Seminar Information

Speaker:

David I. Shreiber, Ph.D.
Assistant Professor
Rutgers, The State University of New Jersey
Department of Biomedical Engineering
Piscataway, NJ

Title:

An engineering approach to study tissue mechanics during acupuncture

Abstract:

Acupuncture has been historically practiced as an integral part of Chinese medicine, and has shown promising results for many diverse conditions in clinical studies.  It is performed by inserting and rotating fine needles into the skin at specific points defined empirically in ancient times by their ability to produce desired short- and long-term functional responses, which can occur locally and remotely from the point of needle insertion. These acupuncture points link segments of ‘meridians’ together to form a longitudinal network of pathways through the body. According to Chinese tradition, these meridian networks represent channels through which ‘energy’ – or qi – flows; disruption of these channels is associated with disease, pain, and/or other pathological states, and manipulation of these points allows the therapist to access these channels and restore balance. Recent studies by Langevin have shown that acupuncture points have >80% anatomical correlation to inter/intramuscular connective tissue fascial planes and meridians have >50% correlation to theses connective tissue planes. Furthermore, both an enhanced biomechanical tissue response and increased changes in subcutaneous, loose connective tissue planes occur during needling at acupuncture points versus control points. Collectively, these results suggest that connective tissue planes, which form a continuous network throughout the body, play a critical role in mediating the effects of acupuncture, and, perhaps, in any manual therapy where subcutaneous soft tissue is deformed, such as acupressure, Gua Sha, cupping, and even massage therapy. However, the anatomical and physiological bases for the enhanced biomechanical response remains unclear – what about the anatomical structure and composition of these tissue makes them amenable to acupuncture needling? Moreover, though it has been suggested that these planes, which also show strong correlation to acupuncture meridians, may serve to propagate the biomechanical signal during needling, it is not clear how large a volume is influenced by needling nor how multiple stimuli can combine to extend the sphere of influence of the therapy. Our goals are to understand the multi-scale factors that govern the biomechanical response of tissue to acupuncture needling through computational modeling and controlled, three dimensional tissue engineered assays. We are examining the effect of geometry and tissue composition in vitro using fibrillar gel models of connective tissue, where the cell and/or matrix composition, boundary conditions, and geometry are controlled a priori, and the response of the tissue and resident cells can be assayed quantitatively over time. We also use simplified models of cross-sectional tissue anatomy to evaluate the sensitivity of the biomechanical response to changes in mechanical properties, boundary conditions, and tissue geometry.  We have thus far been able to recapitulate many of the morphological features observed in vivo and in explants, and have tested several hypothesis relating to the biophysical tissue response that could not be easily examined in the in vivo/explant studies.