Effects of acupressure at the P6 and LI4 points on the anxiety level of soldiers in the Iranian military

Safety and efficacy of electro-thumbtack needle for acute mountain sickness patients: a protocol of a randomized, single-blinded, and placebo-controlled study

BACKGROUND

Acute mountain sickness (AMS) is considered the most common altitude sickness. It can be detrimental to the health of tourists who rapidly ascend high mountains, and can also impair the performance of individuals who move to the plateau for work or education. Acupuncture has been shown to improve AMS as a simple, safe, and effective nonpharmacological method, in case electro-thumbtack needle (ETN) is a more convenient form of acupuncture for both doctor and patient. There are no studies validating the effectiveness of electro-thumbtack needle in improving symptoms in participants with AMS. In this study, we will conduct a randomized controlled trial to evaluate the clinical efficacy and safety of electro-thumbtack needle in participants with AMS. Our hypothesis is that electro-thumbtack needle is safe and effective in treating participants with AMS.

METHODS

This study is a single-center, randomized, single-blinded, and placebo-controlled study involving at least 114 participants who were diagnosed with AMS. The participants randomly assigned in a 1:1 ratio to the electro-thumbtack needle group and the sham acupuncture group. The treatment protocol involved stimulation of seven predefined acupuncture points, including Zhong Wan (RN12), bilateral Nei Guan (PC6), bilateral He Gu (LI4), and bilateral Tai Yang (EX-HN5), for approximately one minute each, with continuous application over 48 h. The primary outcome was improvement in 2018 Lake Louise score (LLS) after 48 h of treatment. Secondary outcome indicators included the incidence of participants with moderate-to-severe AMS (AMS > 5)and AMS, the LLS, visual analogue scale of headache, clinical functioning scores, the Groningen Sleep Quality Survey, the Stanford Somnolence Scale, blood pressure, oxygen saturation, and heart rate, in addition to treatment-related adverse events were also captured.

DISCUSSION

This trial aims to ascertain the therapeutic benefits of ETN in mitigating AMS symptoms, thereby contributing to the evidence base for traditional medical practices, particularly acupuncture, in high-altitude medicine.

TRIAL REGISTRATION

Chinese Clinical Trials Registry: ChiCTR2300073882. Registered on 24 July 2023.

A systematic review of manual therapy modalities and anxiety

CONTEXT

Anxiety disorders have a far-reaching impact on society, with profound implications on both mental and physical health. In response, there is growing interest in manual therapy modalities, with emerging research suggesting their potential to alleviate related symptoms.

OBJECTIVES

To establish a consensus regarding manual therapy modalities for addressing anxiety symptoms, a systematic review of current literature was conducted.

METHODS

A literature search was conducted between May and August 2023, utilizing a systematic search on both PubMed and Google Scholar, adhering to the defined inclusion criteria. In addition, information was gathered utilizing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Both authors (KLW and TH) conducted the literature review. The inclusion criteria include articles written in English, peer-reviewed, anxiety conditions documented, and manual therapy delivered by a respectfully qualified professional. Manual therapy modalities include massage therapy, osteopathic manipulative treatment (OMT), foot reflexology, acupressure, manual therapy, healing touch, therapeutic touch, and gentle touch. After initial data collection, both researchers independently screened articles utilizing two metrics: a level of evidence (LOE) table and a screening criterion incorporating unique elements from the search process. The quality of the included articles was assessed utilizing Strength of Recommendation Taxonomy (SORT). When reviewer discrepancies arose, authors reread full-text studies and discussed the inclusion and exclusion criteria to achieve consensus.

RESULTS

The data searches identified 8,979 articles, with 239 articles remaining after duplicates and nonapplicable articles were removed. A total of 42 articles met the inclusion criteria, with only 40 articles able to be obtained for full-article review. After full review and the exclusion of articles with invalid author conclusions, meta-analysis, or systematic reviews, 34 articles were included in the review. All articles received an LOE rating of 2 or better and aligned with our specific screening criteria. Based on SORT, each modality was assigned a "B" rating. Among the included articles, n=27 demonstrated statistical significance in favor of manual therapy modalities as an anxiety treatment. The positive results for the aforementioned manual therapies on anxiety symptom improvement are shown: 15/18 (83 %) massage therapy, 2/6 (33 %) OMT, 5/5 (100 %) foot reflexology, 1/1 (100 %) acupressure, 1/1 (100 %) manual therapy, 0/2 (0 %) healing touch, 1/1 (100 %) therapeutic touch, and 1/1 (100 %) gentle touch.

CONCLUSIONS

A pattern emerged, wherein individuals receiving manual therapy interventions displayed a statistically significant reduction in anxiety intensity. Considering the positive results, manual therapy should be considered an effective strategy for anxiety management.

The effect of acupressure on pain levels and physiologic indicator in patients undergoing laparoscopic cholecystectomy: A double-blind, randomized clinical trial

BACKGROUND

Postoperative shoulder-tip pain (STP) is a common complication following laparoscopic cholecystectomy (LC). The study seeks to determine whether acupressure can be used as an alternative to medication for pain relief, as medications often come with side effects. This study aims to evaluate the effect of acupressure on pain levels and physiological indicators in patients undergoing LC.

MATERIALS AND METHODS

This double-blind, randomized clinical trial was conducted on 81 patients who underwent LC at Al-Zahra Hospital of Isfahan University of Medical Sciences, Isfahan, Iran, in 2022. The patients were divided into two groups: the intervention group, which received acupressure (42 participants), and the control group (39 participants). The selected pressure points were LI11, LI4, SJ5, HT7, P6, and K1. Demographic and clinical data were collected, and the pain level was evaluated using the visual analogue score (VAS). The data was analyzed using SPSS version 16 software with a significance level of p < 0.05.

RESULTS

The intervention and control groups were homogeneous in terms of age, gender, duration of surgery, and pethidine consumption (p > 0.05). The average VAS significantly decreased in both the intervention and control groups (p < 0.001). The intervention group had a significantly higher reduced score compared to the control group, 30 min and 72 h after applying acupressure (p < 0.001). Significant differences were observed between the two groups in terms of changes in systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), and breath rate (BR) (p < 0.05).

CONCLUSIONS

acupressure can effectively improve STP and physiological indicators in patients undergoing LC.

TRIAL REGISTRATION NO

IRCT20150715023216N14 (Registration date: 2023-01-22, https://irct.behdasht.gov.ir/user/trial/68111/view).

Acupressure: a possible therapeutic strategy for anxiety related to COVID-19: a meta-analysis of randomized controlled trials

Background

From the end of 2019 to December 2023, the world grappled with the COVID-19 pandemic. The scope and ultimate repercussions of the pandemic on global health and well-being remained uncertain, ushering in a wave of fear, anxiety, and worry. This resulted in many individuals succumbing to fear and despair. Acupoint massage emerged as a safe and effective alternative therapy for anxiety relief. However, its efficacy was yet to be extensively backed by evidence-based medicine. This study aimed to enhance the clinical effectiveness of acupoint massage and extend its benefits to a wider population. It undertakes a systematic review of the existing randomized controlled trials (RCTs) assessing the impact of acupoint massage on anxiety treatment, discussing its potential benefits and implications. This research aims to furnish robust evidence supporting anxiety treatment strategies for patients afflicted with COVID-19 disease and spark new approaches to anxiety management.

Objectives

This study evaluates the evidence derived from randomised controlled trials (RCTs), quantifies the impact of acupressure on anxiety manifestations within the general population, and proposes viable supplementary intervention strategies for managing COVID-19 related anxiety.

Materials and methods

This review included RCTs published between February 2014 and July 2023, that compared the effects of acupressure with sham control in alleviating anxiety symptomatology as the outcome measure. The studies were sourced from the multiple databases, including CINAHL, EBM Reviews, Embase, Medline, PsycINFO, Scopus and Web of Science. A meta-analysis was performed on the eligible studies, and an overall effect size was computed specifically for the anxiety outcome. The Cochrane Collaboration Bias Risk Assessment Tool (RevMan V5.4) was employed to assess bias risk, data integration, meta-analysis, and subgroup analysis. The mean difference, standard mean deviation, and binary data were used to represent continuous outcomes.

Results

Of 1,110 studies of potential relevance, 39 met the criteria for inclusion in the meta-analysis. The majority of the studies reported a positive effect of acupressure in assuaging anticipatory anxiety about treatment. Eighteen studies were evaluated using the STAI scale. The acupressure procedures were thoroughly documented, and studies exhibited a low risk of bias. The cumulative results of the 18 trials showcased a more substantial reduction in anxiety in the acupressure group compared to controls (SMD = -5.39, 95% CI -5.61 to -5.17, p < 0.01). A subsequent subgroup analysis, based on different interventions in the control group, demonstrated improvement in anxiety levels with sham acupressure in improving changes in anxiety levels (SMD -1.61, 95% CI: -2.34 to -0.87, p < 0.0001), and blank controls (SMD -0.92, 95% CI: -2.37 to 0.53, p = 0.22).

Conclusion

In the clinical research of traditional Chinese medicine treatment of anxiety, acupressure demonstrated effectiveness in providing instant relief from anxiety related to multiple diseases with a medium effect size. Considering the increasing incidence of anxiety caused by long COVID, the widespread application of acupressure appears feasible. However, the results were inconsistent regarding improvements on physiological indicators, calling for more stringent reporting procedures, including allocation concealment, to solidify the findings.

Additive effects of acupuncture in alleviating anxiety: A double-blind, three-arm, randomized clinical trial

BACKGROUND

In this trial, additive effects of acupuncture to selective serotonin reuptake inhibitors (SSRIs) treatment for reducing anxiety, were investigated.

METHODS

112 patients with anxiety disorder were randomly divided into three groups including SSRIs alone (drug group), SSRIs with sham acupuncture (control group) and SSRI with acupuncture (acupuncture group), and treated for 4 weeks. At the beginning of the study and on day 28, Spielberger State-Trait Anxiety Inventory (STAI) questionnaire was completed and serum levels of cortisol were measured.

RESULTS

105 patients completed the treatment period. STAI score showed significant differences among the three groups at the end of the study; importantly, changes in STAI score in the acupuncture group were significantly larger than the other groups. A decrease in cortisol levels was observed in all groups; though statistically non-significant, this decrease in the acupuncture group was larger.

CONCLUSION

Acupuncture combined with SSRIs can significantly improve anxiety state compared to anti-anxiety therapy using SSRIs alone.

The Effect of Tele-acupressure Self-practice for Mental Health and Wellbeing in the Community During COVID-19

Background:

Preliminary studies support the clinical effect of acupressure in managing neuropsychiatric diseases. However, procedures for the selection of intervention and Tele-acupressure self-practice implementation techniques are lacking. This lack of information hinders further studies on the effect of Tele-acupressure self-practice and its subsequent clinical uses.

Objective:

The aim of this study was to assess the effect of Tele-acupressure self-practice on the improvement of mental health as well as depression, anxiety and well-being during COVID-19 in Malaysia.

Methods:

The goal of this work was to manage Tele-acupressure self-practice for mental health during COVID-19. All the participants (N=80) enrolled in this study were staying at one of the same communities. The participants were randomly allocated to one of the two groups; 40 participants were involved in the Tele-acupressure self-practice group, and 40 participants were involved in the Nonacupressure group. Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, and personal well-being (using the four Office for National Statistics personal well-being questions, ONS-4) were used to assess measurement. Data were collected at baseline and after four weeks of treatment.

Results:

The Hamilton Depression Rating Scale (6.29±1.65), Hamilton Anxiety Rating Scale (7.20±0.65), anxiety score in well-being ONS-4 (3.34±0.38) were significantly lower; the happiness score in well-being ONS-4 (8.82±0.86) was significantly higher in the Tele-acupressure self-practice group compared with the Non-acupressure group in the after four week’s assessments. The two groups were not statistically different regarding satisfaction with life and sorthwhile in the well-being ONS-4 questionnaires.

Conclusions:

Tele-acupressure self-practice had an effect than Non-acupressure in participants during COVID-19 pandemic. But, satisfaction with life and worthwhile in the well-being was better in both of the groups, which proved the participants became more relaxed. Tele-acupressure self-practice being used for the COVID-19 pandemic period facilitates the development of Malaysian public mental health intervention.

Determinants of anxiety levels among young males in a threat of experiencing military conflict-Applying a machine-learning algorithm in a psychosociological study

Background

Anxiety could be felt even in objectively peaceful situations, but a vision of conflict could result in increased stress levels. In this article, we aimed to identify hidden patterns of mental conditions and create male profiles to illustrate the different subgroups as well as determinants of anxiety levels among them in accordance with proximity to a possibility of direct exposure to military action.

Methods

A sample of Ukrainian males, in duty as conscripts to military service (n = 392, M±SD = 22.1±5.3) participated in a survey. We used the 36-Item Short Form Health Survey, and State-Trait Anxiety Inventory. In addition to psychological indices, social-demographic data were collected. To discover the number of clusters, the k-means algorithm was used, the optimal number of clusters was found by the elbow algorithm. For validation of the model and its use for further prediction, the random forest machine-learning algorithm, was used.

Results

By performing k-means cluster analyses, 3 subgroups were identified. High values of psychological indices dominated in Subgroup 2, while lowest values dominated in Subgroup 3. Subgroup 1 showed a more even distribution among the indices. The strength of the relevance and main determinants of the prediction of the presented model mostly consisted of mental qualities, while socio-demographic data were slightly significant.

Conclusions

There is no clear relevance between proximity or even the experience of military actions and anxiety levels. Other factors, mostly subjective feelings about mental conditions, are crucial determinants of feeling anxiety.