Entrevista al ponente Claudio Couto, presidente del GEANF

In the II International Congress about Invasive techniques in Physical Therapy you participate as speaker with other professionals from your country, Argentina and Spain. What do you consider most important of this scientific event for health professionals?

The most important fact to be considered is the possibility to integrate the developed knowledge in the field of pain tratment with different technologies and promote dissemination of science based therapies for all the participants in the event.

You are the Chairman of the Study Group on Neurofunctional Acupuncture. How would you define Neurofunctional Acupuncture?

Neurofunctional Acupuncture is a therapeutic technique that uses acupuncture needles or other modalities of physical or mechanical stimulus to produce somatic and autonomic neuromodulatory effects.

To do so, any neuroreactive zone of the human body can be the target of the interventions whereas it is related previously to a diagnosis of neural sensitization, whether on local, segmental or suprasegmental levels.

The choice and the depth of the places to be stimulated depend, overall, on the neurophysiological properties of the structures that are being stimulated and the predictable effects over the diagnosed organic dysfunction.

Neurofunctional Acupuncture is a technique little known by many professionals, so could you tell us briefly in what kind of patients it would be indicated compared to other techniques such as dry needling or manual therapy?

Neurofunctional Acupuncture, or Percutaneous Peripheral Electrostimulation,  is the direct electrical stimulation of involved nerves outside of the neuroaxis. Mainly based on the medullary neuromuscular reflex and the neuroplastic response to diverse neurostimulation techniques, represent the most effective application of acupuncture needle stimulation based on biomedical rationale. Conventional Spinal Cord Stimulation came to dominate neurostimulation, but percutaneous peripheral nerve stimulation through needles was practiced in a few centers where expertise was developed, as McMaster University, in Canada, and GEANF at Porto Alegre, Brazil, since 2004. As this form of treatment for chronic pain has evolved, descriptions of needle-delivered leads in the vicinity of the named nerve, including the greater occipital nerve, have been recently published. The needle stimulation techniques were developed to restore sensorimotor integration, and so, could be applied for all kind of chronic pain patients, and the mechanisms of action are proper to the neurophysiological mechanism involved on each clinical scenario.

In Brazil, what is the current situation of Neurofunctional Acupuncture in postgraduate training?

GEANF is the only Educational Institution specialized in Medical Neurofunctional Acupuncture, and receives 50 physicians each year in Brazil for 80 hours of  class load. The course is in accordance with the Brazilian Medical College of Acupuncture rules and is offered only for physicians, by law. GEANF also teach courses in other countries, in accordance with the local legislation.

It is a technique about which more and more papers are published…so, what is the direction of  Neurofunctional Acupuncture?

The use of the term «Acupuncture» is an option related to local professional characteristics. The biomedical rationale is the common rule for evidence-based medicine, and so, many kinds of names are related to neurofunctional acupuncture, like MDIMST, PNS, PNES and others (f.ex.,  Couto et al., 2014).

What researchs are underway at this time in relation to this technique? Are you working on some research study?

Some RCS are in development at the Hospital de Clínicas de Porto Alegre (HCPA), and the main researcher is the GEANF Instructor Dr. Leonardo Botelho. I’m working as a consultant for the Pain and Neuromodulation Research Group that has published medical articles in the field of Chronic Pain (f. ex., Botelho et al., A Framework for Understanding the Relationship between Descending Pain Modulation, Motor Corticospinal, and Neuroplasticity Regulation Systems in Chronic Myofascial Pain, Frontiers in Neuroscience, 2016).

You are going to participate in the Congress with a presentation entitled “Shoulder girdle and cervical spine dysfunction. Assessment and treatment with Neurofunctional Electroacupuncture”. Could you forward us some of the main points of your speech?

This title refers to a Workshop that will be held to explore the Clinical Application of the Neurofunctional Theory of Chronic Musculoskeletal Pain Adaptation. The program demonstrates the theoretical base and the practical application of the developed technologies for the treatment of musculoskeletal chronic pain of the shoulder girdle, merging clinical examination with the biomedical rationale for the choice of neuromodulatory targets.