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Objectives: Cesarean deliveries are one of the primary conditions associated with postoperative decreased motility of the gastrointestinal system and are characterized by acute pain and distention. The aim of the present study was to investigate the application of acupressure and the administration of analgesics for women who underwent cesarean section under spinal anesthesia could be delayed and how spontaneous gastrointestinal system motility could be achieved in the postoperative period.Design: Randomized controlled trialSetting: Private Medipol Nisa Hospital, Istanbul, Turkey Intervention: This trial was conducted with 112 primipara pregnant women who delivered via cesarean sec-tion under spinal anesthesia and were randomly assigned into the acupressure (n=52) and control (n=60) groups. The participants in the acupressure group (n=52) were treated for 20 minutes. The participants in the control group (n=60) were treated per the hospital protocol (analgesics for pain, flatulation and defecation, no pharmacological or non-pharmacological application was performed).Results: The time that elapsed for the administration of analgesics was significantly later in the acupressure group than in the control group (p

Background and purpose: Labour pain is a constantly increasing pain. This study thus aims to determine the effects of acupressure and shower on labour pain and postpartum comfort. Methods: In this randomized controlled trial (RCT), the control group consisted of 40 pregnant women, while the experimental groups consisted of 80 pregnant women in total. The experimental groups received routine labour care and either acupressure or showers upon reaching three cervical dilations (4–5, 6–7 and 8–10 cm). The control group only received routine labour care. A maternal information form (MIF), the Visual Analog Scale (VAS) and the Postpartum Comfort Questionnaire (PPCQ) were used to collect data. Results: Pain was significantly reduced in both of the experimental groups, in contrast to the control group, in all periods of the study (p < 0.001). Postpartum comfort also significantly increased in the experimental groups compared to the control group (p < 0.05). Conclusion: Acupressure and showering are effective in reducing labour pain and increasing postpartum comfort. Midwives and nurses can therefore apply them as inexpensive and easy to administer methods for labour pain relief.

Background Restless legs syndrome (RLS), a neurological disorder, often affects sleep quality in hemodialysis patients. This study aimed to evaluate acupressure's effect on the severity of RLS symptoms and sleep quality in hemodialysis patients with RLS. Material and methods This study is a cluster-randomized crossover pilot study. Patients were randomized to two sequences: acupressure for one month and observation for another month (AC); and observation for one month and acupressure for another month (CA). For the four-week acupressure intervention, patients received 36 min of acupressure three times weekly during their hemodialysis sessions. The acupoints were on the bilateral lower limbs, including Zusanli (ST36), Yanglingquan (GB34), Sanyinjiao (SP6), Xuanzhong (GB39), Chengshan (BL57), and Taichong (LR3). RLS severity and sleep quality (measured with the Pittsburgh sleep quality index, PSQI) were measured at baseline, month 1, and month 2. Results AC sequence (n = 14) was similar to the CA sequence (n = 9) in terms of gender, age, education, employment, marital status, comorbid disease, BMI, duration of dialysis, medication for RLS and insomnia, RLS severity, and PSQI. The general linear mixed model revealed no significant carryover effect on RLS severity, PSQI, and the seven subscales of PSQI. A significant treatment effect (acupressure) was only observed in RLS severity (p = 0.0013) but not in PSQI and the seven subscales. The significant period effect was observed in RLS severity (p = 0.0250) and the subscale of sleep disturbance (p = 0.0021). Conclusion In hemodialysis patients with RLS, acupressure can alleviate the severity of RLS but cannot improve sleep quality.

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.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).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.The participants were recruited by distributing study flyers at outpatient clinics and referrals.Participants with chronic low back pain were eliglbe for the study.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.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.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.

Objectives To test the effect of noninvasive self-performed acupressure therapy as an add-on to pharmacological treatment to manage knee main and to evaluate the improvement of pain due to intervention according to age and body mass index. Methods In the study, 240 participants were assigned into three groups (1) KAP group (verum acupressure and pharmacological treatment) (2) Comparison Group 1 (sham acupressure and pharmacological treatment), and (3) Comparison Group 2 (pharmacological treatment only). Outcome measures were subscales of Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Visual analog scale and 36-item Short-Form Health Survey. Intention–to–treat analysis was used and missing data was deal with multiple imputation method. The general linear mixed model was carried out to assess the differences between the study groups at different durations (3 months, 6 months, and 1 year). Results Compared with CG-1 and CG-2, participants of the KAP group reported considerable improvements in WOMAC pain (mean difference: −2.50 units; 95% CI, 3.74–1.25, and mean difference: −1.69 units; 95%CI, −3.24 to −0.13 respectively) at 1 year. Similarly, VAS pain, stiffness, and physical function were also improved among the participants of KAP group. Conclusion Self-administered acupressure has an additive effect to the pharmacological treatment to improve pain, stiffness, and physical function as compared to pharmacological treatment only.

Background Many patients choose complementary and alternative medicine (CAM) to treat various conditions. Among osteoarthritis patients, acupressure is a popular CAM treatment. In Iran, Ghamz (a Persian acupressure technique) uses for musculoskeletal ailments like knee pain. Aims To examine the potential efficacy of Ghamz on osteoarthritis outcomes. Design Clinical Trial. Settings Randomized, single-blind, sham-controlled clinical trial. Participants/Subjects Eighty patients with diagnosed knee osteoarthritis, age over 35 years old. Methods Eighty adult patients with confirmed knee osteoarthritis from three outpatient clinics were recruited. Participants were randomly assigned either to intervention or placebo groups using sham acupressure. The primary outcomes included Knee injury and Osteoarthritis Outcome Score (KOOS) parameters and pain scores measured using the visual analog scales (VAS). Results Seventy-two individuals completed the trial and were included in the analysis. At baseline, there was no difference between the mean scores of both outcomes. After the intervention, the group receiving Ghamz therapy experienced an improvement in KOOS parameters, including symptoms, pain, activity daily livings, sport, recreation function, and quality of life. The mean pain score in the intervention group was significantly decreased from 5.89 at the beginning study to 4.11 at the end of the study, while the pain score did not change substantially in the sham group. These findings remained consistent after adjusting for covariates of age, weight, and pre-treatment. Conclusions This study supports evidence that Ghamz therapy provides an effective option for short-term knee pain relief in patients with knee osteoarthritis. Additional studies are recommended to confirm these findings.

Background Patients admitted to the intensive care units encounter many complications due to the nature of the disease and invasive medical procedures such as intubation and mechanical ventilation. Among these complications, agitation is a frequently-observed and serious problem. Objectives This study aimed to investigate the effect of Shiatsu massage on agitation in mechanically ventilated patients. Methods In this randomized controlled trial, a total of 68 mechanically ventilated patients were selected and then randomly assigned to two groups of intervention and control. Patients in the intervention group received three 5-minute periods of Shiatsu massage with a 2-minute break between them, while patients in the control group only received a touch on the area considered for the message. Data were collected before and after the intervention using the Richmond Agitation-Sedation Scale (RASS) and then analyzed using IBM SPSS Statistics for Windows, version 25.0 (IBM Corp., Armonk, N.Y., USA). Results The results showed that the level of agitation significantly decreased in the intervention group compared to the control group (p=.001). Conclusion Application of shiatsu massage seems to be effective in managing agitation in mechanically ventilated patients. Further studies with greater sample size and longer follow-up period are needed to confirm the current findings.

Objectives To measure pain and anxiety during first trimester uterine aspiration when using auricular acupressure or acupuncture as an adjunct to usual care. Methods This randomized, double-blinded, three-arm trial enrolled patients undergoing an aspiration procedure for an induced abortion, a miscarriage, or other abnormal intrauterine pregnancy. Trial participants received auricular acupressure, auricular acupuncture, or placebo immediately prior to their procedures. The study began with 1:1:1 randomization, but later overenrolled into the acupressure group after providing retraining for greater fidelity to that intervention. All participants received ibuprofen and a paracervical block. Participants reported pain and anxiety levels via visual analog scores (0–100). Our analysis compared pain scores of those receiving acupressure versus placebo, and those receiving acupuncture versus placebo. Results We randomized 177 participants over nine months and excluded data from four participants. We analyzed data from 70 participants who received acupressure, 51 who received acupuncture, and 52 who received placebo. The groups had similar baseline characteristics, including baseline pain and anxiety scores. For acupressure, acupuncture, and placebo groups, respectively, immediate post-procedure median pain scores were 50, 55, 47.5 (p = 0.88); maximum pain scores during the procedure were 77, 79, 79.5 (p = 0.96); postprocedure anxiety scores were 26, 28, and 21 (p = 0.47). The acupressure group results were similar before and after retraining. Conclusions Receiving auricular acupressure or acupuncture did not result in lower pain or anxiety scores among women undergoing vacuum aspiration compared to a placebo group. Implications The results of this trial were null, thus differing from our previous study that had shown a benefit from auricular acupuncture. Given the conflicting results, incorporating these acupuncture techniques into abortion practice would be premature.

Objectives To measure pain during first trimester medication abortion using auricular acupressure or auricular acupuncture as an adjunct to pain management. We measured anxiety as a secondary outcome. Study design This randomized, double-blinded, 3-arm trial enrolled women seeking medication abortion with mifepristone and misoprostol. Participants received auricular acupressure, auricular acupuncture, or inert auricular placebo patches immediately after receiving mifepristone. In addition, all participants received ibuprofen to use at home as needed. The study started with 1:1:1 randomization, but later overenrolled into the acupressure group after retraining for greater fidelity to that intervention. Participants reported pain and anxiety using numeric rating scales via text message for 4 days, and using a visual analog scale at follow-up. Analyses compared median pain scores of those receiving acupressure, acupuncture, or placebo. Results We randomized 136 participants of whom 57 received acupressure, 40 received acupuncture, and 39 received placebo. Groups had similar baseline characteristics. One hundred thirty-two participants (97%) reported outcomes by text message and 120 (88%) completed a follow-up interview. For acupressure, acupuncture and placebo groups the median maximum pain scores reported via text message were 60.0, 75.0, and 55.0 (p = 0.38); median maximum pain scores reported at follow-up were 76.5, 60.0, and 71.0 (p = 0.97), respectively. Acupressure results were similar before and after retraining. Maximum anxiety scores reported via text message were 10.0, 45.0, and 30.0 (p = 0.57). Maximum anxiety scores reported at follow-up were 10.5, 20.0, and 13.0 (p = 0.59). Conclusions Pain and anxiety during medication abortion were similar among women receiving acupressure, acupuncture or placebo. Implications We found no benefit in administering auricular acupressure or auricular acupuncture during medication abortion. These modalities are intended to be simple to use, but perhaps the brief provider training for this study was insufficient. These modalities should not be used in clinical practice without further study.

Nausea and vomiting are complex symptoms related to many disease processes. With many pharmacologic interventions noted to have adverse effects, many patients are turning to alternative therapies, including acupuncture and acupressure. Their efficacy has been proven for nausea and vomiting related to pregnancy, in patients receiving chemotherapy, and in postoperative, pediatric, and female patients. There are minimal to no side effects with the use of acupuncture and acupressure for the treatment of nausea and vomiting. Providers should be encouraged to discuss the efficacy, benefits, and side-effect profile of acupuncture and acupressure with patients who suffer from nausea and vomiting.

Background According to survey conducted by researchers at SMAN 01 Tulang Bawang Tengah, it was found that 88.3% (53) female students from 60 students aged 16 to 18 had dysmenorrhea, which consisted of mild dysmenorrhea of 54.72%, moderate dysmenorrhea of 33.96%, and heavy dysmenorrhea is 11.32%. Purpose Determine the differences of before and after acupressure therapy on decreasing dysmenorrhea pain. Methods The type of research used in this study is quantitative research using a quasi-experimental research design with one group pre-test and post-test approach. The study was conducted at SMAN 1 Tulang Bawang Tengah. The population in this study were all students of class X IPA as many as 60 students who experienced dysmenorrhea at SHS 1 Center Tulang Bawang. The size of the sample using the Slovin formula with the results of 52 female students. The selection of samples in this study was conducted by purposive sampling. The study used univariate and bivariate analysis with the Wilcoxon test. Results The results showed that most respondents were >14 years old, most of the respondents got menarche at age >12 years, most of respondents had menstrual period for >4 days and most respondent overcome pain dysmenorrhea without doing anything. Based on the analysis, the p value was 0.000. Conclusion There is a difference before and after the administration of acupressure therapy to treat pain in dysmenorrhea.

Background Childbirth is a physiological event in every development of a woman to become a mother. This event can cause trauma because of the pain she experienced. The main factors in labor are passage, passager and power, psychological (psychological factors) and childbirth helpers. A woman needs physical, emotional, psychosexual and psychosocial maturity before marriage and becomes pregnant. Feelings of anxiety, fear of pain will make women uneasy facing pregnancy, childbirth and childbirth, non-pharmacological therapy that can be given in various ways, namely; acupressure, acupuncture, cold compresses, warm compresses, hydrotherapy, hypnotherapy, endorphin massage, relaxation and distraction techniques. The effectiveness of giving murotal Al-Quran audio will increase the power of faith and provide peace of mind. Objectives The purpose of this study is to determine the effectiveness of Murotal Al Quran Therapy on Decreasing Labor Pain and Anxiety in Maternity in the First Phase in Maternity Clinic Ar-Rahmah Indralaya Ogan Ilir. The population of this research was maternity inpartu when I was an active phase which amounted to 20 people. Methods The type of research used in this study was quasi-experiment. The research design used was one group comparison pretest–posttest design to test the intensity of pain intensity using Shapiro–Wilk. Result From the results of the study obtained the normality test obtained p = 0.039 and 0.069 which showed the data did not normally distribute, the difference between before and after being given Murotal Al-Quran 0.30 with p = 0.008 showed that there was a difference in pain scale before and after therapy Murotal Al-Quran, for the anxiety of the difference between before and after being given therapeutic Murotal Al-Quran 0.021 with p = 0.025 which shows that there are differences in pain scale before and after the Murotal Al-Quran is concluded. Conclusion It can be concluded that Murotal Al-Quran can reduce pain and anxiety in maternity when I was an active phase. It is expected that midwives can improve services through the development of midwifery care, especially for women who experience severe pain.

Background Nausea and vomiting of pregnancy are common complaints that affect the quality of life significantly, even in mild cases. Although pharmacological treatments are available for these ailments, concerns about their effects on fetal health make healthcare providers and recipients prefer non-pharmacological therapies. Objectives This study examines the effect of Pericardium 6 (P6) acupressure with Sea-Band on the severity and frequency of nausea and vomiting of pregnancy and compares it with a placebo and a control group. Design and participants In this randomized, single-blind, placebo-controlled trial, 75 pregnant women with symptoms of mild to moderate nausea and vomiting of pregnancy with a gestational age of Setting The participants were selected from five healthcare centers in Ardebil, Iran. Interventions Pressure was applied to the P6 in the acupressure group using Sea-Band button for three days; in the placebo group, sea-band was applied without pressure on the P6; the control group did not receive any interventions, except for dietary recommendations similar to the other two groups. Main outcome measures Nausea and vomiting frequency and severity were recorded for six days, twice a day, with the intervention starting on the fourth day. Data were analyzed using the ANOVA, Kruskal-Wallis test, Chi-square test, Fisher’s exact test and Mann-Whitney’s U-test. Results There was a significant reduction in the frequency, duration and severity of nausea and also in the frequency of vomiting in the acupressure and placebo groups but not in the control group after three days of the intervention. A significant difference was observed between the acupressure and placebo groups in terms of the frequency and severity of nausea but not its duration or the frequency of vomiting after the intervention. Conclusion Acupressure on the P6 applied using a wristband for at least three days appears to be effective in the relief of nausea and vomiting of pregnancy; however, this finding may be due in part to the placebo effect. Acupressure on the P6 with Sea-Band button can be used for the management of nausea and vomiting of pregnancy.

Elevated urinary albumin excretion is a clinical manifestation of early-stage diabetic nephropathy (DN).To investigate effect of acupressure at Sanyinjiao on albuminuria in patients with early DN.Total included 53 patients with DN and albuminuria; 21 were assigned to the sham group without acupressure, and 32 were assigned to the experimental group with acupressure at Sanyinjiao (SP6) for 8weeks. The experimental group was divided into experiment A (acupressure45 days) and experiment B (acupressure ≥45 days). The primary outcome measure was the urine albuminuria/creatinine ratio (UACR) or logarithmic transformed urine microalbumin creatinine ratio (log-UACR) changes, and the secondary outcome measures were the estimated glomerular filtration rate and hemoglobin A1c.The difference in UACR and log-UACR before and after the study was higher in the experiment B group than in the experiment A and sham groups.Acupressure at Sanyinjiao for 8 weeks may reduce albuminuria in patients with DN. However, this study was a preliminary design.

Objective Acupressure therapy is a traditional therapy from China where one of the treatments is used to increase milk production in postpartum mothers by doing massage at acupoints points CV17, ST18 and SI1 usually only using fingers or blunt objects that do not injure the body surface, which can provide a suppressing effect so that more acceptable and tolerated by patients. Method The research used was quasi-experiment with pre-post test control group design, which was conducted in the working area of health centre (puskesmas) Pasar wajo sub-district of Buton district with a sample of 70, consisting of 35 intervention groups and 35 control groups. Results The group that was not given acupressure had a non-significant increase in breast milk production while them given acupressure had a significant increase. Conclusion Acupressure at the point of CV18, ST17, SI1 with a frequency of 3 times a week for three weeks can increase breastmilk production in postpartum mothers.

Objective To systematically review current literature to determine the effectiveness of the ischemic compression (IC) technique on pain and function in individuals with shoulder pain. Methods This review was conducted according to recommendations of Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the Cochrane Collaboration for Systematic Reviews; a search was performed in the electronic databases PubMed, Cumulative Index to Nursing and Allied Health Literature, SPORTDiscus, Physiotherapy Evidence Database, and Web of Science. Randomized clinical trials and quasi-randomized clinical trials were included, and the methodological quality was evaluated through the Physiotherapy Evidence Database scale. Results The search found 572 studies; of these, 71 were selected by title and, subsequently, 29 were selected through abstract analyses. After critical analyses, 5 studies were included. The methodological quality ranged from 4 (reasonable) to 9 (excellent) points. Pain was assessed by all studies using the visual analog scale, Global Perceived Effect scale, Numerical Rating Scale, pressure pain threshold, or Perceived Amelioration Numerical Scale. Function was evaluated by 3 studies through the Shoulder Pain and Disability Index; Neck Disability Index; American Shoulder and Elbow Surgeons Standardized Shoulder Assessment; and Disabilities of the Arm, Shoulder, and Hand questionnaires. The studies showed that the IC technique produces immediate and short-term positive effects for pain, and positive short-term effects for shoulder function in individuals with shoulder pain. Conclusion The IC technique seems to be beneficial for pain and shoulder function. However, caution is needed when considering this evidence owing to the limited quality of some studies, the few articles found, and the lack of standardization of the application parameters of the technique to facilitate its reproducibility.

Objective This study was aimed to analyze the potential of acupressure for complementary therapy in postpartum women's breast milk production. Method It was a quasi-experimental, post-test with a control group design. The subject in this study was 80 primipara postpartum mothers. The intervention was carried in June until August 2019 at the Kadolomoko public health center area, Southeast Sulawesi. Acupressure was given within 24 h postpartum for 5 until 10 min and control group was given puerperal gymnastics, which is a standard of midwifery care. Observation of breast milk on days 2, 4, and 7 postpartum. Results The breast milk given by acupressure and puerperal gymnastics both increased on the second, fourth, and seventh day after delivery, but the increase in the group given acupressure was higher than in puerperal gymnastics. Conclusion Acupressure has the potential to be complementary care by midwives in postpartum women to help better breast milk production.

Objective The purpose of this study was to determine potency of back message and acupressure in increasing prolactin hormone in primiparous post-partum mothers given back massage with acupressure. Hopefully back massage and acupressure can be considered to be practiced in midwifery care. Methods The subjects in this study consisted of 30 primipara first day postpartum mothers who had previously performed a pretest by taking blood samples as much as 3 ccs from peripheral veins to check prolactin hormone levels using the human Enzyme-Linked Immuno-Sorbet Assay (ELISA) Kit at the Hasanuddin University Research Laboratory Makassar, then respondents were asked to fill in the table self-report containing the frequency of breastfeeding in 24 h for 3 days. The intervention was given in the form of back massage and acupressure therapy at points LU1, CV17, and SI1 on the body 1 time a day every morning with a duration of 30 min for 3 consecutive days then blood was taken on day 4, namely the median cubital vein on the anterior arm to measure the level of the prolactin hormone using ELISA KIT and compared the prolactin hormone before and after the intervention. Data were processed using paired T-tests. Results The treatment of back massage and acupressure in primiparous postpartum mothers had a significant effect on increasing levels of the hormone prolactin. Conclusion Back massage and acupressure therapy are able to increase levels of the hormone prolactin so that this therapy can be given to postpartum and breastfeeding mothers to breast milk production and can be considered practiced in midwifery care.

Neonatal jaundice is a common health problem seen in 60–80% of newborns. Electronic search in nine databases was done for randomized controlled trials. Twenty seven studies were eligible for quantitative analysis. For neonates requiring phototherapy (PT), in 3rd and 4th days of life, massage and phototherapy was more effective in reducing bilirubin, compared to phototherapy alone. However, this effect became insignificant in the 14th day of life. In contrast, massage with enema and phototherapy significantly reduced bilirubin at the age of 14 days. For neonates not requiring PT, the best reduction was observed with the acupressure massage between the 3rd and 7th days. In the 14th day, massage combined with bathing appears to be the most effective. Massage therapy could be an effective adjuvant to PT in order to reduce the PT duration. However, it did not reduce the requirement for PT.

Context Alternative medical and training approaches to accelerate recovery among athletes are growing in popularity. The potential benefits of acupressure massage on attenuating muscle soreness and promoting post-exercise recovery capacity are still unclear. Objective This study compares the effects of traditional Chinese acupressure massage (TCAM) and active recovery, on subject recovery capacity after acute repeated jumping exercise. Design Twenty healthy male athletes were randomly assigned to traditional Chinese acupressure massage (TCAM; N = 10) or active recovery (AR; performing low-intensity exercise during post-exercise recovery; N = 10) groups. TCAM and AR intervention were applied after repeated jumping exercise. Pain scale, knee active/passive range of motion (AROM/PROM), jumping performance, quadriceps maximum voluntary contraction force, creatine kinase, and leukocyte subpopulations were measured at baseline, after and 48 h after exercise. Results No significant interaction effects were observed between the jumping performance, quadriceps maximum voluntary contraction (MVC) force, power-to-weight ratio for the two groups before the exercise, after the exercise, and 48 h post exercise. However, the knee flexion AROM/PROM was greater in the TCAM group than that for the AR group (p = 0.005). There were no differences in the VAS, MVC, and jumping performance between treatments. The white blood cell (p = 0.024), and monocytes (p = 0.023) responses were lower in the TCAM group. Conclusions We demonstrated that TCAM generates beneficial effects on attenuating joint mobility limitations and lowering systemic inflammatory responses after acute exercise in athletes. These findings suggest that TCAM may be a practical alternative approach for athletes participating in consecutive competitions containing eccentric elements.

Breech is a common fetal presentation in preterm pregnancies. This study aimed to investigate the effect of acupressure at the BL67 point on the spontaneous rotation of fetus with breech presentation.An unblind, two-armed randomized controlled trial was carried out from September 2017 to April 2020. Research participants were 138 pregnant women at 32 to 35 weeks of gestational age that had fetal breech presentation confirmed by ultrasound. They were randomly assigned into intervention and control groups (n=69 in each group). The intervention group received acupressure at the BL67 point on both feet for 10 minutes daily and for two consecutive weeks. The control group received routine care. Demographic and midwifery data questionnaires were used for data collection.The spontaneous rotation of fetus with breech presentation into cephalic was observed in the majority of participants in the intervention group (82.6%) compared to the control group (17.4%) (p0.001). Statistically significant differences in the fetal presentation at delivery was observed between the groups (84.1% cephalic vs. 18.8% breech, p0.001). Regarding the type of delivery, cesarean section was reported mostly (85.5%) in the control group compared to the intervention group (21.7%) (p0.001). However, the first- and fifth-minute Apgar scores of newborns had no statistically significant differences between the groups (p=0.773).It is suggested to incorporate acupressure at the BL67 point into the care process for pregnant women to help with the reduction of the rate of cesarean section and avoid its related complications.

Some adverse events following immunization (AEFI) were observed in potential corelation with COVID-19 vaccination but without prevention or ongoing trial for it. We aimed to investigate efficacy of auricular acupressure (AuriAc) therapy in preventing AEFI after first dosage of the vaccine.We performed a multicentre randomized controlled trial with three arms, including AuriAc, SAuriAc (sham auricular acupressure), and TrAsU (treatment as usual) group, carried out in four medical institutions in Chengdu, China, from March 17th to April 23rd, 2021. We enrolled participants based on eligibility criteria and randomized them into three groups: AuriAc (AEFI-specific auricular points applied, n = 52), SAuriAc (n = 51) or TrAsU (n = 44) group. Primary outcomes were percentages of any AEFI and local pain, and secondary outcomes were percentages who reported other AEFI. They were followed at 1, 3, 5, 7, and 14 days, by phone or online, with severity evaluated.147 participants (73.47% females) were included with median age as 31 years (25-45, IQR). One day after the injection, participants in AuriAc group reported significant reduction on percentages of any AEFI [intention-to-treat, difference of percentage (DP) = -20.13, 95%CI: - 0.39, - 0.02, p = 0.01; per-protocol, DP = -22.21, 95%CI: - 0.40, - 0.03, P = 0.02] and local pain (per-protocol, DP = -18.40, 95%CI: -0.36, -0.01, P = 0.04), compared with TrAsU group. The effects were slight at other follow-up days and for other outcomes, and with a low percentage of mild local allergic reactions.We firstly explored potential of AuriAc for preventing AEFI related to COVID-19 vaccine injection, which is beneficial for the vaccine recipients, but evidence is limited.chictr.org.cn no. ChiCTR2100043210 (http://www.chictr.org.cn/showproj.aspx?proj=121519).

Objective This study was designed to determine the effect of back massage, acupressure, and a combination of a back massage and acupressure to the levels of the hormone oxytocin and uterine involution of postpartum primipara mothers. Method It was a quasi-experimental design with a pretest–posttest control group design that is observations made before and after treatment of the subject. Subjects consisted of 45 primipara postpartum mothers divided into three groups, each group consisting of 15 mothers. The interventions carried out were back massage, acupressure, and a combination of back massage. All interventions were carried out once a day for three days daily with a duration of 30 min every morning at 09.00–09.15. Massage is carried out along the vertebrae until the 5th and 6th costal bone; then acupressure is performed at the LU point 1-rib 2, point CV 17, and point SI 1. Results All groups given complementary therapy showed a significant increase in the oxytocin hormone. However, the highest increase was in the combination of back massage and acupressure. Conclusion The combination of back massage and acupressure therapy is worth considering as a complementary therapy for postpartum primiparous women in helping to increase the hormone oxytocin.

Objective Postpartum blues is an event that occurs in the first week after delivery. Postpartum blues are temporary, but when they cannot be handled properly they will continue to become postpartum depression or anxiety disorders. This study aims to determine the potential of acupressure therapy for decreasing the Edinburgh Postnatal Depression Scale (EPDS) score in mothers with postpartum blues. Method This research was an experimental study with one group pre–posttest design, at RSIA Sitti Khadijah I and the Kassi-Kassi Health Center in Makassar City with a sample of 30 people conducted in August–October 2019. The EPDS questionnaire was conducted before and after acupressure therapy in each respondent who fits the inclusion criteria. Results The results of the study showed that acupressure has the potency to decreased EPDS scores. The highest EPDS scores on the first day are 12.33, and after day 9, EPDS score has decreased to 6.86. The decrease occurs every day until the 9th day. Conclusion Acupressure therapy carried out in mothers with postpartum blues decreased EPDS score in mothers with postpartum blues.

Objective To determine the effects of foot massage and acupressure on pain during heel lancing in neonates. Methods A randomized controlled trial was performed in a university hospital in Turkey between February and December 2018. The neonates were randomized into three groups as acupressure, massage, and control groups. Acupressure was applied to the neonates in the acupressure group, and massage was given to the neonates in the massage group for 2 min before the heel lancing procedure. Pain responses of the neonates in the groups was evaluated with the Neonatal Infant Pain Scale during and 1 min after the heel lancing procedure. Results The study was completed with 139 neonates including 46 neonates in the acupressure group, 47 neonates in the foot massage group, and 46 neonates in the control group. There were statistically significant differences between the acupressure, massage and control groups in terms of their mean NIPS scores during (4.30 ± 2.25, 3.95 ± 2.63, 6.04 ± 1.26; respectively) and 1 min after the heel lancing procedure (1.46 ± 1.46, 1.66 ± 1.66, 3.85 ± 1.37; respectively). There was a significant difference in NIPS scores between the intervention groups and the control groups (p = 0.001). Conclusions Acupressure and massage were effective in reducing pain in neonates during the heel lancing procedure. However, there was no statistically significant difference between acupressure and massage. Acupressure and massage techniques can be applied for procedural pain management in the newborn.

The most well known forms of "energy psychology" combine cognitive and exposure techniques with the stimulation of selected acupuncture points (acupoints) by tapping on them. Most clinicians who learn and utilize an acupoint tapping protocol integrate the approach within their existing clinical frameworks rather than using it as a stand-alone therapy. The method has been highly controversial, with its efficacy, purported speed, and explanatory models all questioned. Nonetheless, its utilization within clinical settings and as a self-help method has continued to expand since it was introduced more than three decades ago. This paper reviews the most salient criticisms of the method and presents research and empirically based theoretical constructs that address them. More than 100 peer-reviewed outcome studies-51 of which are randomized controlled trials-provide an evidential base for evaluating the claims and criticisms surrounding the approach. This review concludes that a growing body of evidence indicates that acupoint-based energy psychology protocols are rapid and effective in producing beneficial outcomes in the treatment of anxiety, depression, PTSD, and possibly other conditions. Mechanisms by which acupoint tapping might bring about these treatment outcomes are also proposed.

Although Shiatsu, a kind of complementary alternative medicine, was developed in Japan and is practiced around the world, no experimental studies on Shiatsu have been conducted. The aim of this study is to investigate the efficacy of Shiatsu therapy for chronic lower back pain.We conducted a prospective, randomized, open, blinded-endpoint design study at St. Luke's International Hospital, Tokyo, Japan from 2015 to 2017. Patients with lower back pain for more than 12 weeks and a score of four or more on the Roland-Morris Disability Questionnaire (RMDQ) at baseline were included in this study. We excluded patients with severe conditions, such as bone metastasis, or dementia. Patients were randomly allocated to either Shiatsu therapy in addition to standard care or standard care only by computer randomization. Those allocated to Shiatsu received one-hour Shiatsu every week for four weeks. Our primary outcome was improvement of RMDQ, and secondary outcomes were improvement of Short-Form McGill Pain Questionnaire (SF-MPQ), Oswestry Disability Index (ODI) and EQ-5D after 4 weeks and 8 weeks. Bivariate analyses were applied for assessing statistical significance.Fifty-nine patients were included; 30 were allocated to Shiatsu, and 29 to the control group. None of the baseline characteristics were significantly different between groups. Twenty seven patients (90%) in the Shiatsu group and 24 patients (83%) in the control group completed the study. At week 4, Shiatsu group tended to show greater improvement only in EQ-5D (difference 0.068, p = 0.07), but not statistically significant, compared to control group, wheres other outcome measures were similar between the groups. At week 8, those in the Shiatsu group tended to have greater improvement in RMDQ (difference 1.7, p = 0.08) compared to the control group. The Shiatsu group showed greater improvement in present pain scale of SF-MPQ (difference 0.5, p 0.05), ODI (difference 4.0, p 0.01) and EQ-5D (difference 0.099, p = 0.01) compared to control group.In our limited sample trail, Shiatsu therapy combined with standard care for lower back pain improves some symptoms and QOL shortly after Shiatsu therapy.

Introduction Osteoarthritis (OA) is one of the most common and fast-growing chronic diseases among older adults. The aim of this study was to assess the effect of acupressure therapy on pain, stiffness, and physical functioning of a knee affected by osteoarthritis. Methods A single-blind pilot randomized control trial was conducted on 51 older adults with OA of the knee living in one of 3 nursing homes. Nursing homes were randomly allocated to one of three study groups; acupressure therapy, placebo, and routine care. The intervention group received acupressure therapy on eight acupoints. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) total score and the separate WOMAC subscales were used to evaluate pain, stiffness and physical functioning of knees. Results A one-way ANOVA revealed that WOMAC index was not significantly different at the baseline between the three groups (P = 0.296). After intervention, ANOVA showed significant differences between groups in regard to total WOMAC index, pain and physical dysfunction (p Conclusion Acupressure may be an effective intervention for reducing the pain, stiffness, and improving the function of knees with osteoarthritis.

Poor sleep and fatigue are among the most common complaints of patients with migraine. These problems can lead to different negative consequences such as headaches. This study aimed to examine the impacts of self-administered acupressure on sleep quality and fatigue among patients with migraine.This double-blind randomized controlled trial was conducted in 2016 on 76 patients who suffered from migraine without aura. Patients were conveniently selected from the neurology clinic of Valiasr (PBUH) teaching hospital and randomly allocated to either an acupressure (n = 38) or a sham acupressure group (n = 38) group. Data collection instruments were a demographic questionnaire, Pittsburg Sleep Quality Index, and Fatigue Severity Scale. Patients in the acupressure and the sham acupressure groups were trained to apply acupressure on respectively acupoints and sham points thrice weekly at bedtime for four consecutive weeks. The data were analyzed through the Chi-square, the independent-sample t, the paired-sample t, and the ANCOVA tests at the significance level of less than 0.05.After controlling sleep quality mean scores at baseline, no significant difference was found between the sleep quality of the two groups after intervention (P 0.05). The mean scores of fatigue significantly decreased in both acupressure and sham acupressure groups (P 0.05). However, the decrease in the acupressure group was significantly greater than in the sham acupressure group (P 0.05).As a noninvasive non-pharmacological therapy, acupressure can significantly reduce fatigue among patients with migraine.

Uncontrolled high blood sugar levels leads to diabetic neuropathy, which is usually develops slowly. Damaged nerves stop sending messages or may send message slowly at the wrong times. The propsed model is an insole for individuals with peripheral neuropathy conditions, where the peak plantar pressure value is measured at specified locations of the foot by means of a pressure sensor, which can be accessed via a mobile applications; Simultaneously, a stimulation is given at acupressure points of the foot to relieve pain at definite intervals of time, based on the signals from the controller. A controller is being used to perform these operations which will be transmitted to the mobile application via Bluetooth terminal.

Objective The prevalence of sport-related concussion (SRC) is high and results in a number of serious health consequences. One area that has received minimal research is the relationship between SRC and sleep. The literature shows that sleep deficiency is a frequent negative consequence of SRC. At the same time, sleep deficiency delays recovery from SRC and contributes added risk of symptom recurrence. A 2014 study of chronic pain patients who learned to apply the complementary and alternative medicine intervention hand self-shiatsu (HSS) had promising, sleep-promoting results that warrant further investigation with other populations. This proof-of-concept study explored the feasibility of HSS as an intervention to promote sleep onset and continuity for young adults with SRC. Methods This study employed a prospective case-series design, where participants act as their own controls. Baseline and follow-up data included standardized self-reported assessment tools and sleep actigraphy. Results Seven athletes, aged between 18 and 25 years, participated in the study. Although statistically significant improvement in actigraphy sleep scores between baseline and follow-up was not achieved, metrics for sleep quality and daytime fatigue showed significant improvement. Conclusion These findings support the hypothesis that HSS has the potential to improve sleep and reduce daytime fatigue in young postconcussion athletes. This pilot study provides guidance to refine research protocols and lays a foundation for further, large-sample, controlled studies.

Background & objective According to the clinical practice guideline of the Traditional Thai Medicine hospital, the therapeutic procedure of knee osteoarthritis (KOA) has been improved. The purpose of this study was aimed to assess the effectiveness of the procedure for the relief of knee pain in KOA patients. Methods A multi-center, open-label, pre-post clinical trial was performed in 39 patients with KOA. Patients were treated with seven points of knee acupressure for 14 min. along with 30 min. of herbal knee poultice (Zingiber cassumunar, Gloriosa superba, Aloe vera, and Cinnamomum camphora). The clinical assessments including WOMAC score, visual analog scale (VAS) for pain as well as knee physical examination were carried out to compare between day 0 and day 3 after the treatment. Results A total of 36 patients were analyzed at the end of the study. The result revealed that WOMAC and VAS significantly reduced (p Conclusion This study proved that the KOA guideline from Traditional Thai Medicine hospital could potentially be applied to relieve pain in KOA.

Introduction Obesity and overweight are common metabolic disorders, affecting people's physical and psychological health. Auriculotherapy is based on the understanding that the external ear represents all parts of the human body, including the internal organs, and provides acupuncture points corresponding to these parts. Previous randomized controlled trials (RCTs) have reported the preliminary results of auriculotherapy for weight loss, but the conclusions were controversial. Therefore, this review aimed to investigate the efficacy and safety of auricular therapy for obese and overweight patients. Methods We searched 9 databases from their inception to August 1, 2020 for randomized controlled trials (RCTs) of auriculotherapy concerning obesity and overweight. All analyses were conducted by RevMan5.3. The Cochrane RoB tool and GRADE were used to assess the risk bias and quality of evidence, respectively. Results Eleven RCTs involving 892 patients were included. Auriculotherapy alone or combined with lifestyle modification showed more body mass index (BMI) reduction than no treatment (MD -1.08 kg/m2, 95%CI [-1.29 to -0.86], P Conclusion Both auricular acupuncture and acupressure seemed to be effective for weight loss, particularly for overweight patients. However, the results were inconclusive due to weak evidence, and robust methodological RCTs with appropriate placebo settings are still needed to reconfirm the findings of our review. (PROSPERO ID is CRD42020136827)

Nausea and vomiting are common postoperative complications that occur within the first 24 h in adults. Clinical practice guidelines and a Cochrane review recommend stimulating the P6 acupoint to prevent or reduce postoperative nausea and vomiting. However, there are currently no standards and optimal timing is not known.The purpose of this study was to evaluate the effect of acupressure application on the P6 acupoint, using acupressure wristbands, in the prevention of postoperative nausea and vomiting and the antiemetic drug requirement in patients who had high postoperative nausea and vomiting risk related to laparoscopic cholecystectomy.This was a longitudinal, randomized controlled clinical study.The study was conducted in the general surgery department of a training and research hospital (105 beds), from March 2015 to March 2016.A total of 111 female patients who underwent laparoscopic surgery were divided into three groups of 37, using a block randomization method.Training on acupressure wristband use was provided to the intervention group and an acupressure wristband with a plastic cap was placed at the P6 acupoint. A wristband with the same appearance as the acupressure wristband, but without a cap, was used in the placebo group. No intervention was used in the control group. The wristband was placed approximately one hour before the surgery and removed six hours after the surgery in both the intervention and placebo groups. The data were collected at the 2nd, 6th, and 24th postoperative hours.The application of the acupressure wristband to the P6 acupoint in patients who underwent laparoscopic cholecystectomy was found to be more effective in decreasing the severity of nausea at the 2nd postoperative hour and the nausea incidence at 2-6 h, postoperatively, when compared to the placebo group (p 0.05). However, there was no statistically significant difference between the intervention group and the control group. Therefore, acupressure application to the P6 acupoint was not found to be clinically effective in decreasing postoperative vomiting, antiemetic drug requirement, and in decreasing pain, anxiety, or the need for analgesic drugs (p 0.05).We did not find the stimulation of the P6 acupoint with an acupressure wristband to be clinically effective in reducing postoperative nausea and vomiting or antiemetic drug requirement in patients who underwent laparoscopic cholecystectomy.

PubMedID: 30057052 Purpose: This study was designed as an experimental controlled study, aiming to identify the effect of ice massage with short duration (40 min) and long duration (80 min) applied on Large Intestinal 4 (LI4) acupressure point on labor process and perception of labor pain. Methods: The participants, who met the research criteria according to the results of power analysis, were 72 healthy pregnant women divided into experiment and control group. Results: Results show that ice massage applied on the LI4 region was effective in the 80th minute. Moreover, in terms of the effect of ice massage on labor duration, the application was found to reduce the labor duration of the women in the experimental group approximately 1 h on average. Conclusion: It was found that the ice massage applied by midwives on the LI4 point during the active phase of delivery could reduce pain and shorten the delivery duration. © 2018 Elsevier Ltd Firat University Scientific Research Projects Management Unit This study is supported with ASYO2013YL1 numbered project by University Scientific Research Projects . Data acquired with the study was sent to the 20th World Congress on Controversies in Obstetrics, Gynecology & Infertility (COGI), December 4–7, 2014 in Paris as a poster presentation.

WOS: 000439902900003, PubMed ID: 30057038, …

Objectives Among the complementary and alternative medicine, Shiatsu might represent a feasible option for depression in Alzheimer’s disease (AD). We evaluated Shiatsu on mood, cognition, and functional independence in patients undergoing physical activity. Design Single-blind randomized controlled study. Setting Dedicated Community Center for patients with AD. Interventions AD patients with depression were randomly assigned to the “active group” (Shiatsu + physical activity) or the “control group” (physical activity alone). Shiatsu was performed by the same therapist once a week for ten months. Main outcome measures Global cognitive functioning (Mini Mental State Examination – MMSE), depressive symptoms (Geriatric Depression Scale – GDS), and functional status (Activity of Daily Living – ADL, Instrumental ADL – IADL) were assessed before and after the intervention. Results We found a within-group improvement of MMSE, ADL, and GDS in the active group. However, the analysis of differences before and after the interventions showed a statistically significant decrease of GDS score only in the active group. Conclusions The combination of Shiatsu and physical activity improved depression in AD patients compared to physical activity alone. The pathomechanism might involve neuroendocrine-mediated effects of Shiatsu on neural circuits implicated in mood and affect regulation.

Atrial fibrillation (AF) is a common arrhythmia associated with increased risk of morbidity and mortality. There is evidence that lifestyle interventions may serve as complementary treatments to reduce AF burden. The objective of this review was to summarize the efficacy of lifestyle interventions for the management of AF. Studies which included patients with systolic heart failure (ejection fraction ≤40%), and those limited to an examination of vigorous physical activity were excluded from our search. Studies were identified through a search of the following databases: MEDLINE, EMBASE, CINAHIL, and PubMed, run from inception through August 2016. All studies were graded for quality using the Oxford Centre for Evidence-based Medicine recommendations. Meta-analyses of the studies were not performed due to the heterogeneity of the studies. From a total of 1,811 publications, 10 articles were identified and included. Selected publications included 1 study on yoga, 2 studies on acupuncture, 3 studies that examined weight loss programs, and 4 studies that evaluated the impact of moderate physical activity. Yoga was associated with less symptomatic AF episodes and improved quality of life. Acupuncture was associated with reduced AF occurrence in patients with persistent and paroxysmal AF. Weight loss was associated with a significant reduction AF burden and symptoms. Moderate exercise resulted in greater arrhythmia free survival and a mean reduction in AF burden. In conclusion, evidence exists to suggest that yoga, weight loss, and moderate exercise are associated with reductions in AF burden and symptoms. Evidence is greatest for weight loss and moderate exercise.

Objective Auricular acupressure (AA) therapy has been widely used in Eastern Asia and Europe to prevent constipation in leukemia patients undergoing chemotherapy. The aim of this systematic review was to review data from randomized controlled trials (RCTs) of auricular acupressure therapy for preventing constipation in leukemia patients undergoing chemotherapy. Methods Databases that were searched from their inception until August 2017 included: MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, as well as four Chinese databases [Chinese BioMedical Database, China National Knowledge Infrastructure, Wan-Fang Data, and the Chinese WeiPu Database]. In this systematic review, only RCTs that were related to the effects of auricular acupressure therapy on preventing constipation in leukemia patients undergoing chemotherapy were included. Study selection, data extraction, and validation were performed independently by two reviewers. Quantitative analyses of RCTs were performed using RevMan 5.3 software, and cochrane criteria for risk-of-bias were used to assess the methodological quality of the trials. Results A total of 5 RCTs met the inclusion criteria, and most were of low methodological quality. Participants in the AA plus routine care group showed significantly greater improvements in the Bristol Stool Form (BSF) [MD = 0.55, 95% CI (0.39, 0.71), p Conclusion Taken together, as a potential safety therapy, only weak evidence supported the hypothesis that AA effectively prevented constipation in leukemia patients undergoing chemotherapy.

© 2017 Australian College of Midwives Complementary and Alternative Medicine (CAM) have increasingly been used by pregnant women with a steady rise in interest by midwives. Literature describing CAM and self-help options midwives recommend to women experiencing a post-date pregnancy is sparse. This study aimed to investigate if Australian midwives’ personal CAM use impacts on discussions and recommendations of CAM/Self-help strategies. Methodology/design: A survey of a national midwifery association midwifery members (n = 3,552) was undertaken at a midwifery conference (October 2015) and via e-bulletins (November 2015–March 2016). The self-administered survey included questions on what self-help and CAM strategies midwives discuss and recommend to women with a post-date pregnancy, midwives’ confidence levels on discussing or recommending CAM, midwives’ own personal use of CAM. Findings: A total of 571 registered midwives completed the survey (16%). Demographics (age, years as a midwife, state of residence) reflected Australian midwives and the midwifery association membership. Most respondents discuss (91.2%) and recommend (88.6%) self-help/CAM strategies to women with a post-date pregnancy. The top five CAM recommended were Acupuncture (65.7%), Acupressure (58.1%), Raspberry Leaf (52.5%), Massage (38.9%) and Hypnosis/Calmbirthing/Hypnobirthing (35.7%). Midwives were more likely to discuss strategies if they personally used CAM (p

Objective To review the evidence relating to nonpharmacological approaches in the management of pain during labour and delivery. To formulate recommendations for the usage of nonpharmacological approaches to pain management. Options Nonpharmacological methods available for pain management during labour and delivery exist. These should be included in the counselling and care of women. Evidence PubMed and Medline were searched for articles in French and English on subjects related to "breastfeeding," "pain," "epidural," "anaesthesia," "analgesia," "labour," "labor," and combined with "gate control theory," "alternative therapies," "massage," "position," "mobility," "TENS," "bathing," "DNIC," "acupuncture," "acupressure," "sterile water injection," "higher center," "control mind," "cognitive structuring," "holistic health," "complementary therapy(ies)," "breathing," "relaxation," "mental imagery," "visualization," "mind focusing," "hypnosis," "auto-hypnosis," "sophrology," "mind and body interventions," "music," "odors," "biofeedback," "Lamaze," "Bonapace," "prenatal training," "gymnastic," "chanting," "haptonomy," "environment," "transcutaneous electrical stimulus-stimulation," "antenatal education," "support," "continuous support," "psychosocial support," "psychosomatic medicine," "supportive care," "companion," "intrapartum care," "nurse," "midwife(ves)," "father," "doula," "caregiver," " hormones," "oxytocin," "endorphin," "prolactin," "catecholamine," "adrenaline," and "noradrenaline" from 1990 to December 2015. Additional studies were identified by screening reference lists from selected studies and from expert suggestions. No language restrictions were applied. Validation methods The quality of the evidence is rated using the criteria described in the Report of the Canadian Task Force on Preventive Health Care. Recommendations for practice are ranked according to the method described in this report. Benefits, risks, and cost The nonpharmacological method encourages an incremental approach to pain management that contributes to reduced interventions through optimal use of the woman's neurophysiologic and endocrine resources and a better understanding of the physiology of stress and pain during labour. Guideline update The guideline will be reviewed 5 years after publication to decide whether all of part of the guideline should be updated. However, if important new evidence is published prior to the 5-year cycles, the review process may be accelerated for a more rapid update of some recommendations. Sponsors This guideline was developed with resources funded by The Society of Obstetricians and Gynaecologists of Canada. Summary Statements 1.It is important that all health care professionals have a good understanding of pain in childbirth including its physiological and psychological management whether or not a person in labour also chooses pharmacological relief (III). 2.A growing body of scientific literature supports the use of nonpharmacological approaches to pain management during childbirth due to their numerous benefits for the mother and child, including a reduction in the need for obstetrical interventions, labour augmentation, or Caesarean section (l). 3.Suffering, as opposed to pain, occurs when a woman is unable to activate her own mechanisms for coping with pain, or when her own mechanisms are insufficient to deal with the situation (III). 4.The Gate Control Theory mechanism, which consists of creating pleasant stimulations in the painful area between or during contractions is best achieved through ambulation, gentle massage, stroking, water, or vibrations (I). 5.The Diffuse Noxious Inhibitory Control (which consists of applying painful stimulations at any site on the body for the duration of each painful contraction) is best achieved through acupressure, sterile water injections, or deep massage (I). 6.The Central Nervous System Control mechanism, which consists of deviating or focussing the woman's attention is best activated through labour support and the practice of yoga, relaxation, visualization, breathing, auto-hypnosis and cognitive restructuring (I). 7.Continuous labour support, as part of nonpharmacological approaches to pain management during childbirth, reduces stress, fear, and anxiety, which in turn decreases the frequency of obstetrical interventions (I). 8.Natural oxytocin is not only important for uterine contractions; it enhances a sense of calmness and reduces pain. Because synthetic oxytocin does not cross the blood-brain barrier in a significant manner, the analgesic and psychological effects on the mother of calmness and well-being are lost (II). 9.Elevated endorphins in labour help reduce maternal stress and pain and may assist in newborn adaptations (II). 10.Health care providers and the birthing environment can have a major impact on labour progress and experience by paying attention to and reducing a woman's stress level (I). 11.Prolactin not only promotes breast milk production, it optimizes the mother's physiologic and behavioural responses in adapting to her role (II). 12.Creating a calm, stress-free environment, encouraging women, and having a positive attitude where possible play an important role to stimulate the endogenous hormone production that promotes and supports the physiologic progress of labour (II). 13.Neurophysiologic and hormonal mechanisms contribute to help women cope with the intensity of labour (l). Recommendations 1.Health care providers should be familiar with the neurophysiological and hormonal mechanisms and related methods in physiological labour and birth (III-A). 2.To help women cope with normal labour, nonpharmacological approaches are recommended as a safe first-line method for pain relief and should be continued throughout labour whether or not pharmacologic methods are used (I-A). 3.To prevent suffering, health professionals should address the emotional component of pain (pain unpleasantness). This is most effectively achieved through support and nonpharmacological approaches to pain management. 4.To develop support measures consistent with the wishes of women, health professionals should work with women and listen to their needs (III-A). 5.To further reduce the need for obstetric interventions and avoid associated risks and side-effects, health professionals should provide continuous labour support with the addition of at least one other nonpharmacological pain modulating mechanism (I-A). 6.Health professionals should, where possible, promote and support the physiological progress of labour, delivery, and the postpartum period trusting the woman's ability to work with her pain and encouraging her to rely on her ability to give birth (III-A). 7.To enhance the endogenous hormone production that promotes and supports the physiologic process of labour, health care providers should reduce a woman's stress level by encouraging her and having a positive attitude where possible and by creating a calm, stress-free environment (I-A). 8.Continuous labour support, as part of nonpharmacological approaches to pain management during childbirth for women should be promoted and provided for all women in labour (I-A). 9.Health professionals should encourage parents and the people assisting them to prepare for the birth by learning about birth physiology and gaining skills in working with pain (III-A).

Aim This study was conducted to examine the effects of auricular acupressure on sleep in elderly people with sleep disorders. Methods This was a randomized, double-blind, sham-controlled study. The participants aged over 65 years old were randomly assigned to the experimental group (n = 21) and the sham control group (n = 21). The participants in the experimental group and the sham control group received auricular acupressure on sleep-disorder-related points or to sleep-disorder-unrelated points, respectively. The intervention was implemented for a total of eight weeks. To validate the effects of the treatment, polysomnography with the Alice portable sleep diagnostic system; actigraphy with Fitbit Alta; and melatonin, serotonin, and cortisol blood tests were conducted. Results Non-Rapid Eye Movement sleep stage 3 duration change (Z = −2.187, p = .029) and Non-Rapid Eye Movement sleep stage 3 ratio change (Z = −2.423, p = .014), measured by polysomnography, of the experimental group showed a significant increase over time compared to the sham control group. Conclusions Auricular acupressure applied for eight weeks was found to be effective in increasing Non-Rapid Eye Movement sleep stage 3 duration and Non-Rapid Eye Movement sleep stage 3 ratio among sleep stages of the elderly. Consequently, it showed that auricular acupressure can be used as a proven nursing intervention method for sleep disorder in elders to increase deep sleep duration and ratio.

Background and purpose This study aimed to identify the research evidence on acupoint stimulation (AS) for cancer-related fatigue (CRF) management. Methods Randomised controlled trials that utilised AS for CRF management were retrieved. The Cochrane Back Review Group Risk of Bias Tool was used for quality appraisal. RevMan 5.3 was used for meta-analysis. Results Fifteen studies were included. Both the overall (SMD = −0.95, p = 0.008) and sub-group (acupuncture: SMD = −1.25, p = 0.002; short-term AS: SMD = −0.95, p = 0.02; medium-term AS: SMD = −0.96, p = 0.003) analyses indicated that AS was more effective in alleviating CRF than standard treatment/care. A comparison between the true and sham AS interventions favoured the true AS for CRF management, although the difference did not reach statistical significance. Conclusion This study identified a promising role of AS in improving CRF. However, the study findings should be interpreted prudently due to the limited quality and sample sizes of some of the included studies.

Introduction Non-traditional acupuncture (NTA), defined as the stimulation of certain parts of the body includes; acupressure, transcutaneous electrical acupoint stimulation (TEAS), laser acupuncture, intradermal needle, and acupoint catgut embedding (ACE). This systematic review evaluated their efficacy and safety for smoking cessation. Methods Randomized controlled trials (RCTs) comparing NTA with sham NTA or conventional therapy for smoking cessation were included. Ten databases were searched from their inception to March 2021. Data were synthesized using risk ratios (RR) or mean differences (MD) with 95% confidence intervals (CI). The primary outcome was abstinence rate defined as abstinence between date of quitting and follow-up. Results Acupressure was more effective than sham acupressure or conventional therapy in the short-term (RR 1.41, 95% CI [1.04 to1.91]; low certainty; 8 trials, n=637) and for mid-term smoking cessation (RR 1.63, 95% CI [1.27 to 2.09]; low certainty; 8 trials, n=749). TEAS appeared more beneficial for mid-term abstinence (RR 1.58, 95% CI [1.10 to 2.27]; moderate certainty; 3 trials, n=325). Laser acupuncture was superior to sham control for long-term abstinence (RR 2.25, 95% CI [1.23 to 4.11]; moderate certainty; 2 trials, n=160). ACE was comparable to Bupropion for mid-term smoking cessation (RR 0.99, 95% CI [0.70 to 1.40]; low certainty; 2 trials, n=177). No serious adverse events were reported. Conclusions Low certainty evidence suggests that NTA was effective in short-term, middle-term or long-term smoking cessation. Further long-term follow-up RCTs are warranted to verify these benefits. Registration INPLASY 202120054.

The biosocial data of 90 children with acute lymphoblastic leukemia, were collected along with assessment of gastrointestinal side-effects of chemotherapy using visual analogue scale. Ginger lozenges has more effect than acupressure in alleviating nausea and vomiting. Acupressure alleviate the nausea best in the group aged 13–15 years. Ginger helped more the other two groups (7–12 years, 69 % of the group didn’t suffer from nausea), versus 50 % aged 13–15). Both acupressure and ginger affected girls more than boys in alleviating nausea. The acupressure effect on vomiting incidence didn’t differ in both males and males, whilst ginger helped the males more.

Objectives This study aimed to determine the effect of acupressure on pain intensity, anxiety, and physiological indexes of patients with cancer undergoing bone marrow biopsy and aspiration. Methods The study was designed as a randomized, double-blinded, controlled trial. Ninety samples was selected using the convenience sampling method, then for allocation groups random block sampling was used (30 for each group). The three groups were similar by age and gender. LI4 and HT7 (Shen Men) acupressure points were examined for the intervention. Sham pressure was used in the placebo group while no intervention was applied in the control group. Results The results showed that the lowest average anxiety score (1.5 ± 0.5; P = 0.01) and the lowest average pain score (4.9 ± 0.8) after the intervention were related to the acupressure method (P = 0.001). Conclusion Cost effectiveness and short-term simple education make acupressure method useful in clinical settings for different illnesses.

Objective To longitudinally describe practice of Complementary and Alternative Medicine (CAM) self-care strategies for nausea during radiotherapy. Methods Two hundred patients daily registered nausea and practice of CAM self-care strategies, beside conventional antiemetic medications, for nausea during abdominal/pelvic irradiation (median five weeks) for gynecological (69%) colorectal (27%) or other tumors (4%). Results During radiotherapy, 131 (66%) experienced nausea, and 50 (25%) practiced self-care for nausea at least once, for a mean (m) of 15.9 days. The six of 50 patients who stayed free from nausea practiced self-care more frequent (m = 25.8 days) than the 44 patients experiencing nausea (m = 14.5) (p = 0.013). The CAM self-care strategies were: modifying eating (80% of all self-care practicing patients, 80% of the nauseous patients versus 83% of the patients free from nausea; ns) or drinking habits (38%, 41% vs 17%; ns), taking rests (18%, 20% vs 0%; ns), physical exercising (6%, 2% vs 33%; p = 0.035), acupressure (4%, 5% vs 0%; ns) and self-induced vomiting (2%, 2% vs 0%; ns). Conclusion A fourth of patients undergoing emetogenic radiotherapy practiced CAM self-care for nausea, mostly by modifying eating or drinking habits. The CAM self-care practicing patients who did not become nauseous practiced self-care more frequent than the nauseous patients did. To make such self-care evidence based, we need studies evaluating its efficacy.

Purpose Postoperative nausea and vomiting (PONV) is a common surgical complication that contributes to poor patient outcomes. The purpose of this study was to determine if acupressure to the P6 pressure point during the immediate postoperative period decreased PONV for the first 24 postoperative hours. Design This was a double-blind, randomized study. Methods Experimental group participants wore a wristband, which administered acupressure to the P6 pressure point of one wrist. Control group wristbands were malpositioned. Bands remained on until patients were discharged from the postanesthesia care unit or up to a maximum of 2 hours. Data on nausea, vomiting, and antiemetic use were tracked for the first 24 postoperative hours. Finding There were no statistically significant between-group differences in PONV or antiemetic use. Conclusions Short-term postoperative acupressure to one wrist did not lead to a 24-hour decrease in nausea, vomiting, or antiemetic use.

Introduction Insomnia can occur independently or in conjunction with other diseases, with the common symptom of poor sleep quantity and/or decreasing time asleep. In Chinese medicine, the acu-point HT7 along heart meridian is a very important acu-point for treating insomnia, however no systematic reviews have been carried out to evaluate the effectiveness of stimulating HT7 as a single point for treating insomnia. Methods A literature search of English and Chinese databases was carried out for randomized controlled trials evaluating the stimulation of HT7 as a sole acu-point for insomnia (irrespective of cause) compared with routine care or placebo. Trial reporting quality was assessed using the Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA) checklist and the Cochrane Risk of Bias Tool (PROSPERO registration numner: CRD42016036191). Results Four trials involving 436 participants were included. All trials were limited in their reporting and methodological quality. Statistically significant improvements were shown for HT7 simulation used for patients with insomnia who had coronary heart disease (measured by improvement ratio), and the simulation included acupressure (P Conclusions There was insufficient evidence to confirm whether HT7 stimulation could improve insomnia but there are some positive indications which warrant further research. These findings should be interpreted with caution due to the poor reporting and methodological quality of included trials.