Acupuncture point localization varies among acupuncturists

Abstract

SummaryBackground: Studies assessing the point-specific effect of acupuncture or the characteristics of acupuncture points (APs) tend to yield inconclusive results. In order to identify a possible confounding factor, we aimed to examine the variability in AP localization by means of a survey. Material and Methods: Attendees of the 14th ICMART (International Council of Medical Acupuncture and Related Techniques) congress as well as DÄGfA (German Medical Society of Acupuncture) lecturers and students were asked to locate and mark the APs LI 10 and TH 5 on a research assistant's arm. Identified points were transferred into a coordinate system, and the respective bivariate distribution function was calculated. Additionally, participants filled out a questionnaire about their acupuncture education and experience, the acupuncture style and point localization techniques used most frequently, and their estimation of the size of an AP. Results: The areas of the ellipses, theoretically containing 95% of AP localizations, varied between 44.49 and 5.18 cm 2 . The largest distance between 2 identified points was 8.45 cm for LI 10 and 5.3 cm for TH 5. Apart from being trained at the same school, no other factor could be identified that determined the variability in AP localization. Conclusion: Our results indicate that congruity of AP localization among experienced acupuncturists might be low. Although there are some limitations to our results, this possible bias should be taken into account when conducting acupuncture trials and interpreting results of previous acupuncture studies. Schlüsselwörter Material and Methods ParticipantsSurveys were performed at the 14th Congress of the ICMART (International Council of Medical Acupuncture and Related Techniques) in Riga, Latvia, in May 2010, and at the DÄGfA (German Medical Society of Acupuncture, Deutsche Ärztegesellschaft für Akupunktur) central office in Munich, Germany, during an acupuncture seminar and a meeting of the DÄGfA scientific committee in June 2010. The ICMART congress was characterized by an international ambience with therapists attending from all over the world. All acupuncturists present on the second occasion had studied acupuncture at the DÄGfA or were part of the DÄGFA faculty. Participants took part voluntarily, were over 18 years of age, held an acupuncture degree, and had a good command of written and spoken English. Overall, we polled 30 acupuncturists at the ICMART congress and 12 at the DÄGfA central office. DesignParticipants were asked to localize the APs LI 10 and TH 5 on the left arm of a member of the study staff and to mark them with a makeup pen. According to the textbooks, LI 10 is located 2 cun distally from LI 11 on the connecting line of LI 5 and Li 11, and TH 5 is found 2 cun proximal to the dorsal wrist crease between the radius and the ulna [28,29]. The person on whom the localization was performed was the same throughout the entire survey. Indicated locations for LI 10 and TH 5 were transferred immediately onto transparent plastic sheets ...