-
American Journal of Obstetrics &... Feb 2024This study aimed to evaluate the bibliographic references available on the contribution of acupuncture as a strategy to avoid labor induction and the methodology used;... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
This study aimed to evaluate the bibliographic references available on the contribution of acupuncture as a strategy to avoid labor induction and the methodology used; and explore the characteristics of the population and the results of the intervention in order to direct the design of future studies.
DATA SOURCE
A systematic search for publications between January 2000 and September 2023 of the CENTRAL, PubMed, CINAHL, SCOPUS, ClinicalTrials.gov, and EUDRACT databases was performed.
STUDY ELIGIBILITY CRITERIA
We included randomized clinical trials of pregnant women who underwent acupuncture before labor induction with a filiform needle or acupressure, including at least 1 of the following outcomes: spontaneous labor rate, time from procedure to delivery, and cesarean delivery rate. Articles published in English or German language were included.
METHODS
Whenever possible, a meta-analysis using RevMan software was performed using a random effects model with the I2 statistic because important heterogeneity in the different acupuncture treatments was expected. When enough data were available, the effect of the participants' characteristics on the results of the interventions were explored using the following subgroups: 1-Age (≥35 vs <35 years), and 2- body mass index (≥30 vs <30 kg/m). When a meta-analysis was not possible, a narrative synthesis of the results was performed. The quality of the evidence was assessed using GRADE.
RESULTS
Seventeen studies including 3262 women fulfilled our inclusion criteria. The meta-analysis showed no statistically significant differences between groups for outcomes (relative risk, 1.00; 95% confidence interval, 0.91-1.10; I, 11%) comparing acupuncture vs sham acupuncture. However, there was a statistically significant increase in the spontaneous onset of labor rate favoring acupuncture vs no acupuncture (relative risk, 1.12; 95% confidence interval, 1.03-1.23; I, 25%). Regarding the age analysis, no differences between groups were observed in the spontaneous labor rate and cesarean delivery rate for acupuncture vs sham and acupuncture vs no acupuncture comparisons (difference between groups, P>.05).
CONCLUSION
This study suggests that acupuncture may be beneficial in reducing the rate of induction of labor; however, well-designed randomized controlled trials are necessary. Maternal age ≥35 years and a high body mass index were underrepresented, and the findings may not be representative of the current population in our context.
Topics: Pregnancy; Female; Humans; Adult; Labor, Obstetric; Acupuncture Therapy; Cesarean Section; Labor, Induced; Body Mass Index; Randomized Controlled Trials as Topic
PubMed: 38151059
DOI: 10.1016/j.ajogmf.2023.101272 -
Sleep Medicine Jun 2024To investigate and rank the evidence for the efficacy of interventions in improving sleep quality after cardiac surgery using comprehensive comparisons. (Review)
Review
OBJECTIVE
To investigate and rank the evidence for the efficacy of interventions in improving sleep quality after cardiac surgery using comprehensive comparisons.
BACKGROUND
Clinical evidence suggests that over 80 % of adult cardiac surgery patients experience sleep disturbances during the first week postoperatively. While certain interventions have been shown to improve post-thoracic surgery sleep quality, a systematic description of the effects of these varied interventions is lacking.
METHODS
This systematic search was conducted across PubMed, Web of Science, Cochrane, Embase, and CINAHL databases to collate all published randomized clinical trials as evidence. Two researchers independently extracted pertinent information from eligible trials and assessed the quality of included studies. Based on statistical heterogeneity, traditional meta-analysis using fixed or random-effects models was employed to assess the efficacy of interventions, and a Frequentist network meta-analysis using a consistency model was conducted to rank the effectiveness of intervention protocols.
RESULTS
Our review incorporated 37 articles (n = 3569), encompassing 46 interventions, including 9 reports on pharmacological interventions (24.3 %), 28 on non-pharmacological interventions (75.7 %), and 5 on anesthetic management interventions (13.5 %). The analysis indicated the efficacy of Benson's relaxation technique, Progressive muscle relaxation, Education, Aromatherapy, Acupressure, Massage, and Eye masks in enhancing postoperative sleep quality. Specifically, Benson's relaxation technique (cumulative ranking curve area: 0.80; probability: 98.3 %) and Acupressure (cumulative ranking curve area: 0.96; probability: 58.3 %) were associated with the highest probability of successfully improving postoperative sleep quality, while Progressive muscle relaxation (cumulative ranking curve area: 0.70; probability: 35.2 %) and Eye masks (cumulative ranking curve area: 0.81; probability: 78.8 %) were considered secondary options. Eye masks and Massage significantly reduced postoperative sleep latency, with Eye masks (cumulative ranking curve area: 0.82; probability: 51.0 %) being most likely to enhance sleep quality postoperatively, followed by Massage (cumulative ranking curve area: 0.60; probability: 27.2 %). Education, Music, Massage, Eye masks, and Handholding were effective in alleviating pain intensity, with Education being most likely to successfully reduce postoperative pain (cumulative ranking curve area: 0.92; probability: 54.3 %), followed by Music (cumulative ranking curve area: 0.91; probability: 54 %).
CONCLUSIONS
Our findings can be utilized to optimize strategies for managing post-thoracic surgery sleep disturbances and to develop evidence-based approaches for this purpose. Benson's relaxation technique, Progressive muscle relaxation, Education, Aromatherapy, Acupressure, Massage, and Eye masks significantly improve sleep quality in postoperative patients. KEY: disorders of initiating and maintaining sleep, sleep wake disorders, thoracic surgical procedures, cardiac surgical procedures, sleep quality, pain, network meta-analysis.
PubMed: 38945038
DOI: 10.1016/j.sleep.2024.06.006 -
Explore (New York, N.Y.) 2024This randomised sham-controlled trial aimed to analyse the effects of acupressure on pain, anxiety, and vital signs in patients who underwent coronary angiography. (Randomized Controlled Trial)
Randomized Controlled Trial
AIM
This randomised sham-controlled trial aimed to analyse the effects of acupressure on pain, anxiety, and vital signs in patients who underwent coronary angiography.
MATERIALS AND METHODS
After undergoing coronary angiography, 105 patients were randomised into acupressure (n = 35), sham acupressure (n = 35), and control groups (n = 35). Patients in the acupressure group received acupressure on the heart meridian 7 (HT7), large intestine meridian 4 (LI4), and pericardium meridian (PC6) acupoints 30 min after admission to the clinic, for a period of 16 min, whereas those in the sham group received acupressure on locations 1-1.5 cm away from these points. The control group received standard treatment. The patient information form, Spielberger's state anxiety inventory, visual analogue scale, and vital signs follow-up form were used for data collection.
FINDINGS
Consecutive measurements revealed that anxiety levels in the acupressure group were lower than that in the sham and control groups (p < 0.05). In addition, compared to the sham and control groups, the pain scores in the acupressure group decreased significantly after acupressure (p < 0.01). Although there was no significant difference between the pain scores of the sham group before and after acupressure intervention (p > 0.05), the scores of the control group increased significantly over time (p < 0.01). Finally, the vital signs decreased significantly in the acupressure and sham groups after intervention (p < 0.01), but increased significantly in the control group (p < 0.01).
CONCLUSION
The findings of this trial indicated that acupressure is an effective method for reducing anxiety, pain, and vital signs.
Topics: Humans; Acupressure; Coronary Angiography; Pain; Anxiety; Vital Signs
PubMed: 37429762
DOI: 10.1016/j.explore.2023.07.001 -
Journal of the Indian Society of... Oct 2023The aim of this study was to evaluate the effect of the Aculief acupressure device on the reduction of pain during local anesthesia (LA) in children and to compare it... (Randomized Controlled Trial)
Randomized Controlled Trial
AIM
The aim of this study was to evaluate the effect of the Aculief acupressure device on the reduction of pain during local anesthesia (LA) in children and to compare it with the cryotherapy technique.
METHODOLOGY
20 children of age group between 6 and 9 years, requiring pulpectomy or extraction bilaterally were chosen for the study. After ethical clearance and parental consent, children who were not experienced to prior local anesthesia were chosen for the study. A split-mouth study design was done to avoid bias, and children were divided into two groups. During the first visit cryotherapy application was done on any one side followed by the LA, and during the second visit Aculief acupressure application was done, which was followed by the LA. The objective and subjective evaluation of pain during the LA was carried out and analyzed.
RESULTS
The objective perception of pain was evaluated using the Sound-Eye-Motor Scale by an observer who was blinded, and the subjective perception of pain by the Wong-Baker Faces Pain Rating Scale was evaluated by the child patient. The statistical analysis and comparison of values were done using the Wilcoxon signed-rank test. The pain during administration of LA was eliminated after the application of the Aculief acupressure device, and the results were superior to the cryotherapy technique.
CONCLUSION
The Aculief acupressure device can be effectively used to eliminate pain perception while administering LA in children. It is a simple, safe, noninvasive, and effective device and is easy to perform.
Topics: Child; Humans; Anesthesia, Local; Anesthetics, Local; Acupressure; Anesthesia, Dental; Pain Perception; Facial Pain
PubMed: 38235817
DOI: 10.4103/jisppd.jisppd_370_23 -
Journal of Dental Anesthesia and Pain... Dec 2023Painless treatment determines the quality of pediatric dental care. Although local anesthesia has been used to manage pain in dentistry, children often cite traditional... (Review)
Review
Painless treatment determines the quality of pediatric dental care. Although local anesthesia has been used to manage pain in dentistry, children often cite traditional aspirating syringes as a symbol of fear and pain. Adequate pain control during dental procedures may help alleviate fear and anxiety and instill positive oral health attitudes in children. Newer approaches such as intranasal spray, centbucridine, jet injectors, buzzy devices, and acupressure have been developed to help dentists provide near-painless injections while reducing dental anxiety. This review aims to summarize newer approaches to alleviate pain and anxiety in children.
PubMed: 38076502
DOI: 10.17245/jdapm.2023.23.6.303 -
Supportive Care in Cancer : Official... Nov 2023To evaluate the efficacy and feasibility of utilizing Traditional Chinese Medicine (TCM) combined group psychotherapy intervention on psychological distress management... (Randomized Controlled Trial)
Randomized Controlled Trial
Effect of traditional Chinese medicine combined group psychotherapy on psychological distress management and gut micro-biome regulation for colorectal cancer survivors: a single-arm phase I clinical trial.
OBJECTIVE
To evaluate the efficacy and feasibility of utilizing Traditional Chinese Medicine (TCM) combined group psychotherapy intervention on psychological distress management and gut micro-biome regulation for colorectal (CRC) survivors.
METHODS
A single-arm phase I clinical trial was conducted between December 2020 and December 2021 in Xiyuan Hospital and Beijing Cancer Hospital in China. Inclusion criteria included stage I-III CRC survivors after radical surgery with age between 18 and 75. The intervention was a 6-week online TCM combined group psychotherapy intervention including 90-min communication, TCM lifestyle coaching, self-acupressure guidance, and mindfulness practice led by TCM oncologist and psychiatrist each week. Outcomes were measured by Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), Fear of Cancer Recurrence Inventor (FCRI), and Quality of Life Questionnaire (QLQ-C30). Fecal samples before and after intervention were collected for 16Sr RNA analysis.
RESULTS
We recruited 40 CRC survivors and 38 of them finally completed all interventions with average age of 58±13 years' old. Paired t-test showed that SAS at week 2(35.4±5.8), week 4 (37.9±10.5) and week 6 (31.3±6.4) during the intervention was significantly lower than baseline (42.1±8.3, p<0.05 respectively). SDS score also declined substantially from baseline (38.8±10.7) to week 2 (28.3±8.8, p<0.001) and week 6 (25.4±7.7, p<0.001). FCRI decreased from 19.4±7.2 at baseline to 17.5±7.1 at week 4 (p=0.038) and 16.3±5.8 at week 6 (p=0.008). Although changes of QLQ-C30 were not statistically prominent, symptom burden of insomnia and fatigue significantly alleviated. The abundances of gut microbiota Intestinibacter, Terrisporobacter, Coprobacter, and Gordonibacter were all significantly elevated after intervention.
CONCLUSIONS
TCM combined group psychotherapy intervention is feasible and effective to reduce CRC survivors' psychological distress and modulate certain gut bacteria which might be associated with brain-gut axis effect. It is necessary to carry out with phase II randomized controlled clinical trial.
Topics: Humans; Middle Aged; Aged; Adolescent; Young Adult; Adult; Medicine, Chinese Traditional; Quality of Life; Survivors; Psychotherapy, Group; Colorectal Neoplasms
PubMed: 37964024
DOI: 10.1007/s00520-023-08131-5 -
European Journal of Cardiovascular... Sep 2023Reduction of blood pressure and improvement of stress and sleep disorders in patients with essential hypertension were important factors. This study aimed to examine the... (Randomized Controlled Trial)
Randomized Controlled Trial
AIMS
Reduction of blood pressure and improvement of stress and sleep disorders in patients with essential hypertension were important factors. This study aimed to examine the effects of auricular acupressure on blood pressure, stress, and sleep quality among elderly with essential hypertension in Korea.
METHODS AND RESULTS
This study was a single-blind, randomized, placebo-controlled study. The experimental group (n = 23) received 8 weeks of auricular acupressure intervention on specific acupoints (superior triangular fossa, Shenmen, kidney, heart, and occiput) related to blood pressure, pulse rate, stress, and sleep, whereas the control group (n = 23) received auricular acupressure on non-specific acupoints. The primary outcomes were the systolic and diastolic blood pressure measured weekly. The secondary outcomes were the pulse rate, heart rate variability, actigraphy measured through Fitbit, and the Pittsburgh sleep quality index (PSQI) were measured before and after the experiment. There were statistically significant differences between two groups in systolic blood pressure (F = 5.67, P = 0.022), diastolic blood pressure (17.53, P < 0.001), and pulse rate (F = 6.78, P = 0.013) over time. Stress index (χ2 = 2.12, P = 0.040) and sleep efficiency (χ2 = 3.57, P = 0.001) were also significantly different before and after the experiment. However, there was no significant difference in the PSQI.
CONCLUSION
The findings showed that auricular acupressure leads to improvements in blood pressure, stress, and sleep in elderly people with essential hypertension. Therefore, auricular acupressure can be used as an alternative nursing intervention for hypertension prevention, stress, and sleep management.
REGISTRATION
WHO ICTRP KCT0007364.
Topics: Humans; Aged; Blood Pressure; Acupressure; Single-Blind Method; Sleep; Essential Hypertension
PubMed: 36594992
DOI: 10.1093/eurjcn/zvad005 -
Journal of Clinical Nursing Jun 2024Sleep disturbance is highly prevalent among post-operative cardiac patients, with negative impacts on surgical recovery and rehabilitation. Post-operative pain and... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Sleep disturbance is highly prevalent among post-operative cardiac patients, with negative impacts on surgical recovery and rehabilitation. Post-operative pain and anxiety commonly seen in cardiac surgery patients are associated with poor sleep. Sleep medications commonly used are not ideal with prolonged usage, and non-pharmacological interventions can be good alternatives or complements.
AIM
To examine effectiveness of non-pharmacological interventions in post-operative cardiac settings on sleep quality, pain intensity and anxiety.
DESIGN
Systematic review and meta-analysis.
METHODS
PubMed, CENTRAL, Embase, CINAHL, Scopus, CNKI and ProQuest Dissertations and Theses were searched on 12 October 2022. Randomised controlled trials of non-pharmacological interventions examining sleep quality for adult post-operative cardiac patients were included. Included studies were appraised using Cochrane Risk of Bias tool version 1. Meta-analysis was conducted using RevMan version 5.4.1, and heterogeneity was assessed using I statistics and Cochran Q's test.
RESULTS
Eighteen studies involving 1701 participants were identified. Coronary artery bypass graft was most common. Non-pharmacological interventions varied in types and duration. All intervention groups were compared to usual care, placebo, no interventions or active comparators. Statistically significant improvement in sleep quality (SMD = -.91, 95% CI = -1.17 to -.65) was found among intervention groups that explored cognitive behavioural therapy, relaxation techniques, exercise, massage, acupressure, aromatherapy, music, eye mask and earplugs. Pain intensity was reduced (SMD = -.63, 95% CI = -1.05 to -.20) with cognitive behavioural therapy, relaxation techniques, massage, music and eye mask. Anxiety was improved (SMD = -.21, 95% CI = -.38 to -.04) with exercise and music.
CONCLUSION
The overall use of non-pharmacological interventions can optimise sleep after cardiac surgery. Further research with greater methodological rigour is needed to investigate different intervention-related characteristics while considering potential confounders.
RELEVANCE TO CLINICAL PRACTICE
Post-operative cardiac settings can consider incorporating non-pharmacological interventions. Patients and healthcare providers can be better informed about the use of such interventions to improve sleep.
REGISTRATION
PROSPERO CRD42022384991.
Topics: Humans; Cardiac Surgical Procedures; Sleep Quality; Sleep Wake Disorders; Male; Anxiety; Female; Pain, Postoperative
PubMed: 38477050
DOI: 10.1111/jocn.17115 -
JAMA Network Open Apr 2024The effects of self-administered acupressure (SAA) on knee osteoarthritis (OA) pain remain unclear. (Randomized Controlled Trial)
Randomized Controlled Trial
IMPORTANCE
The effects of self-administered acupressure (SAA) on knee osteoarthritis (OA) pain remain unclear.
OBJECTIVE
To evaluate the effectiveness of SAA taught via a short training course on reducing knee OA pain in middle-aged and older adults.
DESIGN, SETTING, AND PARTICIPANTS
This randomized clinical trial was conducted among community-dwelling individuals in Hong Kong who were aged 50 years or older with probable knee OA from September 2019 to May 2022.
INTERVENTIONS
The intervention included 2 training sessions for SAA with a brief knee health education (KHE) session, in which participants practiced acupressure twice daily for 12 weeks. The control group (KHE only) received only education about maintaining knee health on the same schedule and duration.
MAIN OUTCOMES AND MEASURES
The primary outcome was the numerical rating scale (NRS) pain score at 12 weeks. Other outcomes included Western Ontario and McMaster University Osteoarthritis Index, Short Form 6 Dimensions (SF-6D), Timed Up and Go, and Fast Gait Speed tests.
RESULTS
A total of 314 participants (mean [SD] age, 62.7 [4.5] years; 246 [78.3%] female; mean [SD] knee pain duration, 7.3 [7.6] years) were randomized into intervention and KHE-only groups (each 157). At week 12, compared with the KHE-only group, the intervention group had a significantly greater reduction in NRS pain score (mean difference [MD], -0.54 points; 95% CI, -0.97 to -0.10 points; P = .02) and higher enhancement in SF-6D utility score (MD, 0.03 points; 95% CI, 0.003 to 0.01 points; P = .03) but did not have significant differences in other outcome measures. The cost-effectiveness acceptability curve demonstrated a greater than 90% probability that the intervention is cost-effective at a willingness to pay threshold of 1 GDP per capita.
CONCLUSIONS AND RELEVANCE
In this randomized clinical trial, SAA with a brief KHE program was efficacious and cost-effective in relieving knee pain and improving mobility in middle-aged and older adults with probable knee OA.
TRIAL REGISTRATION
ClinicalTrials.gov Identifier: NCT04191837.
Topics: Middle Aged; Humans; Female; Aged; Male; Osteoarthritis, Knee; Acupressure; Knee Joint; Pain; Pain Management
PubMed: 38639940
DOI: 10.1001/jamanetworkopen.2024.5830 -
Aging and Disease Aug 2023Increasing incidences of insomnia in adults, as well as the aging population, have been reported for their negative impact on the quality of life. Insomnia episodes may...
Increasing incidences of insomnia in adults, as well as the aging population, have been reported for their negative impact on the quality of life. Insomnia episodes may be associated with neurocognitive, musculoskeletal, cardiovascular, gastrointestinal, renal, hepatic, and metabolic disorders. Epidemiological evidence also revealed the association of insomnia with oncologic and asthmatic complications, which has been indicated as bidirectional. Two therapeutic approaches including cognitive behavioral therapy (CBT) and drugs-based therapies are being practiced for a long time. However, the adverse events associated with drugs limit their wide and long-term application. Further, Traditional Chinese medicine, acupressure, and pulsed magnetic field therapy may also provide therapeutic relief. Notably, the recently introduced cryotherapy has been demonstrated as a potential candidate for insomnia which could reduce pain, by suppressing oxidative stress and inflammation. It seems that the synergistic therapeutic approach of cryotherapy and the above-mentioned approaches might offer promising prospects to further improve efficacy and safety. Considering these facts, this perspective presents a comprehensive summary of recent advances in pathological aetiologies of insomnia including COVID-19, and its therapeutic management with a greater emphasis on cryotherapy.
PubMed: 37163444
DOI: 10.14336/AD.2022.1203