Effects of auricular acupressure on sleep and pain in elderly people who have osteoarthritis and live in nursing homes: A randomized, single-blind, placebo-controlled trial

The Effectiveness of Auricular Acupressure on Chronic Musculoskeletal Pain: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Objectives: To assess the effectiveness of auricular acupressure (AA) in managing pain and disability in individuals with chronic musculoskeletal pain. Materials and Methods: A systematic search on six electronic databases was performed from their inception to May 7, 2023, to identified relevant randomized controlled trials (RCTs). Two independent reviewers screened the abstracts and full texts, extracted data, and assessed risk of bias using RoB 2. The primary outcomes were pain intensity and disability. The secondary outcomes were pain pressure thresholds, pain catastrophizing level, and fear avoidance beliefs. A random-effects model was used for meta-analyses. The certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation. Sensitivity analyses were conducted after removing low-quality papers. Results: Of 633 identified records, six studies involving 496 participants were included. All included studies compared the effectiveness of AA with sham controls in treating various chronic musculoskeletal pain. Four meta-analyses were conducted to compare the effectiveness of AA with sham controls. Low-quality evidence supported that AA had a large effect size on postintervention subjective pain reduction (standardized mean difference [SMD] = -0.95; 95% confidence interval [CI]: -1.36 to -0.54; p = 0.00; I2 = 52.61%); moderate-quality evidence substantiated that AA had a large effect size on enhancing postintervention pressure pain threshold (SMD = -0.55; 95% CI: -0.88 to -0.23; p = 0.00; I2 = 0%). There was low-quality evidence that AA had a large effect on reducing postintervention disability (SMD = -0.68; 95% CI: -1.24 to -0.12; p = 0.02; I2 = 51.33%). Our sensitivity analysis reaffirmed the same conclusion regarding pain reduction immediately after the intervention. Fourteen participants reported minimal adverse events, including soreness, tenderness, irritation, and redness, which disappeared within 1-7 days. Discussion: Our systematic review revealed that AA significantly improved pain, pressure pain thresholds, and disability in individuals with various chronic musculoskeletal pain conditions immediately post-treatment compared with sham treatment. Given the paucity of studies and inconsistent protocols, future RCTs are warranted to evaluate the effectiveness of AA in people with chronic musculoskeletal pain at a longer follow-up with detailed protocols, which allows researchers and clinicians to optimize AA intervention. Conclusion: AA has immediate post-treatment benefits for chronic musculoskeletal pain, whereas its effects at the 1- or 6-month follow-up remain uncertain.

The effect of self-administered acupressure on pain severity and sleep quality of patients with knee osteoarthritis: a randomized controlled trial

BACKGROUND

Pain in the knee joint area and reduced sleep quality are prevalent symptoms of knee osteoarthritis. This study examines the impact of self-administered acupressure on pain severity and sleep quality in patients with knee osteoarthritis.

METHODS

In this trial conducted in 2023, 126 patients were enrolled. They completed a demographic characteristics form, the Visual Analogue Scale (VAS), and the Pittsburgh Sleep Quality Index (PSQI). Afterward, they were randomly allocated to three groups: acupressure, sham, and control. While the control group received routine care, patients in the acupressure and sham groups were instructed to apply pressure on selected acupoints daily for one minute for a duration of one month. All participants completed the PSQI and the VAS one month after the intervention began and one month after it ended. Data analysis involved Fisher's exact tests, chi-square, Kruskal-Wallis, and one-way ANOVA tests. Also, per-protocol analyses were conducted with linear mixed-effects models.

RESULTS

No significant effects associated with group allocation were observed on pain VAS scores in acupressure and sham groups compared to the control group. However, participants in the acupressure group showed a significant decrease in pain VAS scores as time progressed. PSQI scores significantly decreased over time. Interaction effects showed that PSQI scores decreased more in the acupressure than in the control group over time. Finally, PSQI scores in the acupressure group demonstrated a significant decrease from pretest to follow-up, while no significant change was observed over time in the sham group.

CONCLUSIONS

Self-administered acupressure may be useful in improving sleep quality in patients with knee osteoarthritis. This work may be informative in developing acupressure interventions with more effective outcomes in future research.

TRIAL REGISTRATION

This trial is registered on the Iranian Registry of Clinical Trials website with the identifier IRCT20211221053475N1 (Date: 10/01/2022).

The Effects of Auricular Acupressure on Low Back Pain, Neuropathy and Sleep in Patients with Persistent Spinal Pain Syndrome (PSPS): A Single-Blind, Randomized Placebo-Controlled Trial

(1) Background: Various procedures were performed on patients with persistent spinal pain syndrome (PSPS), but the clinical effect and safety were insufficient. The study was to examine the effects of auricular acupressure (AA) on low back pain, neuropathy, and sleep in patients on PSPS. (2) Methods: This was a randomized, single-blind, placebo-controlled study conducted from 1 March 2022 to 31 July 2022. The participants who had at least one lumbar surgery were randomly assigned to either the experimental group (n = 26) or the placebo control group (n = 25). All participants received 6 weeks of AA intervention. To validate the effects of the intervention, pressure pain thresholds (PPT), the Visual Analogue Scale (VAS), douleur neuropathique 4 (DN4) questions, the Pittsburgh Sleep Quality Index (PSQI), and actigraphy with a Fitbit Alta were conducted. The data were analyzed with SPSS/WIN ver. 27.0, using a t-test and repeated-measures ANOVA. (3) Results: The findings showed that there were significant differences in pain (back VAS p = 0.003, leg VAS p = 0.002, PPT p = 0.008), neuropathy (DN4 p = 0.034), and sleep actigraphy (sleep efficiency p = 0.038, number of awake p = 0.001, deep sleep stage p = 0.017). (4) Conclusions: We conclude that AA is an effective, safe, cost-effective, non-invasive nursing intervention that can improve pain, neuropathy, and sleep in patients on PSPS.