Movement disorders and Balance.

David Bomzon. Dip.AC Pnima center Pnimahaifa@gmail.com www.pnima-ac.com www.ynsa.co.il +972 775503410

What is the role of an acupuncturist in a western medical center?

What is the advantage of scalp acupuncture in rehabilitation over body acupuncture?

How can the role of an acupuncturist be maximized in rehabilitation or in integrative western medicine?

Combining Integrative Medicine and YNSA in Rehabilitation

Rehabilitation ward, BnAi Zion medical center, Haifa, Israel Yamamoto New Scalp Acupuncture Increases the Walking Speed of Patients With an Acute Stroke self controlled study David Bomzon, Boris Tchalabian, Suzy Ratner, Ortal Asa, Katalin Goldenberg Rehabilitation ward, BnAi Zion medical center, Haifa, Israel

Introduction Following an acute neuroischemic event, many patients suffer hemiplegia which restricts their mobility. In addition to physical (rehabilitation) therapy, acupuncture has been reported to improve a patient`s mobility and ability to perform daily tasks, to alleviate pain ,and to facilitate muscle contraction. Yamamoto New Scalp Acupuncture (YNSA) is a type of acupuncture in which specific acupuncture points (somatopes) on the scalp are needled and has been shown to be effective in relieving pain and improving mobility in patients with stroke and musculoskeletal pain.  Objective: To investigate the effect of YNSA on the walking speed of stroke patients.

Materials and Methods 20 hospitalized patients after stroke. 17 men, 3 women; aged 37-63. All capable of walking without the help of a physical therapist. YNSA given twice weekly for four weeks before conventional physical therapy. Methods: The time to walk 10 meters was recorded in all patients.

Main Results 10 meter walk with and without ynsa Without ynsa With ynsa Walking time in seconds The walking speed of the patients with the acupuncture needles was significantly faster (p<0.001) than their walking speed without the acupuncture needles.

Walking

(or the mobility of the lower limb ( Why is walking (or the mobility of the lower limb ( so important in a patient’s quality of life?

internal organ disorders blood circulation musculoskeletal pain physical fitness internal organ disorders blood circulation musculoskeletal pain loss of confidence Normal Human Gait (walking pattern)

Normal Human Gait (walking pattern) Normal human gait repeats a basic sequence of limb motions that serve to progress the body along a desired path while maintaining weight-bearing, stability, conserving energy and absorbing the shock of floor impact.

Normal Human Gait (walking pattern) A gait cycle is defined as the time from heel strike to ipsilateral heel strike. The most common method of dividing the gait cycle is into stance and swing Stance- the period the limb is on the ground. Swing- the period that the foot comes off the ground.

Eight phases in the gait cycle Initial Contact (IC)- The moment the foot contacts the ground Loading Response (LR)- Weight is rapidly transferred onto the outstretched limb, the period of double-limb support. Mid-Stance (MSt)- The body progresses over a single, stable limb. Terminal Stance (TSt)- Progression over the stance limb continues. The body moves ahead of the limb and weight is transferred onto the forefoot. Pre-Swing (PSw)- A rapid unloading of the limb occurs as weight is transferred to the contralateral limb, the second period of double limb support. Initial Swing (Isw)- The thigh begins to advance as the foot comes up off the floor. Mid-Swing (MSw)- The thigh continues to advance as the knee begins to extend; the floor clears the ground. Terminal Swing (TS)- The knee extends, the limb prepares to contact the ground for IC.

Eight phases in the gait cycle

Main muscles

Main joints Ankle Knee Pelvis and Hip

Important joints

Hot points on the soul of the foot

Small summary Joint Weight Motion Muscle action Balance and stability

What is interrupting the kinetic chain?

Week limb Neurons Spasticity Pain Sensory system Motor system Cognitive stat Amputation Body poster Stability and Balance

Common compensation disorders Circumduction: the circular movement of a limb https://www.youtube.com/watch?v=dc7cnLxbpKU ting: Rising up on the toes of stance foot so that advancing limb can clear the floor. https://www.youtube.com/watch?v=i2bxODibvb0 Trendelenburg: It means that the center of gravity is over the hip and so it reduces the degree of the pelvic drop. https://www.youtube.com/watch?v=Rz7V1i8kYGU

YANG MING LEG TMM ST QI LINE ST-30 ST-36

LEG SHAO YANG TMM GB-34 GB-30 GB-29 GB-27

LEG TAI YANG TMM UB- 9 UB-36 UB-57 UB-59

LEG TAI YIN TMM SP-6 SP-9

LEG JUE YIN TMM LIV-7 LIV-4

LEG SHAO YIN TMM KID-10 KID-1 KID-4

SCALP POINTS YNSA/SA GB-19, DU-17 DU-19 GB-8, GB-9, GB-6

NO-8

DU-20

FOOT C4=KNEE

DU-20.5 DU-20

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