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Or another way to ask it is, “Why do I do what I do?”
HRV or Heart Rate Variability, is tricky but it gives a glimpse of the very subtle changes that occur in the autonomic nervous system. Other modalities can do this too, fMRI, even pupil size, skin resistance to some degree. But capturing a shift in the sympathetic/parasympathetic nervous system, or stress level, is interesting on a few levels. But HRV is quite cheap, only requiring time and a relatively small initial investment.It is compatible with the flow of the clinic, with the only restraint ( a fairly big one, granted) is that the patient needs to be monitored in the supine position.
The overall goal is to optimize acupuncture treatment by “making the invisible visible”. There are multiple variables in treatment, and the hope is that by monitoring HRV during treatment it will help determine succesful treatment with a physiological parameter and expose the underlying physiology.
1. From previous work, I’ve noted that this drop in LF/HF after needling suggests successful treatment outcome.
2. More recently I’ve been exploring if the absolute LF/HF levels drop over weeks to months.
Because this work is highly speculative, I’m not even sure what questions to ask, or rather, which questions are relevant? Is the type of stimulation important? (So far, doesn’t seem to be. Electroacupuncture seems to give similar results as manual, and manual without subsequent stim same as only in insertion. Uncontrolled results of course.) Is point selection important? (It seems to be. But beyond that, it’s hard to say. Some patients don’t react well to head points, for example. Anecdotally, point selection based on TCM principles seem to give improved results over standard points for stress reduction.) Does auricular acupuncture lead to decreased LF/HF and improved stress reduction? As anyone who has done any continuing education knows, there is a huge body of information about the different ear zones. The “autonomic point” the “parasympathetic point” the point for hypertension. (Jury is out on this one. Doesn’t seem to make a difference during treatment. This is one area that needs to be explored more fully.) Does treatment frequency make a difference? This is an area that I hope to be able to dig through older data to try to get a read on. Traditionally, treatment was given daily, which is not the norm in the U.S. Would that make a difference? I would gladly do daily treatment on patients if I thought it would.
So these are some of the parameters I’m trying to rough out. With grant money incredibly tight, if we better know which questions to ask and study in depth, that’s all to the best.
This discussion will be ongoing. Please leave comments if you have anything to add or thoughts you might have.