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Introduction. Parkinson’s disease cannot be well treated by conventional medication. Acupuncture and Tai Chi are proven to be effective in relieving symptoms of Parkinson’s disease. Traditional Chinese medicine exercises may prove to be an effective complementary therapy. Objective. To evaluate the efficacy and safety of conduction exercise and self-acupressure in treating Parkinson’s disease. Method. This study is an accessor- and data analyzer-blind, add-on, randomized, controlled, pilot clinical study. In the treatment group, they were taught to practice conduction exercise and self-acupressure for 8 weeks. No additional treatment was given in the control group. Assessments were done at week 4 and week 8 of the treatment period. The primary outcomes are the total score and domain scores of the Chinese version of 39-item Parkinson’s Disease Questionnaire. The secondary outcomes are the total score and domain scores of a custom-designed questionnaire, which is a short form of Nonmotor Symptom Scale. Results. 22 patients in the treatment group and 14 in the control group continued to the treatment phase. Patients in the treatment group displayed improvement trends in primary and secondary outcomes. Improvements were significant in two areas of a custom-designed questionnaire: total score (p=0.014) and domain score of gastrointestinal tract (p=0.004). No severe adverse events were reported. Conclusion. Conduction exercise and self-acupressure were well accepted by and feasible for Parkinson’s disease patients. The data generated can be used for the planning of future studies. The exercise regime can be promoted as a home-based, self-practice therapy for Parkinson’s disease patients, due to its safety, low cost, and convenience in implementation. This study is registered with the Chinese Clinical Trial Registry (ChiCTR-IPR-17011987, on 14 July 2017).

Background: Depression is one of the most common complications after stroke, with a prevalence of 30-33%. Patients with post-stroke depression (PSD) usually experience anxiety, hopelessness, and insomnia, which have a negative impact on their daily activities and post-stroke rehabilitation. In this review, we aimed to explore the impact of acupuncture in alleviating symptoms of PSD and to evaluate the difference in effectiveness between acupuncture combined with pharmacotherapies and various non-pharmacotherapies in order to provide guides and advice for clinical personnel. Methods: Six databases (Cochrane Library, PubMed, EMBASE, China National Knowledge Infrastructure, Wanfang Database, Chongqing VIP Database) and two clinical trials registration platforms were searched from inception to May 2021. Randomized clinical trials (RCTs) comparing needle-based acupuncture with pharmacotherapy, and other non-pharmacotherapy or invalid group were included. Two independent reviewers identified eligible studies. Two reviewers independently abstracted and recorded data into a pre-made form. A Bayesian network meta-analysis (NMA) was conducted to assess and compare different techniques using RStudio 3.6.0. The primary outcome was the change in scores of scales measuring depressive symptoms. The secondary outcomes were changes in serotonin levels and in quality of life. Results: Fifty-nine RCTs were included. The results of this NMA showed that compared with western medicine (WM), acupuncture alone or with repetitive transcranial magnetic stimulation (RTMS), Traditional Chinese medicine (TCM) alone or with WM, were superior for alleviating depression symptoms. Compared to Usual Care, acupuncture alone or plus other therapies could significantly decrease scores of the Hamilton Depression Rating scale. However, there was no significant difference found among acupuncture, WM, TCM with AC plus any of other treatment.Conclusions: The results of this study indicate that acupuncture alone or combined with other therapies appear to be effective in improving depression symptoms of stroke survivors. Moreover, in comparison with WM, acupuncture alone or plus RTMS, TCM, TCM with WM, or WM, were more effective in improving depression symptoms. Also, acupuncture with RTMS seems to be the most effective with the highest probability.

Objective: Parkinson's disease (PD) is the second most common neurodegenerative disease in the world. In 2004, approximately 13,000 individuals in Hong Kong, China, had PD. PD greatly affects quality of life and conventional medication can produce severe side effects. The traditional Chinese medicine (TCM) practices of conduction exercise (CE) and self-acupressure (SA) may relieve PD symptoms. This paper presents a protocol for a randomized controlled trial to determine the effectiveness of CE and SA in treating PD. Methods: Patients with primary PD were recruited. Eligible patients were randomly assigned to either a treatment or control group. The assessor and data analysts were blind. The treatment phase duration was 8 weeks, with 8 weekly sessions of CE and SA practice. Baseline, midpoint, and final assessments were carried out during the treatment phase. The primary outcome is scores on the 39-item Parkinson's Disease Questionnaire (PDQ-39), and the secondary outcome is scores on a custom-designed questionnaire based on TCM “Deficiency of Spleen Qi” scores and scores on a non-motor PD symptoms scale. Discussion: This trial is the first rigorous study of the effectiveness of CE and SA in relieving PD symptoms. The aim is to examine the effectiveness of CE and SA in treating a disease that is difficult to treat conventionally. The data obtained will form the foundation for future related studies. Trial registration: Chinese Clinical Trial Registry (ChiCTR-IPR-17011987, Date of registration: 14 July, 2017). Keywords: Parkinson's disease, Traditional Chinese medicine, Conduction exercise, Self-acupressure, Randomized controlled trial

Introduction: Massage is a popularly used complementary and alternative therapy. Previous randomised controlled trials have examined the effects of massage on children, and several systematic reviews have been conducted to synthesise these data. This study aims to assess and summarise the current evidence from published systematic reviews of controlled clinical trials on the practice of paediatric massage, specifically in infants and children aged < 5 years. Methods and analysis: This protocol was developed based on the Cochrane Handbook of Systematic Reviews of Interventions and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols. The online databases MEDLINE, Embase, Health Technology Assessment Database, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, Allied and Complementary Medicine, China National Knowledge Infrastructure, and Wanfang Data will be searched from the inception to June 2020 for evidence of the treatment effects. We will include systematic reviews of randomised control trials in infants and children aged < 5 years. Two reviewers will independently screen the articles for inclusion as per the eligibility criteria. They will extract information from the included studies and assess the methodological quality of the included studies. In addition, a systematic review of the adverse effects of massage on infants and children aged < 5 years will be included in this overview. We will present the treatment effects and adverse effects narratively. The pooled effect estimates for meta-analysed outcomes from the included studies will be extracted when possible. Additionally, we will generate a figure to show the recommendation level of massage therapy for each condition included according to the evidence quality of the studies included in the systematic reviews.Discussion: This overview of systematic reviews will summarise the current evidence on massage, specifically for infants and children aged < 5 years. We will comprehensively present the positive effects and adverse effects of this intervention.Trial registration number: CRD42020186003

Introduction Massage is a popularly used complementary and alternative therapy. Previous randomised controlled trials have examined the effects of massage on children, and several systematic reviews have been conducted to synthesise these data. This study aims to assess and summarise the current evidence from published systematic reviews of controlled clinical trials on the practice of paediatric massage, specifically in infants and children aged Methods The online databases MEDLINE, Embase, Health Technology Assessment Database, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, Allied and Complementary Medicine, China National Knowledge Infrastructure and Wanfang Data will be searched from the inception onwards for evidence of the treatment effects. We will include systematic reviews of randomised control trials evaluating the effects and safety of massage therapy in infants and children aged Discussion This overview of systematic reviews will summarise the current evidence on massage, specifically for infants and children aged Systematic review registration CRD42020186003.

Objective The COVID-19 pandemic is a large-scale public health emergency that likely precipitated sleep disturbances in the community. This study aimed to investigate the prevalence and correlates of sleep disturbances during the early phrase of COVID-19 pandemic. Methods This web-based cross-sectional study recruited 1,138 Hong Kong adults using convenience sampling over a 2-week period from 6th April 2020. The survey collected data on sleep disturbances, mood, stress, stock of infection control supplies, perceived risk of being infected by COVID-19, and sources for acquiring COVID-19 information. The participants were asked to compare their recent sleep and sleep before the outbreak. Insomnia Severity Index (ISI) was used to assess their current insomnia severity. Prevalence was weighted according to 2016 population census. Results The weighted prevalence of worsened sleep quality, difficulty in sleep initiation, and shortened sleep duration since the outbreak were 38.3%, 29.8%, and 29.1%, respectively. The prevalence of current insomnia (ISI score of ≥10) was 29.9%. Insufficient stock of masks was significantly associated with worsened sleep quality, impaired sleep initiation, shortened sleep duration, and current insomnia in multivariate logistic regression (adjusted OR=1.57, 1.72, 1.99, and 1.96 respectively, all p, Highlights • Around 30-40% of the respondents felt their sleep worsened since the local outbreak. • The prevalence of insomnia in Hong Kong during the COVID-19 pandemic was high. • An insufficient store of masks for 1-month was associated with worsening of sleep. • A stable supply of masks may play a role in sleep health during an outbreak.

Background Electromoxibustion devices are commercially available and can be self-administered by patients. Nevertheless, little is known about the effectiveness and potential burn injury of these devices as this topic is under-investigated. Objective To assess the preliminary effects and safety of an electromoxibustion (EM) device for improving knee pain and joint functions in older adults with knee osteoarthritis (KOA). Design, setting, participants and intervention This was a pilot two-armed assessor-blinded randomized controlled trial to assess the effects of electromoxibustion (EM) on older adults with KOA. A total of 38 subjects aged 60 or above, with KOA for 3 months or above were recruited. Participants were randomized to the EM group or the knee health education group. The intervention group (n = 21) received 12 sessions of EM spanning across four weeks, while the control group (n = 17) received two sessions of knee health education. Main outcome measures Primary outcome included the pain severity Numerical Rating Scale (NRS) at baseline and week 4. Secondary outcomes included the Western Ontario and McMaster University Osteoarthritis Index (WOMAC), Short-Form Six-Dimension (SF6D), Timed Up & Go Test (TUG) and Fast Speed Gait (FSG). Results Both groups showed a decreasing trend in knee pain intensity by NRS at post-intervention. There were also trends of improvement in the WOMAC score, TUG score, FGS test score and SF-6D score at week 4. Only a small between-group effect size (d = 0.13) was found, but medium between-group effects sizes were found in the WOMAC total score (d = 0.40) and WOMAC functional sub-score (d = 0.51). However, the differences were not statistically significant. Conclusion This study suggested that EM may be beneficial for KOA in older adults, particularly in terms of improving knee function. Replication of similar studies in larger RCTs is warranted to confirm the effectiveness of EM on reducing pain and knee function of older adults with KOA. Trail registration number NCT04034394.