Vol.2, No.1, 16-19 (2010) Health
SciRes Copyright © 2010 Openly accessible at http://www.scirp.org/journal/HEALTH/
Translational research in acupunctureteleacupuncture
bridges science and practice
Gerhard Litscher
Research Unit of Biomedical Engineering in Anesthesia and Intensive Care Medicine and TCM Research Center Graz, Medical Uni-
versity Graz, Graz, Austria; gerhard.litscher@medunigraz.at
Received 15 October 2009; revised 1 December 2009; accepted 3 December 2009.
In March 2009, the first teleacupuncture between
China and Austria was performed. This publica-
tion summarizes the first important results. 24-
hour electrocardiograms were registered in Bei-
jing and analyzed in Graz. A heart rate variability
monitor partly developed in Austria was used
for recording. Data were transferred via internet
over a distance of 7,650 km. For the spectral
analysis of heart rate variability a new method,
the so-called ‘Fire of Life’ illustration, was ap-
plied. The state of health of a 31-year-old patient
before, during and after acupuncture treatment
sessions was documented. Despite several limi-
tations, transcontinental teleacupuncture opens
up new possibilities in public health.
Keywords: Teleacupuncture; Heart Rate Variability
(HRV); Electrocardiogram (ECG); Sustainable
Health Research
Telemedicine in general is defined as the ‘delivery of
health care and the exchange of health care information
across distance’ [1]. Telecommunication technology in-
cludes the assisted transmission of signals and biological
data over a distance. In this context, telemedicine like
telesurgery and also teleanesthesiology has become more
interesting [2]. However, teleacupuncture has only been
performed by our research group up to now [3]. The term
‘teleacupuncture’ was first mentioned and defined by our
research group at the international symposium ‘Mod-
ernization of Traditional Chinese Medicine’ in May 2009
in Graz [4]. The first scientific descriptions by Litscher
can be found in publications in a Korean [5], Austrian [6]
and American [3] journals in the respective 2009 autumn
The present paper summarizes the first important re-
sults obtained in China and Austria in the research area of
It was the aim of these biomedical pilot measurements
to investigate whether teleacupuncture using computer-
controlled HRV analysis can be performed over long
distances (transcontinentally) via common internet con-
Teleacupuncture integrates mainly medical acupuncture
and telecommunication. Telecommunication in this con-
text means data transfer over a distance of 7,650 km via in-
ternet between Graz, Austria and Beijing, China (Figure 1).
In China, 24-hour electrocardiograms (ECGs) are reg-
istered and the data are transferred via internet to the
Medical University of Graz immediately following the
acupuncture treatment. In Graz, the analysis of the ECGs
is performed. The acupuncturists in China are informed
about the results of the analysis immediately (Figure 2).
The autonomic nervous system plays an important role
in the current investigations. Computer-based heart rate
and heart rate variability (HRV) measurements are the
main parameters. The ECG was recorded with a sampling
rate of 4096 Hz using a system partly developed in Aus-
tria (medilog AR12, Huntleigh Healthcare, Cardiff, UK;
Figure 3).
Heart rate variability is measured as the percentage
change in sequential chamber complexes (RR-intervals)
in the ECG, which is controlled by the blood pressure
control system, influenced by the hypothalamus and, in
particular, controlled by the vagal cardiovascular centre
in the lower brainstem. [7] In these pilot measurements, a
new method of analysis, the so-called ‘Fire of Life’ dia-
gram, was used. For the calculation of changes in spectral
density the medilog Darwin HRV software (Huntleigh
Healthcare, Cardiff, UK) including the method of Burg
(autoregressive model) was applied.
Figure 4 shows exemplarily the first teleacupuncture
G. Litscher / HEALTH 2 (2010) 16-19
SciRes Copyright © 2010 Openly accessible at http://www.scirp.org/journal/HEALTH/
Figure 1. Teleacupuncture between the TCM Research Center
Graz and the China Academy of Chinese Medical Sciences
(CACMS) over a distance of 7,650 km.
Figure 2. Acupuncture and data recording is performed in
China, the analysis at the Medical University of Graz (modi-
fied from [6]).
Figure 3. Bio-signal registration is performed in China using
equipment from the TCM Research Center Graz (modified
from [6]).
measurement in a 31-year-old female patient suffering
from burn-out syndrome (Chinese diagnosis: kidney defi-
ciency and blood stagnation).
The figure shows a ‘Fire of Life’-analysis of the HRV
and can be interpreted as an indicator of the state of health
and the quality of sleep of the patient. Note the appear-
ance of the three typical main spectral components (~ 0.3
Hz; ~ 0.11 Hz; < 0.05 Hz). The component at 0.3 Hz was
significantly reduced. These different components rep-
resent biological rhythms that seem to be currently dis-
tinguishable among the following:
Respiratory sinus arrhythmia (~ 0.3 Hz); centrally
nervous respiratory impulses and interaction with pul-
monary afferents;
The so-called “10-second-rhythm” (~ 0.11 Hz);
natural rhythm of cardiovascularly active neurons in the
lower brainstem (circulatory center and its modulation
by feedback with natural vasomotoric rhythms via
baroreceptor feedback). Analogous blood pressure
waves (blood pressure waves of third order) prove the
Longer wave HRV-rhythms (< 0.05 Hz); effects from
the renin angiotensinsystem or temperature regulation
as well as metabolic processes.
Figure 5 depicts the improvement of the state of health
(sleep-wake-cycle) of the same 31-year-old patient from
Beijing over a period of more than two months. At the
beginning of the acupuncture treatment (comp. Figure 4)
no distinct sleep-wake-cycle can be found. Already after
four acupuncture sessions there is an obvious respiratory
sinus arrhythmia during sleep (centre of Figure 5B;
0.2-0.3 Hz). After ten sessions this norm pattern has be-
come stabilized (Figure 5C).
Heart rate and its variability are important parameters for
the assessment of the autonomic nervous system and are
indicators for ‘neurocardial fitness’ [7]. It has long been
known that an extremely steady pulse represents a deadly
risk. Using computer-based analysis in the time and fre-
quency domain the influence of acupuncture treatments
on HRV parameters was evaluated. HRV has its origin in
the function of the vegetative nervous system. Therefore
the state of health can be quantified [7].
Teleacupuncture may contribute to the omission of
redundant research studies and a simplification of the
diagnostic and therapeutic procedure, thereby not only
cutting costs but also saving time [3-6].
The common research between Graz and Beijing shows
one thing quite clearly: teleacupuncture bridges on the
one hand Eastern and Western medicine and on the other
hand science and practice. The next goal will be to
translate the research results into arising practical possi-
bilities available to all participants in different countries.
G. Litscher / HEALTH 2 (2010) 16-19
SciRes Copyright © 2010 Openly accessible at http://www.scirp.org/journal/HEALTH/
Figure 4. First teleacupuncture between Europe (Graz) and Asia (Beijing). Heart rate variability data of 24 hours
are shown (modified from [5]).
Figure 5. Follow-up investigations during a total of ten acupuncture sessions in China. Note the appearance of
an obvious sleep-wake-cycle already after the fourth acupuncture treatment (modified from [6]).
G. Litscher / HEALTH 2 (2010) 16-19
SciRes Copyright © 2010 Openly accessible at http://www.scirp.org/journal/HEALTH/
Apart from the research-related aspects, transcontinental
teleacupuncture opens up new possibilities for interactive
education and practical training in public health. This
represents another important aspect in quality control and
quality assurance in complementary medicine.
The investigations are part of the project “Bioengineering and clinical
assessment of high-tech acupuncture: A Sino-Austrian research pilot
study,’’ supported by the Austrian Federal Ministries of Science and
Research and of Health and the Eurasia Pacific Uninet. The author is
grateful to Professor Weibo Zhang and Dr. Tao Huang, Institute of
Acupuncture and Moxibustion, China Academy of Chinese Medical
Sciences, Beijing, China; and Dr. Lu Wang and Mag. Ingrid Gaischek,
both TCM Research Center Graz, Austria; and Jan Valentini (Graz and
Beijing), for their valuable support of this project and for the excellent
cooperation. The preliminary report is also part of the initiated ‘OeNB
Jubiläumsfonds’ project 13463 and performed within the areas ‘Sus-
tainable Health Research’ and ‘Neuroscience’ at the Medical University
of Graz.
[1] Wooton, R. and Craig, J. (eds.) (1999) Introduction to
telemedicine, Royal Society of Medicine Press, UK, 4.
[2] Ihmsen, H., Naguib, K., Schneider, G., Schwilden, H.,
Schüttler, J. and Kochs, E. (2007) Teletherapeutic drug
administration by long distance closed-loop control of
propofol. Br J Anaesth, 98(2), 189-195.
[3] Litscher, G. (2009) Teleacupuncture: A new approach for
transcontinental long-distance cooperation between Graz,
Austria and Beijing, China (7,650 km). Medical Acu-
puncture, 21(3), 223-224.
[4] Litscher, G., Huang, T., Valentini, J., Zhang, W.B. and
Wang, L. (2009) Transcontinental teleacupuncture by
means of long distance (7,650 km) computer-based heart
rate variability analysis: First results from pilot meas-
urements. Proceedings of the International Symposium
‘Modernization of Traditional Chinese Medicine’, Graz,
Austria, 39-40.
[5] Litscher, G. (2009) Modernization of traditional acu-
puncture using multimodal computer-based high-tech
methods: Recent results of blue laser and teleacupuncture
from the Medical University of Graz. J Acupunct Merid-
ian Stud, 2(3), 202-209.
[6] Litscher, G. (2009) Transkontinentale Akupunkturfors-
chung mittels Teleakupunktur. promed komplementär, 3,
[7] Litscher, G. (2007) Bioengineering assessment of acu-
puncture (part 7): Heart rate variability. Crit Rev Biomed
Eng, 35(3-4), 183-195.