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manikins are available as a guide for location of acupuncture points corresponding
to certain symptoms. There is no standard protocol that is universally applied for all
patients. The selection of acupuncture points is personalized according to each
patient, location of pain and other symptoms.
Personalized Acupuncture Therapy
Acupuncture needs to be tailored to each patient’s particular symptoms as well as
responsiveness and it is generally recognized that individualization of acupuncture
treatment enhances its effectiveness. Apart from variable selection of acupuncture
points, the dose should be determined for each patient. The dose depends not only
on the intensity of stimulation but may be affected by the state of the patient, e.g.,
nervous, immune and endocrine systems; different doses may be required for differ-
ent conditions (White et al. 2008 ).
A randomized controlled trial has compared the effectiveness of standardized
and individualized acupuncture treatment in patients with chronic low back pain
(Pach et al. 2013 ). Patients received either standardized acupuncture or individual-
ized acupuncture. Treatment consisted of 10–15 treatments based on individual
symptoms with two treatments per week. The main outcome measure was the area
under the curve (AUC) summarizing 8 weeks of daily rated pain severity measured
with a visual analog scale. No signifi cant differences between groups were observed
AUC between individualized acupuncture and standardized acupuncture. The
authors suggested that a multicenter noninferiority study should be performed to
investigate whether standardized acupuncture treatment for chronic low back pain
might be applicable in a broader usual care setting.
Personalized Hyperbaric Oxygen Therapy
Hyperbaric oxygenation (HBO) involves the use of 100 % oxygen under pressure
greater than that found on earth’s surface at sea level and has proven useful in treat-
ment of several disorders (Jain 2009 ). The treatments are administered in a hyper-
baric chamber. Although there are guidelines regarding pressures and durations of
exposure to HBO, patient responses vary. Most of the conditions require repeat
sessions of treatment. Parameters of HBO application can be adjusted depending on
response to initial treatment. Responses may be assessed clinically but responses to
CNS disorders can be evaluated objectively by molecular imaging techniques.
Various technologies available for this purpose are positron emission tomography
(PET), single-photon emission computed tomography (SPECT) and magnetic reso-
nance imaging (MRI). MRI is used to assess the effect of HBO on multiple sclerosis
lesions in the brain. 18F-fl uorodeoxyglucose (FDG)-PET is used for determining
cerebral blood fl ow (CBF) and metabolism. The use of PET is limited by a high
19 Personalized Non-pharmacological Therapies