Dear Erik Dombroski,

You wrote:
> Acupuncture is becoming very popular here to learn at a Post-graduate
> level. Traditional Chinese Medicine is approximately 50% of the course
> content and the use of acupressure is just one of the methods taught. As
> you rightly pointed out Paul, physiotherapists tend to then mix and
> match and finally create a form of treatment that suits them and their
> clients best.

I'm PT in Sweden and I'm using (among other methods) a method called
Acupoint Therapy (AT). AT could be considered an integration of manual
therapy and sensory stimulation. AT can be seen as a result of mixing
and matching. I include a description of the method at the end of this
message.

I'm currently doing scientific research on the method (about halfway to
my PhD). So far we have coducted three studies on the method and the
first one is published (Clinical Journal of Pain vol. 12 (1996)
326-239).

All the best,

David Felhendler


ACUPOINT THERAPY

Acupoint Therapy, AT, has its origin in the therapy system
Akupunkt-Massage nach Penzel (APM). The German Willy Penzel developed a
treatment technique based on connective tissue release
(Dicke/Tei-rich-Leube) and acupuncture. Penzel developed this technique
over a period of 30 years. APM was primarily aimed at German masseurs,
but we have chosen to adapt it for Scandinavian physiotherapy. This
process has been in progress since 1978, and since 1989 Acupoint Therapy
has been separated from APM. The main work in this process has been done
by the Norwegian physiotherapist Erling Damm. Since 1995 research on AT
is done at the University of Linköping in Sweden by physiotherapist
David Felhendler. The results from one of the studies are found in
Clinical Journal of Pain vol. 12 (1996) 326-239.

Theoretical background
TCM divides the meridians into Yin and Yang. Yin corresponds to the
parasympathetic nervous system and Yang to the sympathetic nervous
system. This means that if you stimulate all the Yin meridians you will
get an increased parasympathetic activity (decreased muscle tone,
general relaxation, decreased heart rate and blood pressure, etc.) and
if you stimulate all the Yang meridians you will get an increased
sympathetic activity (increased muscle tone, increased heart rate and
blood pressure, etc.). Sometimes the balance between the sympathetic
nervous system and the parasympathetic nervous system is disturbed, for
example by an injury. AT tries to restore that balance.

Diagnosis
The diagnosis is made through muscle palpation, testing of muscle
function, testing of joint function, etc., in combination with tonifying
and sedating transcutaneous stimuli. The treatment is performed
according to the principles of acupuncture, either by decreasing
hyperactivity or stimulating where there is hypoactivity. Treatment
principles that are specific for AT have also been developed.

The transcutaneous techniques
The primary intention of this part of the treatment is to normalise
blood circulation, muscle tone and reflex activity. Two different
transcutaneous techniques are mainly used. The first one is to stimulate
along the course of the meridian or meridians with a tool consisting of
a handle with a small (2 mm diameter) ball-point at the end (called a
therapy stick).

The stimulation is performed by stroking the skin with the therapy stick
which causes a vasodilatation. This vasodilatation activates the
acupoints along the meridian. The second technique is to stimulate the
individual acupoints. This is achieved with a gliding pressure over the
acupoint applied with the therapy stick. The stimulation is confirmed
when the patient feels a slight stinging sensation. The choice of
acupoints is made based on their different reaction patterns. The
treatment of acupoints has a strong analgesic effect.

Manual therapy
Manual therapy for the spinal joints has a central role in AT. It is
emphasised that all manual therapy for the spine should only be
performed after a thorough examination and if the treatment can be
performed painlessly. The spine is seen as one organ and treated as a
whole irrespective of where the primary cause is localised. Manual
therapy for the extremity joints is performed in combination with
transcutaneous treatment, preferably after finishing the treatment of
the spine. All treatments end with instructions in exercises to maintain
the achieved mobility. Mobilisation of a hypomobile or blocked
sacroiliac joint (SIJ) constitutes the basis of every treatment of
spinal
dysfunction.
Treatment with electrotherapy
At times of prolonged dysfunctions and severely decreased blood
circulation, electrotherapy can be used with advantage.

Summary
AT is indicated for the same dysfunctions as "traditional
physiotherapy". Particularly good results are observed with migraine,
neuralgia, muscular and nervous tension and a diversity of circulatory
dysfunctions. The treatment system is very efficient, as is evidenced by
the small number of treatments required. The system however demands
solid knowledge and experience from the therapist.

Courses
There are 4 courses 4-5 days each. After the 4th course you graduate.
1. The meridian system. Basic diagnostics in AT. Mobilisation of the
sacroiliac joint.
2. The most important acupoints (about 100 of them). More diagnostics.
3. Mobilisation of the spine with help of transcutaneous stimuli.
4. Electrotherapy in AT. Treatment of the extremities.
Graduation. Theoretical and practical tests.


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