Journal of Acupuncture & Meridian Studies

Medical Association of pharmacopuncture Institute (사단법인약침학회)
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Pragmatic Combinations of Acupuncture Points for Lateral Epicondylalgia are Unreliable in the Physiotherapy Setting

  • Alvim, Danielle T. (Laboratory of Computational Simulation and Modeling in Rehabilitation, Postgraduate Program in Rehabilitation Sciences, Augusto Motta University Center) ;
  • Ferreira, Arthur S. (Laboratory of Computational Simulation and Modeling in Rehabilitation, Postgraduate Program in Rehabilitation Sciences, Augusto Motta University Center)
  • Received : 2018.02.23
  • Accepted : 2018.07.30
  • Published : 2018.12.31
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Abstract

This study describes the reliability of pragmatic combinations of acupuncture points for lateral epicondylalgia (LE) as prescribed by physiotherapists who were experts in acupuncture. Raters (n = 14; 33-59 years) independently prescribed acupuncture points for 30 simulated human patients with LE who were surveyed via a printed questionnaire. The frequency and cooccurrence of acupuncture points prescribed for patients with lateral epicondylitis were assessed. Absolute agreement and Light's kappa (${\kappa}_{Light}$) with 95% confidence interval (CI) were used to quantify the interrater agreement. Raters prescribed 103 unique acupuncture points in different combinations with a median (min-max) of 5 (0-11) acupuncture points. The most prescribed acupuncture point was LI-11 (297 of 420; 71%), and the most common cooccurring acupuncture points were LI-11 and LI-4 (160 of 420; 38%). The absolute agreement for prescribing the acupuncture points ranged from 70% (point GB-20) to 0% (points LI-10, SP-6, LI-11, GB-34, LI-12, and LI-4). Point LR-3 showed the highest interrater reliability for prescribing the acupuncture points [${\kappa}_{Light}=0.112$, 95% CI = (0.055-0.194)], whereas point LI-4 showed the lowest reliability [${\kappa}_{Light}=-0.003$, 95% CI = (-0.024 to 0.024)]. These findings suggest that pragmatic prescriptions of acupuncture points for LE are unreliable among physiotherapists who are experts in acupuncture. Explicit, high-level evidence-based rules for prescribing and teaching combinations of acupuncture points for LE are warranted.

Keywords

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