Acupuncture in Physiotherapy: Key Concepts and Evidence-Based Practice

Acupuncture in Physiotherapy: Key Concepts and Evidence-Based Practice

Val Hopwood

Acupuncture has long been recognised as complementing the practice of physiotherapy. Acupuncture in Physiotherapy is written for physiotherapists who have already received a basic training in acupuncture and who wish to extend their practice and achieve an intermediate standard of knowledge. It links the philosophies of Traditional Chinese Medicine with the theory and practice of Western science in a single, clearly written and highly readable text.

Acupuncture in Physiotherapy addresses the important issues on appropriate acupuncture research methodologies, particularly that of placebo control, and enables the reader to judge the quality of RCT evidence. It also examines more recent research into the mechanisms of acupuncture. Treatment vignettes are included throughout the text to demonstrate the immediate relevance of the sophisticated and subtle TCM thinking to modern physiotherapy practice. Research papers and texts are cited where they support TCM theory.

Val Hopwood is an experienced practitioner and is well known for her acupuncture courses. Her ecumenical approach to the subject avoids an abstract separation of the two strands of acupuncture and in its juxtaposition of science and mythology provides a stimulating and original survey. Full of insights, this book will be required reading not only for physiotherapists but any health professional who uses acupuncture in their practice.

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JCM Review

I like this book. The author, one of the founders of the Acupuncture Association of Chartered Physiotherapists (AACP) in Britain, is a highly skilled teacher and an experienced practitioner and researcher, whose PhD was on the topic of acupuncture for stroke. Her book is written primarily for physiotherapists who wish to progress beyond the basic treatments for musculoskeletal pain taught on AACP courses. It also provides a very adequate introduction to TCM for acupuncturists from other backgrounds. The use of illustrative charts, tables and summaries also mean it is well suited as a revision tool.

Val Hopwood’s considered respect for the many schools and traditions of acupuncture, for individuality of approach, for the patient and for physiotherapy itself, results in a nicely balanced book, clearly presented, sensibly and economically written, with a realistic appreciation of the benefits as well as limitations of both acupuncture and physiotherapy in theory and practice. She is well aware, for example, of the need for referral to more fully trained TCM practitioners when this is appropriate.

I particularly like the way neurological conditions such as MS and Parkinson’s are described in terms of functional symptom patterns, and the way the book itself is structured like an ‘onion’ – from a core of qi, blood and body fluids, through the zangfu, extra meridians, the twelve meridians themselves (‘linking the layers’), to superficial acupuncture (musculotendinous, trigger point, intramuscular, huatuojiaji, segmental) and the delightfully titled ‘mini onions’ of microsystems such as ear acupuncture or ECIWO. A chapter on the main TCM syndromes follows, and next an overview of acupuncture trials and methodological considerations that will hopefully encourage research. As Val Hopwood says, ‘a common failing among acupuncture researchers is to test what they believe acupuncture ought to be, rather than what it is’. The two last chapters are on TCM in modern medicine (‘running on empty’, repetitive strain injury and the ‘Fibro five’ – fibromyalgia, interstitial cystitis, chronic fatigue, migraine and irritable bowel syndrome – for example) and the problems of old age.

The book contains a number of case studies illustrative of how the author integrates acupuncture within the practice of physiotherapy, as well as critical coverage of research when this is relevant. I would have liked to see more of both of these, with a mention of the more recent fMRI studies in particular. An opportunity has also been missed, I feel, for enlarging on the role of shen (spirit) in acupuncture, and the importance of practitioner intention. Instead, Val Hopwood takes a more body-centred approach, for example in her discussion of needling technique.
Minor quibbles I have are that some of the illustrative charts are possibly a little oversimplified or prescriptive, there are certain inconsistencies in the use of pinyin and Wade-Giles transliteration, consistent misspelling of Robert Bekkering’s surname, some quotations are not referenced, and the ‘mini onions’ chapter could be more informative.

Quibbles apart, however, I think this is a thoroughly useful book. More than that, whatever your background, it includes perspectives that will make you reconsider what you do in practice. I would not have thought, for instance, of focusing on distal acupoints for qi stagnation and local points for blood stagnation. And I will certainly explore the experiment in experiencing qi that Val Hopwood describes. I also enjoyed the fascinating asides that she slips in – for instance, on how even Western medical diagnoses are emphasised very differently in different countries. The author’s creative ability to make new connections between the different models she employs certainly makes for an enjoyable read.
In conclusion, although this book may not appeal to those wishing to dissect the finer points of TCM, it is a welcome and readable alternative to the many formulaic megatomes on acupuncture that are currently being published, and a very respectable and non-partisan textbook for those who undertake the integrative AACP training.
David Mayor

David Mayor is an acupuncturist working in Hertfordshire.
His textbook on electroacupuncture is scheduled for publication by Churchill Livingstone in July 2005.

Contents

Chapter 1
Overview of the main TCM theories and their place in modern practice

Chapter 2
Qi, Blood and body fluids - the core of the onion

Chapter 3
Zang Fu, the TCM organ system

Chapter 4
The Extra meridians - the deepest level

Chapter 5
Meridian Acupuncture - linking the layers

Chapter 6
Superficial acupuncture - just under the skin

Chapter 7
Acupuncture Microsystems - (mini onions)

Chapter 8
Pulling it all together - working in code

Chapter 9
Possible Acupuncture mechanisms

Chapter 10
Acupuncture trials and methodological considerations

Chapter 11
TCM theory in modern medicine

Chapter 12
Old age problems

Further reading

Symptom Checklist

Overview

AuthorVal Hopwood
PublisherButterworth-Heinemann
Number Of Pages275
Book Formatpaperback
ISBN978-0750653282

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