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sábado, 19 de enero de 2013

The practice of acupuncture in pediatrics

Despite the lack of complete physiologic understanding, acupuncture is gaining credibility in the western world.  The acupuncture in the pediatric population has received less attention and scientific reviews compared with the acupuncture in adults population.

The practice of acupuncture in children is more complex than in adults. A difficulty in treating is the children's fear of needles.

In order to reduce the anxiety and establish a friendly and trusting enviroment, practioners might used: Toys, like hand puppets, drawings, pictures, testing acupressure firstly, insertions with shorter needles and avoid the overstimulation.

Noninvasive modalities are usually well accepted by the children (even in those under 6 years age):

- Applying pressure (acupressure).
- Tuina or Anmo (chinese massage combined with acupressure)
- Shonishin (japanese massage therapy for children)
- Electrically stimulating the skin without a needle (noninvasive electroacupuncture),
- Laser beam directed on the acupoint (laser stimulation).

Bronchitis / Asthma (Treatment and fotograph: R.Klowersa, Berlin)

Inflammations of the ear and Enuresis  (Treatment and fotograph: R.Klowersa, Berlin)
Osteochondritis dissecans and Bronchitis / Asthma (Treatment and fotograph: R.Klowersa, Berlin)

The acupuncture is applicable to the pediatric population in general. There is evidence for its efficacy in postoperative symptoms management and strong potential for chemotherapy-induced nausea/vomiting and pain. Also, acupuncture also seems to be fairly well tolerated in children in that the incidence of side effects is low and mostly inconsequential. Nevertheless, parents should be cautioned to seek properly licensed practitioners who have experience in treating children.

There are conditions in which acupuncture has been proven to be effective when treating adults, however, there is a clear need for further information about pediatrics.

For example, chemotherapy-induced nausea and vomiting is one such area where promise for efficacy in children is seen. At the National Center for Complementary Alternative Medicine in collaboration with the Children’s Oncology Group, they are conducting the first ever multicenter study exploring acupuncture’s role in pediatric oncology patients. The Cochrane Collaboration review suggests that electroacupuncture is effective for reducing the incidence of acute vomiting induced by chemotherapy in adults, but questions whether these effects are similar for delayed nausea and vomiting.
In the other hand, a prospective randomized trial that compares laser acupuncture versus desmopressin supports the use of the acupuncture like a valid alternative in treating nocturnal-enuresis.

I really hope that new scientific studies will go to expand our knowledges about the role and efficacy of acupuncture in pediatrics.


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