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1. ACUPRESSURE & ACUPUNCTURE -MANSI PATEL (19SPTPT21019) -DHVANI TERAIYA (19SPTPT21020)

2. ACUPRESSURE Acupressure involves application of manual pressure usually with finger tips to specific points on the body.

3. GENERAL DIRECTIONS Use firm pressure Acupressure points are very sensitive areas Massage until numbness is felt No limit in the number of exercise per day Increase the massage intensity slowly During massage, client can sit or lie down and breath deeply. Client need not massage on his own.

4. BASIC PRINCIPLE Chinese philosophy believe that a person is healthy when Qi flows evenly along the meridian. The root cause of all the diseases is a disorder in this energy vibration It defines 12 meridians connected to 12 vital organs. Any factor affects the flow leads to - ILLNESS. Imbalance caused blockage

5. PROCEDURE It is administered by acupuncturist. Pressure increased for 30 seconds and held for 30sec – 2 mins . Repeated 3 – 5 times Acupressure and acupuncture – same active points

6. MECHANISM OF ACTION Energy flows through the various channels irrigating and nourishing the tissues An obstruction in the movement causes disease and ailments . Needling unblocks the obstruction and reestablish flow through meridians . Acupuncture helps internal organ to correct imbalances in digestion absorption and energy production. Stimulation of endorphins and hormones.

7. PRECAUTIONS Acupressure should never be painful. Pressure should be gentle. AVOID – osteoporosis , bruising and bleeding disorders, circulatory problems.

8. SIDE EFFECTS Soreness and temporary lightheadedness (rarely).

9. ACUPUNCTURE In latine ACUS means needle and PUNCTURA means pricking. It is a Chinese art of healing ,where various disease of the body cured by inserting very fine needle in specific points of the body.

10. THEORY Traditional acupuncture is based on the belief that an enrgy or life force, flows through the body in channels called meridian. This life force is known as Qi (chi). “ Qi”is an universal and present at all the time in different form. It is invisible force responsible for all the movement of life. It has 2 component yin and yang . They are dynamically opposite yet hormonising energies. They act as opposite poles negative and positive and are compalimentary to each other. Yang signifies for male,light,active , warm,sun , and all are positive Ying signifies for femal,passive , dark,cold moon and all are negative.

11. A close circle divided into two equal halves by a sinus curve reprent it. Two different colour are use for both circle. In each half circle, there is a small circle of opposite colour this opposite colour shows that yin is suppressed while yang is on its peak and yang is suppressed while yin is on its peak . There are some other theories like… Five element theory Mother and son law Husband and wife law

12. EFFECT OF ACUPUNCTURE Subjective effects Pain Numbness Heaviness Soreness Distension

13. Objective effect Analgesia Sedation Homeostatic Immunity improvement Psychological effect Motor recovery

14. T-SUN: A UNIT OF MEASUREMENT Unit of measuring acupuncture points on the body is t-sun or cun . One t-sun is the distance between the palmer creases over the proximal and distal inter phalangeal joint of the middle finger of the patient. The combined breath of the index and middle finger is 1.5 t-sun. The combine breadth of the four fingers together is 3 t-sun.

15. METHODS OF STIMULATION IN ACUPUNCTURE

16. METHOD OF ACUPNCTURE Nowadays, most commnly used needle are made up of stainless steel with handle of silver which is quite effective and economical there are several shape and size of needle. Types of needle Filliform needle Intra dermal needle Triangular needle Cosmetic needle Seven star derman needle Hidden subdermal needle Hot needle

17. STERILIZATION OF NEEDLE The needle are kept in 70% alcohol or 24 hours or it can be sterilized in autoclave due to danger of contamination with hepetitis and AIDS.

18. TRADITIONAL ACUPUNCTURE TECHNIQUES It is an ancient technique. Needle should be between thumb and index finger. Bring the tip of needle near the acupuncture point and use it rapidlly for piercing the skin. After inserting the needle it should be manipulated by hand “ te -chi” and “de- qi ” is achieved. Te-chi or de-qi : when the tip of the needle is inserted to the correct depth sensation of pain soreness, numbness, heaviness, fullness may be experience by the client. There should be no pain if the procedure is done properly

19. DIRECTION OF THE NEEDLE Perpendicular - used for extremities at 90 angle Slanting - 30-60 used where less muscle are present as chest ad head Horizontal 10-20 used for less muscular area

20. TYPES OF STIMULATION Up and own movement within 1cm Rotation to and fro rotation of needle between thumb and index finger Flicking- usually 20 flicks per period of stimulation Vibration- 1-2mm rapid up and down movement done with the first for 1-2 min. Snapping- snapping of middle finger on needle gently

21. DEGREE OF STIMULATION Strong stimulation- up and down snapping, flicking for acute cases and younger patients Medium stimulation - up and down snapping, flicking similarly as above but gently and slowly applied Weak stimulation - slow snapping and slow flicking used for old patients and chronic cases

22. DURATION OF STIMULATION Short - 20 sec. toothache and headache Intermediate - 2-3 minutes to 10-20 minutes, sciatica, migrane and artheritis Continuous - 1 to 2 hours renal colic and acute headache

23. DIAGNOSIS It can be done by two ways: 1 modern way 2 traditional chinese way

24. COMPLICATIONS Pain Needle dystocia Bent needle Fainting Injury to the internal organ Infection Bleeding Forgotton needle

25. CONTRAINDICATION It should not be used on certain area Umbilicus, nipple and breast tissues, external genitals, fontanelles in children It should be used in following circumstances Hernia, fracture, patient under influence of alcohol, full stomach, heavy exertion, malignancy, pregnancy , patient with bleeding disorder

26. TITLE -1 To study the effectiveness of acupuncture on the perception of stress in patients who study or work on a large, urban college campus. AUTHOR - Stefanie schroder , james burnis , antony denton JOURNAL – journal of acupuncture and meridian studies 10 (3), 165-170, 2017

27. METHOD This study included 111 participants. The participants were randomized into a verum acupuncture or sham acupuncture group. Both the groups received treatment once a week for 12 weeks. The Cohen's global measure of perceived stress scale (PSS-14) was completed by each participant prior to treatment, at 6 weeks, at 12 weeks, and 6 weeks and 12 weeks post-treatment completion.

28. RESULT While participants of both the groups showed a substantial initial decrease in perceived stress scores, at 12 weeks post treatment, the verum acupuncture group showed a significantly greater treatment effect than the sham acupuncture group. CONCLUSION This study indicates that acupuncture may be successful in decreasing the perception of stress in students and staff at a large urban university, and this effect persists for at least 3 months after the completion of treatment.

29. TITLE -2 The effectiveness of acupuncture, acupressure and chiropractic interventions on treatment of chronic nonspecific low back pain in Iran: A systematic review and meta-analysis AUTHOR - Mohsen yeganeh , saeed Dastgiri JOURNAL - complementary therapies in clinical practice, vol 27, may-2017, 11-18

30. Methods A systematic literature search was completed without date restrictions up to May 2013 in five major databases (Medline, CINAHL , Science Direct , CAJ Full-text Database , and Cochrane databases). Only randomized controlled trials published in Persian (Farsi) or English languages were included. Two independent reviewers extracted the data. The quality of the papers was assessed using the Cochrane Back Review Risk of Bias criteria.

31. Results Initial searches revealed 415 papers, 382 of which were excluded on the basis of abstract alone. After excluding 23 papers due to duplication, the remaining 10 trial papers were subjected to a more detailed analysis of the full text, which resulted in three being excluded. The seven remaining trials had a lack of methodological and clinical homogeneity, precluding a meta-analysis. The trials used different comparators with regards to the primary outcomes, the number of treatments, the duration of treatment and the duration of follow-up. Conclusion This systematic review demonstrates that acupuncture, acupressure and chiropractic may have a favorable effect on self-reported pain and functional limitations on NSCLBP. However, the results should be interpreted in the context of the limitations identified, particularly in relation to the heterogeneity in the study characteristics and the low methodological quality in many of the included studies.

32. TITLE -3 Self- acupressure for older adults with symptomatic knee osteoartheritis : A randomized controlled trial AUTHOR - L ydia W Li, Richard E Harris, Alex Tsodikov JOURNAL - Artheritis care & research 70(2),221-229,2018

33. METHOD - 150 subjects were randomly divided into 3 groups: verum acupressure, sham group and usual care. participants in the verum and sham group were tought to self-apply acupressureonce daily, 5 days\week for 8 weeks. outcome measure includes Western ontario and McMaster Universities osteoartheritis index (WOMAC) and numeric pain rating scale. CONCLUSION - self-apply acupressure is superior to usual care in pain and physical functional improvement for older adult with knee OA.

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