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Kawi J, Yeh CH, Grant L, Thrul J, Wu H, Christo PJ, Evangelista LS. Adapting and Evaluating a Theory-Driven, Non-Pharmacological Intervention to Self-Manage Pain. Healthcare (Basel) 2024; 12:969. [PMID: 38786380 PMCID: PMC11121327 DOI: 10.3390/healthcare12100969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 05/02/2024] [Accepted: 05/06/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND The existing literature has limited detail on theory-driven interventions, particularly in pain studies. We adapted Bandura's self-efficacy framework toward a theory-driven, non-pharmacological intervention using auricular point acupressure (APA) and evaluated participants' perceptions of this intervention on their pain self-management. APA is a non-invasive modality based on auricular acupuncture principles. METHODS We mapped our study intervention components according to Bandura's key sources of self-efficacy (performance accomplishments, vicarious experience, verbal persuasion, and emotional arousal) to facilitate the self-management of pain. Through a qualitative study design, we conducted virtual interviews at one and three months after a 4-week APA intervention among 23 participants using purposive sampling to describe their experiences in managing their pain based on our theory-driven APA intervention. RESULTS Using thematic analyses, we found four themes: the enhanced self-management of pain, improved pain outcomes, the feasibility of technology, and the sustainability of APA. CONCLUSIONS Describing how interventions are mapped according to the elements of theoretical frameworks can help to guide intervention development, advance science and knowledge development, and promote the implementation of interventions. As such, using Bandura's self-efficacy theory as a foundation for the APA intervention, APA was found to be feasible and sustainable, improving self-management, pain intensity, and pain-related outcomes. Participants provided recommendations for the further improvement of this theory-driven intervention.
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Affiliation(s)
- Jennifer Kawi
- Cizik School of Nursing, University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Chao Hsing Yeh
- Cizik School of Nursing, University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Lauren Grant
- Kirk Kerkorian School of Medicine, University of Nevada, Las Vegas, Las Vegas, NV 89106, USA;
| | - Johannes Thrul
- School of Public Health, Johns Hopkins Bloomberg, Baltimore, MD 21205, USA;
| | - Hulin Wu
- School of Public Health, University of Texas Health Science Center at Houston, Houston, TX 77030, USA;
| | - Paul J. Christo
- School of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA;
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Tou SI, Huang CY, Yen HR. Effect of Acupoint Stimulation on Controlling Pain from Heel Lance in Neonates: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1024. [PMID: 37371256 DOI: 10.3390/children10061024] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 05/19/2023] [Accepted: 06/05/2023] [Indexed: 06/29/2023]
Abstract
To evaluate the effect of acupoint stimulation compared to other interventions on pain control in neonates who underwent heel lance, we searched for randomized controlled trials across six databases (CINAHL, Cochrane Library, EMBASE, Medline, PubMed, and Web of Science) published up to January 2023. Studies comparing acupoint stimulation and other interventions for controlling heel lance pain in neonates were included. These reports measured at least one of the following variables: pain score, crying time, oxygenation saturation, heart rate, respiration rate, and duration of the procedure. The data were independently extracted by two authors, and the PRISMA guidelines for study selection were followed. A total of 79 articles were screened, and 10 studies, with results on 813 neonates, were included in the final selection. The pain scores recorded during the heel lance procedure were not significantly different between the acupoint stimulation cohort and the control cohort (SMD of -0.26, 95% confidence interval (CI) from -0.52 to 0.01; p = 0.06; I2 = 68%). After processing the subgroup analyses, significant differences were found in the comparisons of acupuncture vs. usual care (SMD of -1.25, 95% CI from -2.23 to 0.27) and acupressure vs. usual care (SMD of -0.62, 95% CI from -0.96 to -0.28); nonsignificant differences were found in other comparisons. Our results demonstrate that acupoint stimulation may improve pain score during the heel lance procedure.
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Affiliation(s)
- Sio-Ian Tou
- Department of Pediatrics, Chung Kang Branch, Cheng-Ching General Hospital, Taichung 407, Taiwan
| | - Chia-Yu Huang
- Department of Family Medicine, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung 427, Taiwan
- Graduate Institute of Chinese Medicine, School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 404, Taiwan
| | - Hung-Rong Yen
- Graduate Institute of Chinese Medicine, School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 404, Taiwan
- International Master Program in Acupuncture, College of Chinese Medicine, China Medical University, Taichung 404, Taiwan
- Department of Chinese Medicine, China Medical University Hospital, Taichung 404, Taiwan
- School of Post-Baccalaureate Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 404, Taiwan
- Research Center for Traditional Chinese Medicine, Department of Medical Research, China Medical University Hospital, Taichung 404, Taiwan
- Chinese Medicine Research Center, China Medical University, Taichung 404, Taiwan
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Lee EJ, Noh JH, Kim EK, Lee CA. Effects of Auricular Acupressure on Hip Flexibility and Pain in Taekwondo Participants: Randomized Controlled Trial. Pain Manag Nurs 2023:S1524-9042(23)00078-4. [PMID: 37258401 DOI: 10.1016/j.pmn.2023.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 02/09/2023] [Accepted: 03/18/2023] [Indexed: 06/02/2023]
Abstract
BACKGROUND In sports, hip flexibility is essential to reduce injuries and improve performance. AIM This study aimed to examine the effects of auricular acupressure on hip flexibility and pain in Taekwondo participants. METHOD This randomized controlled trial was performed in the Republic of Korea from January 2021 to August 2021. The Numeric Rating Scale for Pain and Hip Flexibility was used. Twenty-one participants received auricular pressure once weekly for six weeks, while 17 participants did not receive any intervention. Auricular acupressure was applied to the hip (AH13), Shinmun, and auricular acupressure points associated with the pain areas reported by the participants. RESULTS Auricular acupressure improved hip flexibility (t = 2.67, p = .011) and back pain (t = 2.11, p = .043). The mean difference in post-pretest hip flexibility in the experimental group was 16.24 degrees (±13.63), whereas that in the control group was 4.77 degrees (±15.07). The mean difference in the experimental group's pre-post-test scores of back pain was 1.24 (±2.64), whereas that in the control group was 0.18 (±1.41). CONCLUSIONS The results of this study showed that auricular acupressure could be used to treat pain and improve hip flexibility.
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Affiliation(s)
- Eun Jin Lee
- Department of Nursing, Inha University, Incheon, Republic of Korea
| | - Jeong Hwan Noh
- Youngin University National Brain Taekwondo, Incheon, Republic of Korea.
| | - Eun Kyung Kim
- Department of Nursing, Inha University, Incheon, Republic of Korea
| | - Cheong Ah Lee
- Department of Nursing, Inha University, Incheon, Republic of Korea
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Yeh CH, Lukkahatai N, Huang X, Wu H, Wang H, Zhang J, Sun X, Smith TJ. Biological Correlates of the Effects of Auricular Point Acupressure on Pain. Pain Manag Nurs 2023; 24:19-26. [PMID: 36543665 PMCID: PMC9928890 DOI: 10.1016/j.pmn.2022.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 10/20/2022] [Accepted: 11/16/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND To identify candidate inflammatory biomarkers for the underlying mechanism of auricular point acupressure (APA) on pain relief and examine the correlations among pain intensity, interference, and inflammatory biomarkers. DESIGN This is a secondary data analysis. METHODS Data on inflammatory biomarkers collected via blood samples and patient self-reported pain intensity and interference from three pilot studies (chronic low back pain, n = 61; arthralgia related to aromatase inhibitors, n = 20; and chemotherapy-induced neuropathy, n = 15) were integrated and analyzed. This paper reports the results based on within-subject treatment effects (change in scores from pre- to post-APA intervention) for each study group (chronic low back pain, cancer pain), between-group differences (changes in scores from pre- to post-intervention between targeted-point APA [T-APA] and non-targeted-point APA [NT-APA]), and correlations among pain intensity, interference, and biomarkers. RESULTS Within-group analysis (the change score from pre- to post-APA) revealed statistically significant changes in three biomarkers: TNF-α (cancer pain in the APA group, p = .03), β-endorphin (back pain in the APA group, p = .04), and IL-2 (back pain in the NT-APA group, p = .002). Based on between-group analysis in patients with chronic low back pain (T-APA vs NT-APA), IL-4 had the largest effect size (0.35), followed by TNF-α (0.29). A strong positive monotonic relationship between IL-1β and IL-2 was detected. CONCLUSIONS The current findings further support the potential role of inflammatory biomarkers in the analgesic effects of APA. More work is needed to gain a comprehensive understanding of the underlying mechanisms of APA on chronic pain. Because it is simple, inexpensive, and has no negative side effects, APA can be widely disseminated as an alternative to opioids.
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Affiliation(s)
- Chao Hsing Yeh
- University of Texas Health Science Center at Houston Cizik School of Nursing.
| | | | - Xinran Huang
- University of Texas Health Science Center Houston School of Public Health
| | - Hulin Wu
- University of Texas Health Science Center Houston School of Public Health
| | - Hongyu Wang
- University of Texas Health Science Center at Houston Cizik School of Nursing; University of Texas Health Science Center at Houston, McGovern Medical School
| | - Jingyu Zhang
- Johns Hopkins University Krieger School of Arts and Sciences
| | - Xinyi Sun
- Johns Hopkins University Krieger School of Arts and Sciences
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Lim Y, Park H. 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. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1705. [PMID: 36767071 PMCID: PMC9913948 DOI: 10.3390/ijerph20031705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 01/15/2023] [Accepted: 01/16/2023] [Indexed: 06/18/2023]
Abstract
(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.
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Affiliation(s)
- Yunmi Lim
- Department of Spine Center, Samsung Medical Center, Seoul 06351, Republic of Korea
| | - Hyojung Park
- College of Nursing, Ewha Womans University, Seoul 03760, Republic of Korea
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Teja Y, Nareswari I, Simadibrata CL. The Role of Acupuncture in Treating a Patient with a Gambling Disorder. Med Acupunct 2022; 34:331-336. [PMID: 36311885 PMCID: PMC9595637 DOI: 10.1089/acu.2021.0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Addiction is a chronic/relapsing disorder characterized by compulsive seeking and continuous involvement despite dangerous consequences. It causes long-term changes in the brain. Gambling disorder is a nonsubstance behavioral addiction. An important feature of gambling disorder is maladaptive gambling behavior that is persistent and repetitive, and interferes with patients' personal lives, families, and/or activities. Acupuncture is a nonpharmacologic therapeutic modality for managing addiction, with good results. Case A 32-year-old man with a gambling disorder was referred from a psychiatry department. The patient had a history of gambling since high school. He began to gamble in larger amounts in 2019. The patient got antiseizure, antidepressant, and antipsychotic medications, and cognitive behavioral therapy in the psychiatry department. Manual acupuncture therapy was performed at GV 20, Ex-HN 1, Ex-HN 3, PC 6, ST 40, and LR 3. Electroacupuncture was performed at LI 4, LI 11, ST 36, SP 6, and ST 25. Laser acupuncture was performed at NADA protocol bilateral ear points. The patient also received scalp acupuncture for extrapyramidal symptoms After this combination of acupuncture therapy for 8 sessions, with pharmacotherapy and psychotherapy, the patient's condition improved. Conclusions Acupuncture produces positive results in patient with gambling disorders. It helps regulate the reward system; stimulates release of neurotransmitters in the brain; produces neuroprotective effects; and activates certain brain areas to suppress impulsivity and craving and to balance emotions. Acupuncture is thought to be related to increased blood flow in the frontal lobe, thereby increasing nerve metabolism, as well as regulating dopamine in the basal ganglia. A combination of acupuncture, pharmacologic agents, and psychotherapy has a positive synergistic effect in patients with gambling disorder.
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Affiliation(s)
- Yolanda Teja
- Department of Medical Acupuncture, RSUPN, Dr. Cipto Mangunkusumo, and Medical Acupuncture Specialist Program, Faculty of Medicine, Universitas Indonesia, both in Jakarta, Indonesia
| | - Irma Nareswari
- Department of Medical Acupuncture, RSUPN, Dr. Cipto Mangunkusumo, and Medical Acupuncture Specialist Program, Faculty of Medicine, Universitas Indonesia, both in Jakarta, Indonesia
| | - Christina L. Simadibrata
- Department of Medical Acupuncture, RSUPN, Dr. Cipto Mangunkusumo, and Medical Acupuncture Specialist Program, Faculty of Medicine, Universitas Indonesia, both in Jakarta, Indonesia
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Fogleman C, McKenna K. Integrative Health Strategies to Manage Chronic Pain. Prim Care 2022; 49:469-483. [DOI: 10.1016/j.pop.2022.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Moura CDC, Chaves EDCL, Nogueira DA, Iunes DH, Azevedo C, Corrêa HP, Pereira GA, Silvano HM, Macieira TGR, Chianca TCM. Effect of Ear Acupuncture plus Dry Cupping on Activities and Quality of Life in the Adults with Chronic Back Pain: a Randomized Trial. J Acupunct Meridian Stud 2022; 15:130-142. [DOI: 10.51507/j.jams.2022.15.2.130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 11/08/2021] [Accepted: 12/10/2021] [Indexed: 11/03/2022] Open
Affiliation(s)
| | | | - Denismar Alves Nogueira
- Department of Statistics, Exact Sciences Institute, Federal University of Alfenas, Alfenas, Brazil
| | - Denise Hollanda Iunes
- Institute of Rehabilitation Sciences, Federal University of Alfenas, Alfenas, Brazil
| | - Cissa Azevedo
- Department of Medicine and Nursing, Federal University of Viçosa, Viçosa, Brazil
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Choi SY, Kim YJ, Kim B. [Effect of Auriculotherapy on Musculoskeletal Pain: A Systematic Review and Meta-Analysis]. J Korean Acad Nurs 2022; 52:4-23. [PMID: 35274617 DOI: 10.4040/jkan.21121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 12/14/2021] [Accepted: 12/21/2021] [Indexed: 11/09/2022]
Abstract
PURPOSE The aim of this study was to evaluate the effect of auriculotherapy on musculoskeletal pain in adults. METHODS A total of 885 studies were retrieved from nine databases (PubMed, Scopus, CINAHL, Web of Science, Ovid Medline, Cochrane Library, RISS, KMbase, and KISS). Sixteen studies were selected for meta-analysis, which satisfied the inclusion criteria and the evaluation of risk of bias. Demographic data, auriculotherapy types, intervention characteristics, auricular points, and outcomes related to pain (subjective pain scale, and amount of analgesic) were extracted from all included studies. The effect size of auriculotherapy was analyzed through comprehensive meta analysis 3.0, and the presence of publication bias was analyzed through a funnel plot and Egger's regression. RESULTS The results of the meta-analysis (n = 16) revealed that the auriculotherapy was significantly superior to the control group on present pain in adults (Hedges' g = -0.35, 95% Confidence Interval [CI] = -0.55~-0.15). According to the results of subgroup analysis, the effect size of auricular acupuncture therapy (Hedges' g = 0.45, 95% CI = -0.75~-0.15) was higher than the auricular acupuncture (Hedges' g = 0.27, 95% CI = -0.53~0.00): the longer the intervention period, the greater the effect size. CONCLUSION In this study, auriculotherapy demonstrates a significant reduction in musculoskeletal pain in adults. Therefore, it is necessary to refine the curriculum to include auriculotherapy as a nursing intervention to relieve musculoskeletal pain in adults and encourage its use in clinical settings.
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Affiliation(s)
- Sun Yeob Choi
- College of Nursing, Ewha Womans University, Seoul, Korea
| | - Yeo Ju Kim
- College of Nursing, Ewha Womans University, Seoul, Korea
| | - Bomi Kim
- College of Nursing, Ewha Womans University, Seoul, Korea.
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Madmoli Y, Rokhafroz D, Zarea K, Maraghi E. Effects of SP6 and ST36 Acupressure on Pain and Physiological Indexes in Addicted Men: A Single-Blind Randomized Clinical Trial. ADDICTION & HEALTH 2022; 14:52-61. [PMID: 35573760 PMCID: PMC9057643 DOI: 10.22122/ahj.v14i1.1251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 10/22/2021] [Indexed: 11/09/2022]
Abstract
Background Pain is the most crucial reason to seek treatment, and acupressure is one of the most common ways to relieve pain; therefore, this study was conducted with the aim to investigate the effectiveness of acupressure on the reduction of pain and stability of physiological indexes in addicted men. Methods The present single-blind, randomized, clinical trial was performed on 90 participants who were hospitalized in an addiction treatment camp in Masjed-e-Soleyman, Iran. The participants were divided into acupressure group (n = 45) and control group (n = 45) through allocating permutation blocks method. The acupressure group received acupressure on SP6 and ST36 points for 3 consecutive sessions and each session for 10 minutes. The data collection tools used included a demographic information questionnaire, the Short-Form McGill Pain Questionnaire (SF-MPQ), and a physiological index registration form, tympanic thermometer, sphygmomanometer, pulse oximetry device, and digital watch. Repeated measures ANOVA was used to analyze the data. P ≤ 0.05 was considered statically significant. Findings There was a statistically significant decrease in the sensory dimension of pain in the acupressure group compared to the control group in all 3 sessions (P ≤ 0.001; P ≤ 0.001; P = 0.001, respectively). There was no statistically significant difference in the overall pain score (P ≥ 0.005), emotional pain dimension (P ≥ 0.005), and physiological indexes of pain (P ≥ 0.005) between the two groups after the intervention. Conclusion Acupressure is a non-invasive and cost-effective method that reduces the sensory dimension of painý, and its application does not require special tools; ýthus, the use of such a safe and secure method for relieving pain is recommended.
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Affiliation(s)
- Yaghoob Madmoli
- Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Dariush Rokhafroz
- Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran,Correspondence to: Dariush Rokhafroz; Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran;
| | - Kourosh Zarea
- Nursing Care Research Center in Chronic Diseases, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Elham Maraghi
- Department of Biostatistics and Epidemiology, School of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Evaluating Auricular Point Acupressure for Chronic Low Back Pain Self-Management Using Technology: A Feasibility Study. Pain Manag Nurs 2021; 23:301-310. [PMID: 34961729 DOI: 10.1016/j.pmn.2021.11.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 11/09/2021] [Accepted: 11/20/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND Chronic low back pain, one of the most common reasons for seeking healthcare services, causes significant negative impacts on individuals and society. Nonpharmacologic therapies and self-management are included in practice guidelines, but their implementation is challenging. AIM To assess the feasibility of using an auricular point acupressure (APA) mobile app as a self-guided tool to learn and self-administer APA to manage chronic low back pain (cLBP) and to compare cLBP outcomes between 2 groups (app vs app + telehealth). DESIGN A 2-phase study design was used. In phase 1, participants (app group, n = 18) had in-person study visits and installed the app to learn and self-administer APA to manage cLBP. In phase 2, all research activities occurred remotely due to the COVID-19 pandemic, so a second group was recruited (app + telehealth, n = 19). The app + telehealth group underwent a virtual session, installed the app, and were provided the opportunity for questions and verification on the accuracy of the self-administered APA. SETTING The participants were recruited by distributing study flyers at outpatient clinics and referrals. PARTICIPANTS Participants with chronic low back pain were eliglbe for the study. METHODS Using a quasi-experimental design with a mixed methods approach, all participants were instructed to download the APA app, provided an APA kit (includes seeds embedded within pre-cut squares of adhesive tape), and advised to self-administer APA with guidance from the app for 4 weeks to manage their cLBP. Study outcomes were collected at the preintervention time point as well as postintervention and 1-month follow-up. Interviews were also conducted at the postintervention time point. RESULTS Of the 37 participants enrolled, six dropped out, and the attrition rate was 16%. Adherence to APA practice was high (85%-94%). After 4 weeks of APA treatment, participants in the app + telehealth group experienced a 29% decrease in pain intensity during the postintervention time point and a 35% reduction during the 1-month follow-up. Similar improvements were noted in pain interference (28%) and physical function (39%) for participants in the app + telehealth group at the 1-month follow-up. These changes are slightly higher compared with those in the app group (21% pain intensity reduction, 23% improved pain interferences, and 26% improved physical function) during the 1-month follow-up. Overall, APA was found to be feasible using the app and the qualitative findings showed acceptability of the intervention in both groups. CONCLUSIONS It is feasible to learn and self-administer APA with an app, supplemented with either in-person or telehealth sessions, presenting a promising intervention toward cLBP self-management. Telehealth was found to boost this intervention effectively.
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Teja Y, Nareswari I. Acupuncture Therapies for Addressing Post Odontectomy Neuropathy. Med Acupunct 2021; 33:358-363. [PMID: 35003505 DOI: 10.1089/acu.2020.1472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Third-molar extraction is a common oral surgical procedure that can cause complications. Although rare, nerve injuries that result in permanent neuropathy can occur and include a variety of complaints such as sensory disorders, taste-sensation disorders, speech articulation disorders, etc. Acupuncture is one of several nonpharmacologic therapies that has played a role in managing neuropathic lesions and has been proven to produce good results. Case: A 44-year-old woman with postodontectomy neuropathy developed paresthesia, dysarthria, xerostomia, dysgeusia, pain in the gums and lower right jaw, a chewing disorder, and cephalgia. Her numerical rating scale (NRS) results were: lower right gum pain, 3/10; numbness of the tongue, 4/10; and headache, 1/10. A physical examination revealed dysarthria, a decreased sense of sharpness and dullness in the right mandibular nerve branches, decreased right masseter muscle contractions, and tenderness on the right GB 20 point. Electromyography revealed partial functional lesions in the postganglion at the right fifth cranial nerve. She had body acupuncture therapy at GV 20, GB 20, ST 5, ST 6, ST 7, CV 23, LI 4, HT 5, ST 36, LU 7, and KI 6; ear acupuncture at the Parotid and Shenmen points; and treatment with the Tan Balance Method. Results: After 3 consecutive sessions of acupuncture therapy, this patient's symptoms were reduced. Conclusions: Acupuncture was helpful for reducing paresthesia, dysarthria, xerostomia, dysgeusia, gum and lower right jaw pain, a chewing disorder, and cephalgia in this patient with postodontectomy neuropathy. Clinical trials are needed to support the findings in this case.
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Affiliation(s)
- Yolanda Teja
- Department of Medical Acupuncture, RSUPN Dr. Cipto Mangunkusumo, Central Jakarta, DKI Jakarta, Indonesia.,Medical Acupuncture Specialist Program, Faculty of Medicine, Universitas Indonesia, Jakarta, Daerah Istimewa Jakarta, Indonesia
| | - Irma Nareswari
- Department of Medical Acupuncture, RSUPN Dr. Cipto Mangunkusumo, Central Jakarta, DKI Jakarta, Indonesia.,Medical Acupuncture Specialist Program, Faculty of Medicine, Universitas Indonesia, Jakarta, Daerah Istimewa Jakarta, Indonesia
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Mejías-Gil E, Garrido-Ardila EM, Montanero-Fernández J, Jiménez-Palomares M, Rodríguez-Mansilla J, González López-Arza MV. Kinesio Taping vs. Auricular Acupressure for the Personalised Treatment of Primary Dysmenorrhoea: A Pilot Randomized Controlled Trial. J Pers Med 2021; 11:jpm11080809. [PMID: 34442453 PMCID: PMC8398516 DOI: 10.3390/jpm11080809] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 08/16/2021] [Accepted: 08/17/2021] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Dysmenorrhoea is the medical term for menstrual pain. The World Health Organization estimates that up to 81% of women of childbearing age are affected by this condition, and it is one of the leading causes of absenteeism from work and school among women. Although there are pharmacological treatments available for menstrual-pain relief, they do not respond to all women's needs. Therefore, there is a need to study and develop non-pharmacological alternatives to broaden the individualised treatment options for dysmenorrhea. There are scarce studies published on non-pharmacological treatments, such as kinesio tape and auricular acupressure for the relief of menstrual pain, but the scientific evidence available suggest that these techniques may be beneficial in addressing this problem. The objective of this pilot study was to assess and compare the effectiveness of kinesio tape and auricular acupressure to decrease pain and drug intake in women with primary dysmenorrhoea. METHODS This was a double-blind randomized clinical controlled trial. The period of study was from September 2017 to August 2018. Women enrolled in the University of Extremadura and who had primary dysmenorrhoea were randomized to five groups: control (n = 23), kinesio tape (n = 23), placebo kinesio tape (n = 23), auricular acupressure (n = 23) and placebo auricular acupressure (n = 22). Measures were taken during the pretreatment phase (at four menstrual cycles), during the post-intervention phase (at four menstrual cycles) and during the follow-up phase (at the first and third menstrual cycles after the treatment was completed). The primary outcome measures were mean pain intensity, maximum pain intensity, number of painful days and dose of drug intake during menstruation, measured with the Visual Analogue Scale. The secondary outcome measures were the length of the cycle, the length of menstruation, the drug intake and the type of drug. RESULTS In all, 108 participants completed the study. The statistical analysis (MANOVA, ANOVA, t-paired and McNemar tests) showed that kinesio tape and auricular acupressure have a beneficial effect on pain relief (mean pain intensity, p < 0.001; maximum pain intensity, p < 0.001; number of painful days, p = 0.021; dose of drug intake, p < 0.001). In addition, once the treatments were withdrawn, the auricular-acupressure group maintained lower scores during the first follow-up cycle (p < 0.001). CONCLUSIONS Kinesio tape and auricular acupressure decrease pain and drug intake in women with primary dysmenorrhoea. The changes in the auricular-acupressure group seemed to last longer. The results suggest that these techniques could be used as complementary personalised therapies to the pharmacological treatment and not as a substitution.
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Affiliation(s)
- Elena Mejías-Gil
- ADOLOR Research Group, Department of Medical-Surgical Therapy, Faculty of Medicine and Health Sciences, Extremadura University, 06006 Badajoz, Spain; (E.M.-G.); (M.J.-P.); (M.V.G.L.-A.)
| | - Elisa María Garrido-Ardila
- ADOLOR Research Group, Department of Medical-Surgical Therapy, Faculty of Medicine and Health Sciences, Extremadura University, 06006 Badajoz, Spain; (E.M.-G.); (M.J.-P.); (M.V.G.L.-A.)
- Correspondence: (E.M.G.-A.); (J.R.-M.)
| | - Jesús Montanero-Fernández
- Mathematics Department, Faculty of Medicine and Health Sciences, Extremadura University, 06006 Badajoz, Spain;
| | - María Jiménez-Palomares
- ADOLOR Research Group, Department of Medical-Surgical Therapy, Faculty of Medicine and Health Sciences, Extremadura University, 06006 Badajoz, Spain; (E.M.-G.); (M.J.-P.); (M.V.G.L.-A.)
| | - Juan Rodríguez-Mansilla
- ADOLOR Research Group, Department of Medical-Surgical Therapy, Faculty of Medicine and Health Sciences, Extremadura University, 06006 Badajoz, Spain; (E.M.-G.); (M.J.-P.); (M.V.G.L.-A.)
- Correspondence: (E.M.G.-A.); (J.R.-M.)
| | - María Victoria González López-Arza
- ADOLOR Research Group, Department of Medical-Surgical Therapy, Faculty of Medicine and Health Sciences, Extremadura University, 06006 Badajoz, Spain; (E.M.-G.); (M.J.-P.); (M.V.G.L.-A.)
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Kim SK, Park H. The Effect of Auricular Acupressure for Chronic Low Back Pain in Elders: A Randomized Controlled Study. Holist Nurs Pract 2021; 35:182-190. [PMID: 34115736 DOI: 10.1097/hnp.0000000000000457] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Chronic low back pain (CLBP) is a major problem throughout the world and getting worse because of population increase and aging. The cost of treatment increases as the population of people with CLBP increases. This study aimed to examine the effect of auricular acupressure (AA) on pain and disability in elders with chronic low back pain. The randomized, single-blinded, and placebo-controlled study was conducted on 51 elders with CLBP in South Korea from June 2019 to August 2019. The experimental group (n = 26) received AA on low back pain-related points, whereas the placebo control group (n = 25) received AA on points unrelated to low back pain. Participants received 6 weeks of AA in weekly cycles. Collected data were analyzed using IBM SPSS Statistics, version 25. Statistically significant differences between the 2 groups emerged in the visual analog scale (P < .001), pain threshold (P < .001), and Oswestry Disability Index (P < .001). This study showed that 6 weeks of AA improved CLBP and pain-related disability. Therefore, AA can be used as a noninvasive and self-managed alternative intervention for CLBP in older adults.
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Affiliation(s)
- Soo Kyoung Kim
- California Pacific Medical Center, San Francisco, California (Ms Kim); and College of Nursing, Ewha Womans University, Seoul, Republic of Korea (Ms Kim and Dr Park)
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15
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Nielsen A, Gereau S, Tick H. Risks and Safety of Extended Auricular Therapy: A Review of Reviews and Case Reports of Adverse Events. PAIN MEDICINE 2021; 21:1276-1293. [PMID: 32430505 DOI: 10.1093/pm/pnz379] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Auricular acupuncture (AA) and extended auricular therapy (AT) are a part of acupuncture practice shown to benefit patients with pain, anxiety, and other conditions, with cost-effective access enhanced when given in a group setting. Yet there are safety concerns and risks, perhaps unnecessary risks, that attend embedded, indwelling needles applied to the ear as a means of extended AT. METHODS Electronic searches were conducted in PubMed, MEDLINE, CINAHL and Cochrane Central Register of Controlled Trials (CENTRAL) for "auriculotherapy," "auricular acupuncture" or "auricular acupressure," "safety," "adverse events," "chondritis," and "perichondritis," with additional manual review of titles, links, and reference lists. Individual auricular therapy adverse event (AE) case reports were included, as well as systematic reviews and or meta-analyses if they evaluated AEs associated with AT. RESULTS Nineteen auricular AE case reports and nine safety reviews of or including auriculotherapy were included. Ten systematic reviews of AT with eight specific reviews of auricular acupressure (AP) were also included. CONCLUSIONS The primary AE risks is infection, perichondritis, and chondritis stemming from embedded or indwelling needles or potential inadvertent needlesticks from contaminated roaming sharps. Extended AP i.e., application of spheres, preferably seeds (natural, nontoxic botanical Vaccaria seeds) provides clinical benefit without the risks associated with embedded needles. More research is needed to establish if embedded needles at the ear are even necessary or have any advantage over in-session auricular acupuncture for immediate pain relief followed by ear acupressure.
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Affiliation(s)
- Arya Nielsen
- Department of Family Medicine and Community Health, Icahn School of Medicine at Mount Sinai, New York, New York
| | | | - Heather Tick
- Department of Family Medicine, Anesthesiology and Pain Medicine, University of Washington School of Medicine, Washington, USA
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HUNG HM, CHIANG HC, WANG HL. The Impact of Gender on the Effectiveness of an Auricular Acupressure Intervention Administered to Community-Dwelling Poor Sleepers: A Cluster Randomized Controlled Trial. J Nurs Res 2021; 29:e153. [PMID: 33756521 PMCID: PMC8126490 DOI: 10.1097/jnr.0000000000000427] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2020] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Women report a higher incidence of sleep problems than men. Few studies addressing the effect of gender on the efficacy of administering auricular acupressure (AA) at shenmen points (heart meridian 7 [HT7]) on sleep quality have been published. PURPOSE The primary aim of this study was to investigate the effects of a 4-week AA intervention applied at the HT7 points on sleep quality, perceived physical health, and perceived mental health in community-dwelling individuals with poor self-reported sleep quality. Additional analyses were used to evaluate the gender-specific effects of this intervention. METHODS A cluster randomized controlled trial with repeated-measures design was used. One hundred seventy-nine eligible participants were randomly assigned to either the AA group (n = 88; 47 women, 41 men) or the sleep hygiene instruction (SHI) group (n = 91; 52 women, 39 men). The AA group self-administered acupressure at HT7 on both ears for a 4-week period, whereas the SHI group received an SHI information sheet. Outcome measures included the Pittsburgh Sleep Quality Index (PSQI) and the Short-Form Health Survey-12 Version 2, with data collected at baseline and at 2, 4, and 8 weeks posttest. RESULTS Linear mixed-model analysis revealed that the participants in the AA group experienced significantly greater reductions in mean PSQI global score and the three indices of sleep latency, subjective sleep quality, and daytime dysfunction than the SHI group at 2 and 4 weeks posttest. The improvements in subjective sleep quality and daytime dysfunction remained at 4 weeks posttest in the AA group, but not in the SHI group. The PSQI global score decreased significantly more in men than women in the AA group between baseline and 4 weeks posttest. CONCLUSIONS/IMPLICATIONS FOR PRACTICE Four weeks of self-administered acupressure at HT7 on both ears is an effective intervention for community-dwelling poor sleepers who are over 45 years old. Moreover, the improvements in subjective sleep quality and daytime dysfunction persist for up to 4 weeks after the end of the intervention. This self-administered acupressure intervention is more effective in men than in women in terms of improving sleep quality. Gender bias is known to influence research results and may lead to inappropriate generalizations. Thus, future studies that are performed to build basic scientific evidence should include considerations of the effects of gender in the study design.
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Affiliation(s)
- Hsuan-Man HUNG
- PhD, RN, Associate Professor, Department of Nursing, Fooyin University, Kaohsiung City, Taiwan, ROC
| | - Hsiao-Ching CHIANG
- MSN, RN, Lecturer, Department of Nursing, Tajen University, Yanpu City, Taiwan, ROC
| | - Hui-Ling WANG
- PhD, RN, Assistant Professor, Department of Nursing, Fooyin University, Kaohsiung City, Taiwan, ROC
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Li T, Li X, Huang F, Tian Q, Fan ZY, Wu S. Clinical Efficacy and Safety of Acupressure on Low Back Pain: A Systematic Review and Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2021; 2021:8862399. [PMID: 33708260 PMCID: PMC7932783 DOI: 10.1155/2021/8862399] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 01/09/2021] [Accepted: 02/16/2021] [Indexed: 01/19/2023]
Abstract
OBJECTIVES To evaluate the effectiveness and safety of acupressure on low back pain (LBP). METHODS We searched 7 electronic databases and 2 trial registries through December 28, 2020. Randomized controlled trials (RCTs) of acupressure on LBP were considered for meta-analysis with Revman 5.3 and Stata 15.0 software. Methodological quality was evaluated using the Cochrane Collaboration's tool. Trial sequential analysis (TSA) was used to quantify the statistical reliability. HETRED analysis and GRADE were used to determine the heterogeneity and quality of the results, respectively. RESULTS Twenty-three RCTs representing 2400 participants were included. Acupressure was superior to tuina massage on response rate (RR 1.25; 95% CI, 1.16 to 1.35; P < 0.00001) and in the standardized mean difference (SMD) for pain reduction [SMD -1.92; 95% CI, -3.09 to -0.76; P=0.001]. Likewise, acupressure was superior to physical therapy [SMD, -0.88; 95% CI, -1.10 to -0.65; P < 0.00001] and to usual care [SMD, -0.32; 95% CI, -0.61 to -0.02; P=0.04] in pain reduction. The Oswestry Disability Index was significantly improved by acupressure compared with usual care [SMD, -0.55; 95% CI, -0.84 to -0.25; P=0.0003]. The combination of acupressure with either manual acupuncture or electro-acupuncture showed significant improvements over the adjuvant therapies alone in response rate [RR 1.19; 95% CI, 1.13 to 1.26; P < 0.00001], pain reduction, and the Japanese Orthopedic Association score (JOA). However, each study displayed substantial heterogeneity. Through subgroup sensitivity analysis and -HETRED analysis, the heterogeneity of acupressure compared with manual acupuncture decreased while the results maintained significance with respect to pain reduction [SMD -0.9; 95% CI, -1.21 to -0.6; P < 0.00001] and JOA [SMD, 0.66; 95% CI, 0.33 to 0.98; P < 0.00001]. Similar results were obtained comparing acupressure with electro-acupuncture with respect to pain [SMD, -1.07; 95% CI, -1.33 to -0.81; P < 0.00001] and JOA [SMD, 0.89; 95% CI, 0.51 to 1.27, P < 0.00001]. TSA demonstrated the effectiveness of acupressure as a standalone or as a combinative treatment (with manual acupuncture or electro-acupuncture) for LBP. CONCLUSION Acupressure is an effective treatment for LBP. However, GRADE assessments downgraded the evidence in the trials, indicating that additional investigations are needed to confirm these observations.
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Affiliation(s)
- Tao Li
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong, China
- Massage Department, Guangdong Hospital of Traditional Chinese Medicine, Guangzhou 510405, Guangdong, China
| | - Xiaohui Li
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong, China
- Massage Department, Guangdong Hospital of Traditional Chinese Medicine, Guangzhou 510405, Guangdong, China
| | - Fan Huang
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong, China
- Massage Department, Guangdong Hospital of Traditional Chinese Medicine, Guangzhou 510405, Guangdong, China
| | - Qiang Tian
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong, China
- Massage Department, Guangdong Hospital of Traditional Chinese Medicine, Guangzhou 510405, Guangdong, China
| | - Z. Y. Fan
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong, China
- Massage Department, Guangdong Hospital of Traditional Chinese Medicine, Guangzhou 510405, Guangdong, China
| | - S. Wu
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong, China
- Massage Department, Guangdong Hospital of Traditional Chinese Medicine, Guangzhou 510405, Guangdong, China
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18
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Therapeutic effects of auricular point acupressure on the recovery of patients after pterygium surgery: A pilot study. Complement Ther Clin Pract 2021; 43:101339. [PMID: 33639517 DOI: 10.1016/j.ctcp.2021.101339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 02/08/2021] [Accepted: 02/17/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND and purpose: Postoperative pain in the pterygium of the eye seriously affects patient recovery. This study was conducted to assess the efficacy of auricular point acupressure treatment on post-operative recovery in patients after pterygium surgery. MATERIALS AND METHODS This was a pilot, randomized controlled study. A total of 60 patients (60 eyes) were randomly assigned to two groups. After pterygium surgery, the auricular group was treated using ear acupressure (acupressure points with Cowherb seeds) and the control group was treated using sham auricular therapy (acupressure points without Cowherb seeds). Both groups were treated for one week. Outcome measures included pain score, corneal epithelial score, best-corrected visual acuity, and recurrence rate. RESULTS Fifty-three patients completed the study. The mean pain scores and corneal epithelial scores were significantly reduced over time in the auricular group compared with those in the control group (p < 0.05). The time-group interaction for both pain scores and corneal epithelial scores was significant between the two groups (p < 0.05). Simple main effect analysis showed the mean pain scores in the auricular group were significantly lower at each time point (the first 2-h, the first day, the third day and the first week, p < 0.05) than the control group. Mean corneal epithelial scores of the auricular group were significantly lower on the first day and third day respectively than the control group (p < 0.05). There was no significant difference in the best-corrected visual acuity or recurrence rate between the two groups (p > 0.05). CONCLUSION Auricular point acupressure accelerates corneal epithelium reconstruction and suppresses postoperative pain, making it an ideal adjunct treatment for postoperative pterygium recovery. CLINICAL TRIAL REGISTRATION NUMBER ChiCTR2000032490 on http://www.chictr.org.cn/.
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Murphy SL, Harris RE, Keshavarzi NR, Zick SM. Self-Administered Acupressure for Chronic Low Back Pain: A Randomized Controlled Pilot Trial. PAIN MEDICINE 2020; 20:2588-2597. [PMID: 31237610 DOI: 10.1093/pm/pnz138] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objective Chronic low back pain (CLBP) is associated with fatigue, pain, poor sleep, and disability. Acupressure is a low-risk treatment option used to manage symptoms in other groups, but its efficacy, particularly on fatigue and sleep, is unknown in CLBP. This study examined preliminary effects of two types of self-administered acupressure (relaxing and stimulating) on fatigue, pain, sleep, and reported disability. Methods A randomized pilot trial was conducted (N = 67) in which participants were randomized into six weeks of relaxing acupressure, stimulating acupressure, or usual care. Fatigue was measured by the Brief Fatigue Inventory, pain was measured by the Brief Pain Inventory, sleep was measured by the Pittsburgh Sleep Quality Index, and reported disability was measured by the Roland Morris Scale. Results Baseline characteristics were similar across groups. An intent-to-treat analysis using general linear models showed positive improvement in pain in acupressure groups compared with usual care. Pain was reduced by 35-36% in the acupressure groups. Improvement in fatigue was also found in stimulating acupressure compared with usual care. Adverse events were minimal and related to application of too much pressure. Discussion Although this was a small study, acupressure demonstrated promising preliminary support of efficacy for pain and fatigue reduction in this population.
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Affiliation(s)
- Susan Lynn Murphy
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, Michigan.,VA Ann Arbor Health Care System, GRECC, University of Michigan, Ann Arbor, Michigan
| | | | | | - Suzanna Maria Zick
- Department of Family Medicine.,Department of Nutritional Sciences, University of Michigan, Ann Arbor, Michigan, USA
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McKee MD, Nielsen A, Anderson B, Chuang E, Connolly M, Gao Q, Gil EN, Lechuga C, Kim M, Naqvi H, Kligler B. Individual vs. Group Delivery of Acupuncture Therapy for Chronic Musculoskeletal Pain in Urban Primary Care-a Randomized Trial. J Gen Intern Med 2020; 35:1227-1237. [PMID: 32076985 PMCID: PMC7174252 DOI: 10.1007/s11606-019-05583-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 11/25/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Acupuncture has been shown to be effective for the treatment of chronic musculoskeletal back, neck, and osteoarthritis pain. However, access to acupuncture treatment has been limited in medically underserved and low-income populations. OBJECTIVE Acupuncture therapy delivered in groups could reduce cost and expand access. We compared the effectiveness of group versus individual acupuncture for pain and function among ethnically diverse, low-income primary care patients with chronic musculoskeletal pain. DESIGN This was a randomized comparative effectiveness non-inferiority trial in 6 Bronx primary care community health centers. Participants with chronic (> 3 months) back, neck, or osteoarthritis pain were randomly assigned to individual or group acupuncture therapy for 12 weeks. PARTICIPANTS Seven hundred seventy-nine participants were randomized. Mean age was 54.8 years. 35.3% of participants identified as black and 56.9% identified as Latino. Seventy-six percent were Medicaid insured, 60% reported poor/fair health, and 37% were unable to work due to disability. INTERVENTIONS Participants received weekly acupuncture treatment in either group or individual setting for 12 weeks. MAIN MEASURES Primary outcome was pain interference on the Brief Pain Inventory at 12 weeks; secondary outcomes were pain severity (BPI), physical and mental well-being (PROMIS-10), and opiate use. Outcome measures were collected at baseline, 12 and 24 weeks. KEY RESULTS 37.5% of individual arm and 30.3% in group had > 30% improvement in pain interference (d = 7.2%, 95% CI - 0.6%, 15.1%). Non-inferiority of group acupuncture was not demonstrated for the primary outcome assuming a margin of 10%. In the responder analysis of physical well-being, 63.1% of individual participants and 59.5% of group had clinically important improvement at 12 weeks (d = 3.6%, 95% CI - 4.2%, 11.4%). CONCLUSIONS Both individual and group acupuncture therapy delivered in primary care settings reduced chronic pain and improved physical function at 12 weeks; non-inferiority of group was not shown. TRIAL REGISTRATION Clinicaltrials.gov # NCT02456727.
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Affiliation(s)
- M. Diane McKee
- Department of Family and Social Medicine, Albert Einstein College of Medicine, New York, USA
- Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, USA
| | - Arya Nielsen
- Department of Family Medicine & Community Health, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Belinda Anderson
- Department of Family and Social Medicine, Albert Einstein College of Medicine, New York, USA
- Pacific College of Oriental Medicine, Chicago, USA
| | - Elizabeth Chuang
- Department of Family and Social Medicine, Albert Einstein College of Medicine, New York, USA
| | - Mariel Connolly
- Department of Family and Social Medicine, Albert Einstein College of Medicine, New York, USA
| | - Qi Gao
- Department of Family and Social Medicine, Albert Einstein College of Medicine, New York, USA
| | - Eric N Gil
- Department of Family and Social Medicine, Albert Einstein College of Medicine, New York, USA
| | - Claudia Lechuga
- Department of Family and Social Medicine, Albert Einstein College of Medicine, New York, USA
- Institute of Clinical and Translational Research, Albert Einstein College of Medicine, New York, USA
| | - Mimi Kim
- Department of Family and Social Medicine, Albert Einstein College of Medicine, New York, USA
| | - Huma Naqvi
- Department of Rehab Medicine, Albert Einstein College of Medicine, New York, USA
| | - Benjamin Kligler
- Department of Family and Social Medicine, Albert Einstein College of Medicine, New York, USA
- Department of Family Medicine & Community Health, Icahn School of Medicine at Mount Sinai, New York, USA
- Integrative Health Coordinating Center , U.S. Veterans Health Administration, Washington, D.C., USA
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Deng J, Lu C, Xiang Y, Deng H, Wen Z, Yao D, Xuan M, Yan Y. Auricular acupressure as a complementary therapy for psoriasis vulgaris: study protocol for a multicenter randomized controlled trial. Trials 2019; 20:358. [PMID: 31208470 PMCID: PMC6580514 DOI: 10.1186/s13063-019-3475-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 05/27/2019] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Psoriasis vulgaris is a common skin disease characterized by persistent localized erythematous scaly plaques, typically on the elbows, knees, and scalp. It is an immune-abnormal disease that progresses slowly over a long period with frequent symptom recurrence. Current studies have shown that acupuncture is an effective therapy for psoriasis. However, the scientific evidence of the efficacy of auricular acupressure treatment for patients with psoriasis is still insufficient. Therefore, we designed a randomized controlled clinical trial to investigate the effect, safety, and cost-effectiveness of auricular acupressure in addition to medication in patients with psoriasis. METHODS AND ANALYSIS This on-going study is a two-arm parallel, assessor-blinded, randomized controlled trial in which 180 participants with psoriasis will be recruited and then randomly allocated into two groups in a 1:1 ratio. Equal randomization will be conducted using a computer-generated random allocation sequence. Participants in the intervention group will receive auricular acupressure treatment once per week for 4 weeks, and calcipotriol betamethasone ointment for topical use once daily for 4 weeks. Participants in the control group will receive only calcipotriol betamethasone ointment treatment once daily for 4 weeks. All patients will be followed up for 12 weeks. The primary outcome is relapse rate. The secondary outcomes include time to relapse, rebound rate, time to new onset, Psoriasis Area and Severity Index score improvement rate, body surface area affected, a visual analogue scale, and Dermatology Life Quality Index. Cost-effectiveness analysis will be carried out from a health and community care provider perspective. DISCUSSION This multicenter randomized controlled trial will provide important clinical evidence for the effect and safety of auricular acupressure as a complementary therapy in patients with psoriasis. TRIAL REGISTRATION Chinese Clinical Trial Registry, ChiCTR-TRC-14004916 . Registered on 20 May 2014. This protocol is version 3.0 which was updated on 24 September 2016.
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Affiliation(s)
- Jingwen Deng
- Psoriasis Clinical and Basic Research Team, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120 China
- Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, 510120 China
| | - Chuanjian Lu
- Psoriasis Clinical and Basic Research Team, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120 China
- Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, 510120 China
| | - Yu Xiang
- Psoriasis Clinical and Basic Research Team, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120 China
- Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, 510120 China
- Guangdong Provincial Key Laboratory of Clinical Research on Traditional Chinese Medicine Syndrome, Guangzhou, 510120 China
- School of Medical Information Engineering, Guangdong Pharmaceutical University, Guangzhou, 510006 China
| | - Hao Deng
- Psoriasis Clinical and Basic Research Team, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120 China
- Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, 510120 China
| | - Zehuai Wen
- Key Unit of Methodology in Clinical Research, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120 China
| | - Danni Yao
- Psoriasis Clinical and Basic Research Team, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120 China
- Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, 510120 China
| | - Meiling Xuan
- Key Unit of Methodology in Clinical Research, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120 China
| | - Yuhong Yan
- Psoriasis Clinical and Basic Research Team, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120 China
- Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, 510120 China
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Huang CF, Guo SE, Chou FH. Auricular acupressure for overweight and obese individuals: A systematic review and meta-analysis. Medicine (Baltimore) 2019; 98:e16144. [PMID: 31261540 PMCID: PMC6617497 DOI: 10.1097/md.0000000000016144] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Auricular acupressure has been used for treating obesity, but inconsistent outcomes have been reported. Moreover, systematic reviews and meta-analyses have seldom addressed the effects of auricular acupressure and duration of treatment in overweight/obese individuals. This study reviewed research articles on auricular acupressure for weight reduction, analyzed the related effects on obesity, and explored the relationships between weight reduction and treatment duration, as well as outcome variables. METHODS We searched PubMed, Cochrane Library, CINAHL, MEDLINE with Full Text, National Digital Library of Theses and Dissertation in Taiwan, and Airiti Library for articles up to July 4, 2018. Eight eligible trials were identified for qualitative synthesis, and one of them was excluded from quantitative synthesis. Inclusion criteria were as follows: intervention contained auricular acupressure, study subjects were overweight and/or obese, as defined by published authors, and the study design had 2 or more arms for comparison. RESULTS Pooled analysis of the 7 remaining studies revealed that auricular acupressure alone, or with diet and/or exercise, was effective for weight reduction, particularly for decreasing body weight (BW), body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), body fat mass (BFM), and body fat percentage (BFP), compared with no treatment, sham treatment, or use of surgical tape with diet and/or exercise. However, there was no effect on hip circumference. A 12-week acupressure intervention was associated with a larger effect on lowering BW and BMI compared with 4-, 6-, and 8-week interventions. The methodologic quality of trials included in the quantitative synthesis ranged from scores 2 to 6 based on the modified Jadad scale. Additionally, this meta-analysis combined studies that used different acupoints and outcomes evaluated at different timepoints, which may have been potential sources of bias. CONCLUSION The study results indicate that auricular acupressure is effective for weight reduction. However, further vigorous studies that use double-blind randomized controlled design are needed to verify these findings. WC, WHR, BFP, or BFM should be used as obesity-related parameters in weight reduction studies to detect changes in fat, muscle, and skeletal weight.
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Affiliation(s)
- Ching-Feng Huang
- Department of Nursing, Chang Gung University of Science and Technology, Chiayi County
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, Chang Gung Medical Foundation
- Doctoral student, College of Nursing, Kaohsiung Medical University, Kaohsiung
| | - Su-Er Guo
- Department of Nursing, Chang Gung University of Science and Technology, Chiayi County
- Department of Pulmonary and Critical Care Medicine, Chiayi Chang Gung Memorial Hospital, Chang Gung Medical Foundation, Chiayi County
| | - Fan-Hao Chou
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Republic of China (Taiwan)
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Tesser CD, Moré AOO, Santos MC, da Silva EDC, Farias FTP, Botelho LJ. Auriculotherapy in primary health care: A large-scale educational experience in Brazil. JOURNAL OF INTEGRATIVE MEDICINE-JIM 2019; 17:302-309. [PMID: 31076373 DOI: 10.1016/j.joim.2019.03.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 01/11/2019] [Indexed: 01/15/2023]
Abstract
Auriculotherapy consists of physical stimuli applied to the outer ear and is commonly associated with traditional Chinese medicine (TCM). The authors present and discuss the development of a course that offers a semi-on-site auriculotherapy course for Brazilian primary health care (PHC) professionals. The course was funded by the Brazilian Ministry of Health and developed at the Federal University of Santa Catarina in 2015 by a team of experts in auriculotherapy. It consisted of 75 h of distance learning (five sequential modules) and 5 h of on-site learning. The modules included the following items: (1) introduction to integrative practices; (2) ear reflexology; (3) introduction to TCM; (4) biomedical view of auriculotherapy; and (5) auriculotherapy in PHC. The teaching material included a workbook for each module, 14 video lectures and an interactive ear (online resource) to study location and application to the main auricular points. The on-site lectures follow a structured script of ear palpation techniques, auricular seed insertion practice and clinical case discussions, under the supervision of trained instructors. The course was offered in 2016 and 2017 and on-site lectures took place in 25 cities, covering all Brazilian regions, in coordination with municipal or state boards of health. A total of 4273 health professionals concluded the training and their evaluation of the course was highly positive. The Brazilian experience of large-scale training shows the potential to disseminate auriculotherapy in the context of PHC, given that its practice is fast, easy to learn, safe, effective for different health problems and well accepted by the patients.
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Affiliation(s)
- Charles Dalcanale Tesser
- Department of Public Health, Federal University of Santa Catarina, Florianópolis, Santa Catarina 88036-800, Brazil; Post-graduate Program in Public Health, Federal University of Santa Catarina, Florianópolis, Santa Catarina 88036-800, Brazil
| | - Ari Ojeda Ocampo Moré
- Integrative Medicine and Acupuncture Service, University Hospital, Federal University of Santa Catarina, Florianópolis, Santa Catarina 88036-800, Brazil; Florianópolis Municipality Health Office, Florianópolis, Santa Catarina 88036-800, Brazil.
| | - Melissa Costa Santos
- Florianópolis Municipality Health Office, Florianópolis, Santa Catarina 88036-800, Brazil
| | | | | | - Lúcio José Botelho
- Department of Public Health, Federal University of Santa Catarina, Florianópolis, Santa Catarina 88036-800, Brazil; Post-graduate Program in Public Health, Federal University of Santa Catarina, Florianópolis, Santa Catarina 88036-800, Brazil
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Zhong Q, Wang D, Bai YM, Du SZ, Song YL, Zhu J. Effectiveness of Auricular Acupressure for Acute Postoperative Pain after Surgery: A Systematic Review and Meta-Analysis. Chin J Integr Med 2019; 25:225-232. [PMID: 30815805 DOI: 10.1007/s11655-019-3063-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To identify the effectiveness of auricular acupressure (AA) in patients with acute postoperative pain after surgery by systematic review. METHODS A search of randomized controlled trials was conducted in 5 English medical electronic databases and 4 Chinese databases. Two reviewers independently retrieved related studies, assessed the methodological quality, and extracted data with a standardized data form. Meta-analyses were performed using all time-points meta-analysis. RESULTS A total of 26 studies with 1,682 participants were included. Results showed that compared with conventional therapy, AA significantly improved the total effective rate [risk ratio=1.25, 95% confidence interval (CI), 1.13 to 1.37, Plt;0.0001; heterogeneity: Plt;0.0001, I2=85%]. In the subgroup analysis, the results changed in different follow-up time and surgery categories. The pain relief in the AA group might be the most significant at 72 h after surgery (mean difference=-0.85, 95% CI,-1.20 to-0.50, Plt;0.0001) and in abdominal surgery (mean difference=-1.15, 95% CI,-1.41 to-0.90, Plt;0.0001). Sensitivity analysis demonstrated that the results of this meta-analysis were stable. No serious adverse effects were recorded. CONCLUSION It was recommended to provide AA to patients with acute postoperative pain. However, a more accurate estimate of the effect requires further rigorously designed large-scale and high-quality RCTs for improving acute postoperative pain after surgery.
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Affiliation(s)
- Qin Zhong
- School of Nursing, Nanjing University of Traditional Chinese Medicine, Nanjing, 210046, China
| | - Di Wang
- School of Nursing, Nanjing University of Traditional Chinese Medicine, Nanjing, 210046, China
| | - Ya-Mei Bai
- School of Nursing, Nanjing University of Traditional Chinese Medicine, Nanjing, 210046, China.
| | - Shi-Zheng Du
- School of Nursing, Nanjing University of Traditional Chinese Medicine, Nanjing, 210046, China
| | - Yu-Lei Song
- School of Nursing, Nanjing University of Traditional Chinese Medicine, Nanjing, 210046, China
| | - Jing Zhu
- School of Nursing, Nanjing University of Traditional Chinese Medicine, Nanjing, 210046, China
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