• Danielle T Alvim and Arthur S Ferreira.
• Laboratory of Computational Simulation and Modeling in Rehabilitation, Postgraduate Program in Rehabilitation Sciences, Augusto Motta University Center, Praça das Nações, 34, Bonsucesso, Rio de Janeiro, RJ, 21041-010, Brazil; Research Laboratory of Exercise Sciences, Physical Education Center Admiral Adalberto Nunes, Brazilian Navy, Av. Brasil, 10590, Penha, Rio de Janeiro, RJ, 21012-350, Brazil.
• J Acupunct Meridian Stud. 2018 Dec 1; 11 (6): 367-374.

AbstractThis 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 (κLight) 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 [κLight = 0.112, 95% CI = (0.055-0.194)], whereas point LI-4 showed the lowest reliability [κLight = -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.Copyright © 2018. Published by Elsevier B.V.

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