Peter Dorsher - Academia.edu (original) (raw)

Papers by Peter Dorsher

Acupuncture involves treating illness by inserting needles at specified body locations (acupoints... more Acupuncture involves treating illness by inserting needles at specified body locations (acupoints). The Principal meridians are pathways that join acupoints with related physiologic effects. Despite nearly 5000 years of continuous clinical study, an accepted anatomic or physiologic basis for acupuncture’s clinical effects has remained elusive. Some acupoints overlie peripheral nerves, and fMRI studies demonstrate that acupoints have specific effects on central nervous system processing. Traditional Chinese Medicine (TCM) founders described the body’s viscera based on anatomic dissections yet not a discrete nervous system. By applying computer graphics and virtual human imaging techniques to human developmental neuroanatomy, this paradox may potentially be explained: acupuncture Principal meridians likely are TCM’s representation of the nervous system. This neuroanatomic model of the Principal meridians is consistent with acupuncture’s known neurophysiologic effects, and may allow 5 ...

PubMed, Jul 1, 1991

The medical records of 31 patients (19 male and 12 female) with clinical and electrophysiologic f... more The medical records of 31 patients (19 male and 12 female) with clinical and electrophysiologic features of Wohlfart-Kugelberg-Welander syndrome were reviewed. The reported age at onset ranged from less than one year to 46 years, and the age at diagnosis ranged from three to 66 years. Proximal muscle weakness, especially of the lower extremities, and muscular atrophy were the predominant clinical features. Elevated serum creatine kinase levels were noted in four female and 12 male patients, and the degree of elevation was higher in the male patients (up to 32 times the upper limit of normal) than in the female patients. On initial evaluation, two patients were wheelchair-bound, whereas the others were ambulatory. On follow-up evaluation three to 32 years later (mean, 15.5 years), 11 patients used wheelchairs, although only three were wheelchair-bound. The disease followed a steady, slowly progressive course. The outcome of ambulatory status did not correlate with the initial creatine kinase determination.

Traditional Chinese Medicine, Jan 30, 2008

目的探讨激痛点(Trigget point)及其感传痛路线(Referral pain pattern)和传统针灸腧穴及其所属的经络关系.方法利用解剖图和解剖图分析软件,共研究比较了255个... more 目的探讨激痛点(Trigget point)及其感传痛路线(Referral pain pattern)和传统针灸腧穴及其所属的经络关系.方法利用解剖图和解剖图分析软件,共研究比较了255个激痛点和747个腧穴,观察和分析了激痛点与腧穴的对应程度.本研究还比较了这些对应点的临床主治,以及激痛点的疼痛感传路线与其对应的腧穴所在的经络分布.结果在255个激痛点中,92%(235/255)与腧穴在解剖位置上对应.在747个腧穴中,79.5%(594/747)的穴位所主治的局部疼痛与其对应的激痛点相似.在这些对应穴中,其肌筋膜感传痛路线与其对应的针灸腧穴所在的经络分布完全或基本一致的占76%,14%部分一致.结论肌筋膜疼痛的科学基础应有助于进一步阐明针灸治疗疼痛的治疗机制.这项研究的结果可能有助于针灸与当代临床疼痛治疗的进一步整合。

Techniques in Regional Anesthesia and Pain Management, Apr 1, 2011

Journal of Alternative and Complementary Medicine, Dec 1, 2008

Advances in Urology, 2012

Congenital anomalies such as meningomyelocele and diseases/damage of the central, peripheral, or ... more Congenital anomalies such as meningomyelocele and diseases/damage of the central, peripheral, or autonomic nervous systems may produce neurogenic bladder dysfunction, which untreated can result in progressive renal damage, adverse physical effects including decubiti and urinary tract infections, and psychological and social sequelae related to urinary incontinence. A comprehensive bladder-retraining program that incorporates appropriate education, training, medication, and surgical interventions can mitigate the adverse consequences of neurogenic bladder dysfunction and improve both quantity and quality of life. The goals of bladder retraining for neurogenic bladder dysfunction are prevention of urinary incontinence, urinary tract infections, detrusor overdistension, and progressive upper urinary tract damage due to chronic, excessive detrusor pressures. Understanding the physiology and pathophysiology of micturition is essential to select appropriate pharmacologic and surgical interventions to achieve these goals. Future perspectives on potential pharmacological, surgical, and regenerative medicine options for treating neurogenic bladder dysfunction are also presented.

CRC Press eBooks, Apr 19, 2016

Medical Acupuncture, Sep 1, 2008

Three basic classes of acupuncture points are described: the 361 classical ("channel") acupoints,... more Three basic classes of acupuncture points are described: the 361 classical ("channel") acupoints, extra (extraordinary) points that are almost always off-channel, and Ah Shi local tender points. The classical acupuncture points are the oldest and most clinically important points. Their locations, as well as those of the extra points, have traditionally been described and taught using the Chinese "cun" measurement system, 1 cun being defined as the width of the interphalangeal joint of the thumb. Recent research demonstrates that the use of the traditional cun method to find acupuncture points is inaccurate and may lead acupuncturists to needle sites that are as far as 2 cm away from these points' actual (true) locations. Although acupuncture clinical trials in the past 2 decades have demonstrated improved reporting of the acupuncture points selected, needling techniques, and modes of needle stimulation, their methodologies do not address a fundamental issue raised by these point location studies: were the proper acupuncture point locations needled in those clinical trials? Inaccurate point localization may produce negative or suboptimal acupuncture intervention outcomes that result in type II statistical errors and may explain a portion of the outcome variability seen in acupuncture clinical trials. A best-practices description of optimal acupuncture point localization based on acupuncture references and recent research is presented in this article. The implications of optimal point location for clinical practice, training, and acupuncture research are described.

The Journal of Pain, Jul 1, 2009

Recently published data suggest substantial anatomic, clinical, and physiologic (referred pain to... more Recently published data suggest substantial anatomic, clinical, and physiologic (referred pain to meridian) overlap of myofascial trigger points and acupuncture points, particularly in the treatment of pain disorders. This qualitative study examines whether myofascial referred-pain data from the Trigger Point Manual can provide independent physiologic evidence of acupuncture meridians. Trigger point regions were subdivided from prior, validated trigger point region-classical acupuncture point correspondence results into subsets according to the 12 acupuncture Organs of their anatomically corresponding acupuncture points (Bladder, Gallbladder, Heart, Kidney, Large Intestine, Liver, Lung, Pericardium, Small Intestine, Spleen, Stomach, and Triple Energizer). The referred-pain patterns for each subset of trigger point regions were graphically applied to a virtual human model along with the subset&amp;amp;amp;#39;s corresponding acupuncture Principal meridian. All 12 meridian distributions were compared qualitatively with the summed referred-pain distributions of their anatomically corresponding trigger point regions. For all 12 subsets of trigger point regions, their summed referred-pain patterns accurately predicted the distributions of their corresponding acupuncture meridians, particularly in the extremities. The myofascial referred-pain data from the Trigger Point Manual provides independent physiologic evidence of acupuncture meridians. Understanding these meridians may enhance treatment of both pain and non-pain conditions. This article demonstrates that myofascial referred-pain data provide independent physiologic evidence of acupuncture meridians. The acupuncture tradition provides pain practitioners with millennia of accumulated clinical experience treating pain (and visceral) disorders and offers the potential for novel pain treatment approaches and understanding of pain neurophysiology.

Medical Acupuncture, Apr 1, 2021

Objective: This pilot study of acupuncture primary channel coupling examined the effect of anteri... more Objective: This pilot study of acupuncture primary channel coupling examined the effect of anterior tibialis (AT) muscle activation (Stomach = ST channel distribution muscle) on ipsilateral anterior deltoid shoulder elevation strength (Large Intestine = LI channel distribution muscle).Design: Pilot study: prospective before and after trial, nonblinded.Materials and Methods: Twenty healthy adults ages 20–60 years without shoulder pathology were recruited from our institution. All subjects consented with the IRB-approved minimal risk protocol for this study. Average shoulder elevation break strength (kg) with arm elevated 90° from side was measured by dynamometer over 3 trials for each of 4 conditions: standing (baseline), standing with ipsilateral AT activation, seated with legs dangling ipsilateral AT activation, and seated with legs dangling ipsilateral gastrocsoleus (GS) activation. The main outcome measures were percentage decrement in shoulder elevation strength in AT and GS conditions compared with baseline. Paired t-test with a statistical significance alpha level of 0.05 was used for all statistical analyses.Results: A statistically and clinically significant 9.5%–12.5% (P < 0.001) decrease in shoulder elevation strength was found with ipsilateral AT activation whether in the standing or seated position. Reciprocal inhibition of the AT muscle through GS activation in the seated position produced markedly smaller 3%–4% decreases in shoulder elevation strength from baseline.Conclusions: This study provides quantitative physical examination evidence of LI-ST channel coupling, demonstrating a statistically (P < 0.001) and clinically significant decrement in shoulder elevation strength (9.5%–12.5%) with ipsilateral AT activation. These findings support the acupuncture concept of primary channel coupling, with results suggesting a neural basis for these results rather than from a fascial signaling mechanism.

Medicine and Science in Sports and Exercise, Jul 1, 2020

Medicine and Science in Sports and Exercise, May 1, 2006

Medical Acupuncture, Dec 1, 2012

267 words text: 1985 without references, tables, and legends figures: 3 tables: 4

Medicine & Science in Sports & Exercise, 2020

Revista Internacional De Acupuntura, 2009

Myofascial Trigger Points, 2013

Medical Acupuncture, 2010

T ennis elbow (lateral elbow pain) has a prevalence of 1.3% with no gender predominance. The path... more T ennis elbow (lateral elbow pain) has a prevalence of 1.3% with no gender predominance. The pathology is thought to be due to an overuse syndrome of the long extensor muscles of the forearm leading to a localized fasciitis or enthesopathy at lateral epicondyle where the extensor tendons insert. Lateral elbow pain is brought on by resisted supination (e.g., wringing a towel or backhand tennis serve), or simply gripping heavy objects. Tennis elbow pain was described in ancient texts of Traditional Chinese Medicine as zhǒu láo, which is due to repetitive injury of the tendons with stagnation of blood and excess moisture in the corresponding Large Intestine meridian. In my clinical practice, for treating tennis elbow pain, 1-2 Ah Shi points (maximum tenderness) are normally selected, together with Shǒusānlı (LI 10), Q € u u € u uchı (LI 11), and Zhǒuliáo (LI 12). Needles, 0.20mmÂ20 mm, are inserted perpendicularly except at the Ah Shi points which are at 208 to the skin surface. If pain is mild to moderate, it would be beneficial to add 2 Hz low frequency electrical stimulation from a TENS machine. For severe pain, TENS is not recommended and manipulation of needles should be performed to maintain De Qi. During cold and damp weather, indirect moxibustion can be added to the area with a moxa stick to activate the Qi and alleviate blood stagnation. The duration for each acupuncture treatment should be 30-35 minutes, to be repeated 2 to 3 times weekly, for a period of 4 weeks. Across the board, over 60% of patients report pain relief and improvement of functionality of their forearm.