Acupuncture

Auditory-Tactile-Visual-Vestibular (ATVV) Intervention
January 16, 2025

Acupuncture

Evidence reviewed as of before 01-01-2021

Author(s):Ogourtsova, T. (PhD OT); Steven, E. (MSc App OT); Iliopoulos, G. (MSc App OT); & Majnemer, A. (PhD, OT, FCAHS)

 

Introduction

Acupuncture is part of an ancient practice of traditional Chinese medicine. It is a practice that uses thin, solid, metallic needles to penetrate the skin at specific points of the body. Traditional Chinese medicine has identified more than 2000 acupuncture points connected by pathways or meridians. These pathways are believed to create an energy flow (or Qi, pronounced “chee”) through the body which is responsible for maintaining overall health.

Various acupuncture therapies are believed to be able to stimulate these points of access where Qi flows close to the surface. In addition to needles, other techniques can be used which are less invasive (see types of acupunture). Acupuncture points are believed to stimulate the central nervous system by releasing chemicals into the muscles, spinal cord and brain. This may stimulate the body’s natural healing abilities and improve physical and emotional health.

Resources

Parent & Family Information

What is acupuncture?

Acupuncture is a practice used in traditional Chinese medicine. It is a technique that uses thin needles inserted into the skin at specific points of the body. These acupuncture points are believed to be connected to pathways or meridians where energy flows throughout the body (called Qi). It is believed in Chinese medicine that these pathways of energy are responsible for overall health. Therefore, by applying acupuncture to specific points, disruptions to Qi can be released.

Acupuncture is most commonly used for pain relief but has recently been used for clienteles with neurological conditions such as stroke and cerebral palsy. In these populations, it is used to treat spasticity, loss of mobility and hemiplegia (loss of sensation and/or strength in one side of the body).

While it is not fully understood how acupuncture achieves certain results, it is believed that acupuncture can stimulate the central nervous system by releasing chemicals into the muscles, spinal cord and brain. This may cause biological responses that promote physical and emotional health.

What is acupuncture used for?

There is evidence that acupuncture is effective in treating many different conditions (respiratory, musculoskeletal, digestive, etc.) and their associated issues (pain, nausea, headaches, asthma, etc.).

Acupuncture for cerebral palsy is considered a new treatment approach. It is hypothesized that it can benefit children with CP by treating associated disorders such as:

  • Cognitive issues
  • Hearing deficits
  • Speech delays
  • Physical limitations
  • Pain relief
  • Gross motor functioning
Are there different types of acupunture?

Instead of needles other forms of stimulation can be used over acupuncture points. They include:

  • Heat (moxibustion)
  • Pressure (acupressure)
Accessed on June 28, 2022 from https://theacupunctureden.com/index.php/services/children/#next
  • Friction
  • Suction (cupping)
Accessed on June28, 2022 from https://theacupunctureden.com/index.php/services/children/#next
  • Impulses of electromagnetic energy (used with needles)
  • Sonopuncture (uses sound waves over acupuncture points)
  • Reflexology (uses pressure over parts of the feet and ankles)
Does acupuncture work for CP?

Acupuncture treatment for CP is considered a relatively new therapy. There are few research studies that explore its effectiveness compared to other treatment modalities.

One high quality study compared acupuncture combined with conventional therapy to conventional therapy only for children (12-72 months) with spastic CP (GMFCS level I-III). It found that acupuncture with conventional therapy was not more effective than conventional therapy alone in improving gross motor function and functional skills (self-care, mobility and social skills).

What can I expect?

Acupuncture is typically provided in wellness centers and specialized clinics. It is important to discuss the use of acupuncture with a doctor first as there are certain contraindications.

An initial evaluation will be conducted to understand your child’s condition and medical history to determine the goals of the treatment and frequency/duration of sessions. During treatments, the acupuncturist inserts hair thin needles into specific acupuncture points around the body depending on the condition being treated. When the needle is inserted there will be a sensation of pressure or ache but there should be little or no pain. The client is expected to lie still while the treatment is being administered.

Who provides acupuncture?

There may be different requirements to be qualified to practice acupuncture depending on where you live. In general, each candidate must attend a 3-4 year program accredited by the Accreditation Commission for Acupuncture or Oriental Medicine (ACAOM). The person providing the treatment may also be required to obtain a licensed certification from the professional order of acupuncturists in your province or state. It is important to check the requirements of the regulatory body in your place of residence to ensure a practitioner meets the requirements.

Keep in mind that you will want to choose someone who specifically specializes in helping children with cerebral palsy, as their situations are always unique.

How long is the treatment period (frequency/duration)?

Treatment durations and frequency are based on the conditions treated, their severity and how long they have been present. The acupuncturist will be able to provide more information after the first consultation or after observing the client’s progress after treatments. In the reviewed study, the treatments were provided 5x/week for a total of 12 weeks.

Are there side effects or risks?

There is a low risk of side effects during acupuncture treatments. Normally they are not serious in nature and reactions disappear on their own or can be corrected during later treatment(s).

They can include:

  • Dizziness
  • Pain at the site entry (where the needle enters the skin)
  • Infections
  • Nerve puncture injuries
  • Fatigue
  • Bruising
  • Muscle twitching
  • Emotional release, which may lead to crying (this is generally a positive side effect)

In the U.S. and Canada, there is a mandate that acupuncture needles must be sterile single use needles to reduce the risk of infection.

Is acupuncture right for my child?

Acupuncture treatment for cerebral palsy is a fairly new approach. There is very little research to determine if it works for children with CP.

Only one recent study examines the effectiveness of acupuncture for young children (12-72 months) with spastic CP (GMFCS level I-III). It found that acupuncture and conventional therapy was not more effective than conventional therapy only in improving gross motor function and functional skills. More research is required to examine the effectiveness of acupuncture for children with different types and severities of CP.

Please note that acupuncture may not be suitable for every child. It is best to contact a licensed acupuncturist to assess whether it is appropriate for your child as well as consult your child’s physician to discuss any potential contraindications.

Information on this website is provided for informational purposes only and is not a substitute for professional medical advice.

Clinician Information

Download results table PDF

Children with spastic CP

GMFCS level I-III

Functional skills - As effective - 1b

One high quality RCT (Duncan et al., 2012) investigated the effects of acupuncture and conventional therapies (occupational therapy, physiotherapy, hydrotherapy) on functional skills among children with spastic CP (GMFCS level I-III). This high quality RCT randomized participants to receive either acupuncture with conventional therapies (weeks 0-12) or only conventional therapy (weeks 0-12) with delayed acupuncture (weeks 16-28). Functional skills were assessed using the Paediatric Evaluation of Disability Inventory – Functional Skills (PEDI-FS: self-care, mobility, social skills) at 12 weeks post-treatment, 16 weeks post-treatment, and 28 weeks post-treatment. No significant between-group differences were found at any time points.

Conclusion: There is moderate evidence (Level 1b) from one high quality RCT that acupuncture and conventional therapies is as effective as the comparison intervention (conventional therapies only) in improving functional skills in children with spastic CP (GMFCS level I-III).

Gross motor function - As effective - 1b

One high quality RCT (Duncan et al., 2012) investigated the effects of acupuncture and conventional therapies (occupational therapy, physiotherapy, hydrotherapy) on gross motor function among children with spastic CP (GMFCS level I-III). This high quality RCT randomized participants to receive either acupuncture with conventional therapies (weeks 0-12) or only conventional therapy (weeks 0-12) with delayed acupuncture (weeks 16-28). Gross motor function was assessed using the Gross Motor Function Measure at 12 weeks post-treatment, 16 weeks post-treatment, and 28 weeks post-treatment. No significant between-group differences were found at any time points.

Conclusion: There is moderate evidence (Level 1b) from one high quality RCT that acupuncture and conventional therapies is as effective as the comparison intervention (conventional therapies only) in improving gross motor function for children with spastic CP (GMFCS level I-III).

References

Duncan, B., Shen, K., Zou, L.-P., Han, T.-L., Lu, Z.-L., Zheng, H., Walsh, M., Venker, C., Su, Y., Schnyer, R., & Caspi, O. (2012). Evaluating intense rehabilitative therapies with and without acupuncture for children with cerebral palsy: A randomized controlled trial. Archives of Physical Medicine and Rehabilitation93(5), 808–815. https://doi.org/10.1016/j.apmr.2011.12.009

Definitions

Cerebral palsy

A group of lifelong disorders affecting a person’s movement, coordination, and muscle tone and which are the result of damage to the brain before, during, or shortly after birth.

GMFCS

Gross Motor Functional Classification System. It is a tool used to categorize the gross motor skills of children with cerebral palsy into 5 different levels across 5 age bands. It evaluates the child’s abilities in sitting, walking and wheeled mobility as well as the type of assistive devices needed for mobility. The levels are assigned based on the severity of the limitations, ranging from mild (level I) to severe (level V).

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