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Abstract
Objective
To investigate the precision of acupuncture needle placement using two methods of guidance (termed assisted and guided).
Method
A lamb shoulder in vitro study model was chosen. In the case of assisted acupuncture, the track the needle would take was visualized before subsequent blind needle placement. For guided acupuncture, the needle placement was seen in real-time. In total, 33 measurements of needle tip–target distance were performed for each of the two methods of acupuncture needle placement. Descriptive statistics were used to compare the precision of the two methods. Repeated measurements were analysed to investigate operator reliability using the intra-class correlation coefficient (ICC) statistic.
Results
In terms of precision of needle placement, guided placement was more precise than assisted. Guided acupuncture (0.2 mm ± 0.19 SD) was more precise than assisted (4.4 mm ± 4.08 SD). Operator reliability of measurement of needle tip–target distance was good for both methods. Assisted method gave an ICC of 0.99, whereas the guided method was 0.90.
Discussion
Precision of acupuncture placement is improved by diagnostic ultrasound guidance. The utilization of diagnostic ultrasound prior to needling in anatomically challenging areas may contribute to patient safety. The visualization of needle track anatomy may facilitate skill acquisition when training in acupuncture.
Acknowledgements
This study was carried out as part of Dr Allen's Master's degree in Medical Musculoskeletal Ultrasound at the Anglo-European College of Chiropractic, Bournemouth, UK. Dr Allen wishes to thank his supervisor Prof. Jennifer E Bolton PhD, MA Ed, for her encouragement and guidance while preparing and writing the original dissertation and Dr Budgie Hussain, D.Med Img., MSc, DMU for advice on article submission and facilitating the study at the Centre for Ultrasound Studies, Bournemouth, UK.