche Ärztegesellschaft für Akupunktur. Leitlinie: Chronische Schmerzen – Akupunkturbehandlung. Mnichov: DÄGfA 2020.
  37. Société Française d’Acupuncture. Recommandations sur la prise en charge des douleurs chroniques par acupuncture. Paris: SFA 2018.
  38. Swiss Federal Office of Public Health. Complementary Medicine in Switzerland: Current Situation and Development 2012. Bern: BAG 2012.
  39. National Institute for Health and Care Excellence. Low back pain and sciatica in over 16s: assessment and management. 2016. [online]. Dostupné z: https://www.nice.org.uk/guidance/ ng59.
  40. Derry CJ, Derry S, McQuay HJ et al. Systematic review of systematic reviews of acupuncture published 1996–2005. Clin Med (Lond) 2006; 6(4): 381–386. doi: 10.7861/ clinmedicine.6-4-381.
  41. Madsen MV, Gøtzsche PC, Hróbjartsson A. Acupuncture treatment for pain: systematic review of randomised clinical trials with acupuncture, placebo acupuncture, and no acupuncture groups. BMJ 2009; 338: a3115. doi: 10.1136/bmj. a3115.
  42. Moffet HH. Sham acupuncture may be as efficacious as true acupuncture: a systematic review of clinical trials. J Altern Complement Med 2009; 15(3): 213–216. doi: 10.1089/ acm.2008.0356.
  43. Witt CM, Jena S, Selim D et al. Pragmatic randomized trial evaluating the clinical and economic effectiveness of acupuncture for chronic low back pain. Am J Epidemiol 2006; 164(5): 487–496. doi: 10.1093/aje/kwj224.
  44. Fuentealba Cargill F, Biagini Alarcón L. Efectividad de la acupuntura en el tratamiento del dolor agudo postquirúrgico en adultos, en comparación con tratamientos activos o con acupuntura simulada [Acupuncture for postoperative pain, a literature review]. Rev Med Chil 2016; 144(3): 325–332. doi: 10.4067/ S0034-98872016000300007.
  45. Kietrys DM, Palombaro KM, Azzaretto E et al. Effectiveness of dry needling for upper-quarter myofascial pain: a systematic review and metaanalysis. J Orthop Sports Phys Ther 2013; 43(9): 620–634. doi: 10.2519/jospt.2013.4668.
Štítky
Fyzioterapie Rehabilitační a fyzikální medicína Tělovýchovné lékařství

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Rehabilitation & Physical Medicine

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