Efeitos imediatos da acupuntura manual sobre a função muscular do bíceps braquial de indivíduos saudáveis e hemiparéticos espásticos crônicos

Abstract

A large number of studies have focused on important functional and neuropsychological outcomes involving various acupuncture interventions in hemiparetic stroke victim. The lack of success in the production of evidence, not just the results and hypotheses, which mostly comes from badly formulated questions, theoretical framework superficial, disjointed study designs or serious failures of implementation and interpretation. This study follows the recommendations of international organizations in clinical trials on acupuncture (STRICTA and CONSORT), by reference, authors, ancient, modern and contemporary Chinese medicine, in order to assess the immediate effects of manual stimulation of acupoints on the muscle function (electrical activity and strength) of the brachial biceps of healthy individuals and patients. Methods: This clinical trial, randomized, single-blinded, with 4-parallel groups was conceived, designed and executed over two years, taking as a starting point a review about the methodological issues and bioethical concerns inherent in acupuncture research in humans, followed by a deepening medical theorist on Eastern and Western pathophysiology of stroke. The prescription of acupoints classical acupuncture for interventions with hemiparesis was guided by a statistical distribution and temporal frequency of use. And even before his execution had his detailed methodology and published in a separate article. Results: Methodological and ethical issues raised by clinical studies with acupuncture point incongruities ranging from the election of the intervention, the valuation methods and their variables, as well as the lack of randomization and control criteria and the use of placebo questionable procedures. Regarding the etiopathology hemiparesis, we observe that the causes attributed to AVC and their sequel do not differ significantly from the Chinese classic reports until the present day, and that patterns findings in the population of patients were the Fire Heat and Phlegm. The meridians of yang systems of limbs are stimulated with greater frequency, and the IG4 point most cited among modern and pre- modern authors. Finally, we note that acupuncture manual (LI11 and PC2) promotes a neuromuscular stimulation sufficient to generate significant reduction of motor units recruitment of biceps in individuals, but the same didn't happen in chronic spastic hemiparesis volunteers. Conclusions: Currently, there is no physiologic explanation for the observed neuromuscular parameters. Previous studies reported a “reflex loop” but without clear explanations on physiologic mechanisms and structures enrolled. Based on the current results and along with consideration on the sEMG signal characteristics and neurophysiology, a theoretical model was proposed for explanation of the results observed in healthy subjects that is compatible to the adaptive changes observed in post-stroke subjects and considers acupuncture technique.