1. Movement disorders and Balance.

2. David Bomzon. Dip.AC Pnima center Pnimahaifa@gmail.com

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

4. What is the advantage of scalp acupuncturein
rehabilitation over
body acupuncture?

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

6. Combining Integrative Medicine and YNSA
in Rehabilitation

7. 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

8. 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.

9. Materials and Methods 20 hospitalized patients after stroke.
17 men, 3 women; aged
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.

10. 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.

11. Walking

12. (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?

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

14. 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.

15. 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.

16. 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.

17. Eight phases in the gait cycle

18. Main muscles

19. Main joints
Ankle
Knee
Pelvis and Hip

20. Important joints

21. Hot points on the soul of the foot

25. Small summary
Joint
Weight
Motion
Muscle action
Balance and stability

26. What is interrupting the kinetic chain?

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

28. Common compensation disorders
Circumduction: the circular movement of a limb
ting: Rising up on the toes of stance foot so that advancing limb can clear the floor.
Trendelenburg: It means that the center of gravity is over the hip and so it reduces the degree of the pelvic drop.

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

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

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

32. LEG TAI YIN TMM
SP-6
SP-9

33. LEG JUE YIN TMM
LIV-7
LIV-4

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

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

39. NO-8

45. DU-20

46. FOOT
C4=KNEE

48. DU-20.5
DU-20

49. THANK YOU ALL FOR COMMING