Table 1: Characteristics of the studies that assessed the effects of acupuncture on enhancing muscle strength.
Authors |
No |
Intervention group |
Control/sham group |
Outcome Measures |
Results |
Justification for point selection |
PEDro score |
So, et al. [8]
|
17 |
ST-36, UB-57, GB-34, SP-6 15 minutes TENS 1 session per week over 3 weeks |
Psudo-TENS applied to sham points |
EMG Peak torque muscle force recovery of the knee extensors. |
SD for muscle force recovery Peak torque
|
The four acupuncture points was selected based on their therapeutic effect on recovery from general weakness and enhancement on lower limb neuromuscular function. |
3/10 |
Hubscher, et al. [6]
|
36 |
MA to ST-36, SP-6, CV-6 and auricular Shenmen. One 15 minutes session. Assessment immediately following treatment. Crossover design |
SA needling at least 1 cm from classical acupuncture point. Placebo laser-acupuncture. |
EMG Maximum isometric voluntary force. Isometric muscular endurance. |
SD between acupuncture and placebo laser. No SD for jump height or muscle endurance. |
No justification given for choice of points. |
8/10 |
Huang, et al. [7] |
30 |
EA (40 Hz) to ST-36 and ST-39. 15 minutes session. 3 sessions per week |
Control (no treatment). |
Maximum strength in ankle dorsiflexion. |
SD in the increase in strength of both legs in EA groups. |
Points ST-36 and ST-39 were chosen because they have been shown to have an effect on retarding muscle impairment, hemiplegia, and paralysis of the lower extremities. |
7/10 |
Hubscher, et al. [9]
|
22 |
MA to GB-34, Lu-3, Lu-5, LI-11, SP-10 and Ah-Shi points. Treatment applied 24 and 48 hours after DOMS for 15 minutes. |
SA Superficial needling at non-acupoints. Control group (No treatment). |
Maximal isometric voluntary force. |
No SD. The mean maximal isometric voluntary force was not SD between groups |
Acupoints was chosen based on the positive findings of a previous study by Lin and Yang (1999) in terms of their effect on decreasing muscle tenderness. |
7/10 |
Fragoso & Ferreira, et al. [16] |
47 |
MA LI-11. One 20-minute session. Assessment immediately following treatment. |
PC-2
|
EMG Maximal isometric voluntary contraction. |
No SD between groups.
|
Previous study used PC-2 and LI-11 for stroke related disorders. |
8/10 |
Tough, et al. [20]
|
35 |
MA LI-4, LI-10. One 20-minute session. Crossover trial. |
Control group (no treatment). Control (MA to PC-3 and PC-6). |
EMG activity in wrist extensor muscle strength. |
No SD between groups. |
Points chosen based on their relationship to motor points. |
5/10 |
Costa & Araujo, et al. [15]
|
30 |
MA ST-36. One 20-minute session. |
Control group (SP-9). |
EMG activity of the anterior tibialis muscle. |
No SD between groups. |
ST-36 was chosen because it is in the tibialis muscle and SP-9 is reported to be effective in treating the muscular system. |
6/10 |
Damasceno, et al. [17] |
53 started 26 completed |
Tonification points. R-3, BP-3, BP-6, VB-34, F-8, E-36, TA-6. 24 treatments over 3 weeks. |
Control (no treatment). |
Hand grip strength |
No SD between groups |
No justification given for choice of points. |
6/10 |
de Souza, et al. [18] |
38 |
Local group SI-14. Distal group SI-8. One 20-minute session. |
Control group Ki-3. Control group (no treatment). |
EMG
|
SD in both intervention groups compared to control groups. |
Point chosen based on their location within the muscles of the shoulder. |
7/10 |
Jang, et al. [23] |
20 |
MA ST-36, SP-6, CV-6, Shenmen. One 15-minute session. Crossover trial. Assessment immediately following treatment. |
SA needling into the skin 2.5 cm from the true acupuncture points. Control group received skin stimulation with a Park sham placebo device. |
Maximum voluntary isometric contraction. EMG activity of the rectus femoris and tibialis anterior muscles |
SD between groups. The real acupuncture group had higher EMG activity in both rectus femoris and tibialis anterior muscles.
|
No justification given for choice of points |
7/10 |
Silverio-Lopes, et al. [19]
|
73 |
MA TE-5, ST-36, GB-34. One 20-minute session. Assessment immediately following treatment. |
SA group received superficial needling at non acupoints.
|
Hand grip strength in Kgf. |
SD between groups. True acupuncture significantly increased hand grip strength by 4.78 kgf. There was no significant increase in strength in the sham or control groups. |
ST-36 is considered most effective for muscle strength, GB-34 most effective for tendon strength and TE-5 suggested to increase “Yang energy”. |
7/10 |
Yan, et al. [3] |
62 |
TENS ST-36, Liv-3, GB-34, UB-60 and standard care. 60-minute session. 5 days per week for 3 weeks. |
Placebo stimulation and standard care. Control received standard care only. |
Plantarflexor spasticity, ankle muscle strength, and functional mobility. |
SD between group. TENS showed a significant increase in ankle dorsiflexion strength. However, there was a reduced EMG activity. |
No justification given for choice of points. |
9/10 |
Payton, et al. [1] |
20 |
MA or EA ST-36, SP-6, ST-39.
25-minute 3 time per week for 6 weeks. |
Control group received no treatment. |
Maximum voluntary contraction of the ankle plantarflexors |
SD in the increase in muscle strength for both MA and EA.
|
Point selection base on previous studies that demonstrates the effect of selected point on enhancing muscle strength. |
7/10 |
Huang, et al. [13] |
50 |
MA or EA (40 Hz) to ST-36 and ST-39. 15-30-minute 3 sessions per week for 8 weeks.
|
EA and MA at non acupoints in the tibialis anterior muscle. Control group (no treatment). |
Maximum voluntary contraction of the ankle dorsiflexors |
SD between intervention and control groups. No change in strength gain in control group. No SD in strength gain in the acupuncture and non-acupuncture group |
Points ST-36 and ST-39 were chosen because they have been shown to have an effect on retarding muscle impairment, hemiplegia, and paralysis of the lower extremities. |
7/10 |
Micalos, et al. [24] |
25 |
MA to Liv-3, LI-4, Gov-20. One 20-minute session. Assessment immediately following treatment. |
Control group rested for 20 minutes (no treatment). |
Peak isometric muscle torque of the knee extensors. |
SD between group. Acupuncture group showed a 1.6% increase.The control showed a 6.4% decrease in repeat performance. |
No justification given for choice of points. |
6/10 |
Zanin, et al. [14] |
52 |
MA HT-3 local group. MA to HT-4 distal group.
20-minute session. Assessment 10- and 20-minutes following treatment. |
UB-60 control group. Control group (received no treatment). |
EMG. Maximal isometric wrist flexion contraction (Kgf). |
No SD in maximal isometric wrist flexion contraction (Kgf) between groups.
|
The Heart meridian points were chosen because of their anatomical location to the wrist flexor muscles. UB-60 was chosen because it has no anatomical location with the wrist flexors. |
7/10 |
Zhou, et al. [5] |
43 |
MA or EA (40 Hz) to ST-36 and ST-39. 15-30-minute 3 sessions per week for 6 weeks. |
EA on 2 non acupoints in the tibialis anterior muscle, Control (no treatment). |
Maximal isometric contraction in ankle dorsiflexion. |
No SD in control group. Significant muscle strength gain in all intervention group but no SD between intervention groups. |
No justification given for choice of points. However, these authors have published an earlier paper using these points. |
7/10 |
Mucha, et al. [21] |
32 |
EA (8 Hz) ST-36 One 2-minute session. Assessment immediately following treatment. Crossover trial. |
EA (8 Hz) UB-60. One 2-minute session. Assessment following treatment |
Explosive strength consisting of squat jumps to determine increase in hight. |
SD in the increased jump hight in favour of the ST-36 acupuncture group. |
ST-36 was chosen because of its known therapeutic effect on muscle strength. UB-60 was chosen because the author believes that its properties would have no effect on muscle strength. |
4/10 |
Zhou, et al. [22] |
32 |
MA to LI-11, LI-10, LI-4, SI-8, SJ-10, SJ-5. One 20-minute session. Assessment immediately following treatment. |
SA to non-acupuncture points with superficial needling. |
Isokinetic maximum muscle strength of the forearm/elbow flexors. |
Significant increase in muscle strength in the true acupuncture group. No SD in strength in the SA group. |
Classical acupuncture points selected based on the location to stimulate the nerves in the muscles under investigation. |
5/10 |
Wang, et al. [25] |
20 |
MA to ST-32, ST-34, ST-36, SP-10, UB-57. One 20-minute session. Assessment immediately following treatment. |
SA consisted of blunt tip acupuncture needles. |
Isokinetic maximum torque, average power, and peak power of the knee extensors and flexors. |
Significant increase in maximum torque, average power, and peak power of the knee extensors in the MA group. No SD in the SA group. |
ST-36 for improvement in speed and muscle strength and its location in the tibialis anterior. ST-32 and ST-34 because of their location in the rectus femoris muscle, SP-10 on the medial femoris and UB-57 on the gastrocnemius muscle. |
5/10 |
SD: Significant Differences, No SD: No Significant Differences, MA: Manual Acupuncture, EA: Electroacupuncture, SA: Sham Acupuncture