Complementary Therapies in Clinical Practice

Published by Elsevier
Print ISSN: 1744-3881
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Entire study group of 102 children showing two measures, at baseline and follow-up, Po0:001 for both measures.
Demographics of PPCE study population.
Subgroup of 60 showing two measures, at baseline and follow-up, Po0:001 for both measures.
Parent oral assessments of behavioral problems for all 102 children for 1 year follow-up as reported by phone. Number of children in each category is indicated in each column.
A growing body of research in neuroscience points to the impact of variations in maternal nurturing on child development and provides a rationale for interventions that target stress adaptation conditioning through natural family nurturing. This pilot study was collected within the course of private practice to assess the progress of children with severe behavioral disorders who were treated effectively with a multiple family therapy prototype, Prolonged Parent-Child Embrace (PPCE) Therapy. Subjects were a consecutive series of 102 patient children aged 4-18 years and their families. Children and their family members were guided for 16h over two consecutive days through intense PPCE Therapy. Families were instructed to continue PPCE Therapy at home for at least 1 year. Scores were compared statistically using t-tests and analysis of variance. For 96 children scores declined on two written measures by approximately 50% between baseline and follow-up (P<0.001). Results showed that PPCE Therapy resulted in significant and prolonged improvements in symptomatic behavior in a majority of children.
 
This article considers briefly how and why complementary and alternative medicine has developed in children's care during the last 10 years. Some of the therapies utilised by children are discussed, similarities and differences to trends in CAM for adults highlighted and a potential role for CAM in children's care in the future, suggested.
 
The present study was undertaken to produce a detailed specification of a programme of massage, controlled breathing and visualization performed regularly by birth partners, from 36 weeks gestation and assisted by a trained professional, following hospital admission during labour and birth. As current research on massage interventions for pain relief in labour is poorly characterized, we began by undertaking a feasibility study on an established massage programme [Goldstone LA. Massage as an orthodox medical treatment past and future. Complementary Therapies in Nursing & Midwifery. 2000;6:169-75]. The intervention was designed in light of experimental findings that repeated massage sessions over 14 days increases pain threshold, by an interaction between oxytocin and opioid neurons [Lund I, Yu L-C, Uvnas-Moberg K, Wang J, Yu C, Kurosawa M, et al. Repeated massage-like stimulation induces long-term effects on nociception: contribution of oxytocinergic mechanisms. European Journal of Neuroscience 2002;16:330-8]. A 4 week time-frame was selected to coincide with a physiological increase in maternal pain threshold [Cogan R, Spinnato JA. Pain and Discomfort Thresholds in Late Pregnancy. Pain 1986;27:63-8, Whipple B, Josimovich JB, Komisaruk BR. Sensory thresholds during the antepartum, intrapartum, and postpartum periods. International Journal of Nursing Studies 1990;27(3):213-21, Gintzler AR, Komisaruk BR. Analgesia is produced by uterocervical mechano-stimulation in rats: roles of afferent nerves and implications for analgesia of pregnancy and parturition. Brain Research 1991;566:299-302, Gintzler AR, Liu N-J. The maternal spinal cord: biochemical and physiological correlates of steroid-activated antinociceptive processes. In: Russell JA, Douglas AJ, Windle RJ, Ingram CD, editors., Progress in Brain Research. Volume 133. The Maternal Brain. Neurobiological and Neuroendocrine adaptation and disorders in pregnancy and postpartum. Amsterdam: Elsevier Science, 2001. p. 83-97]. The main objective was to measure the effects of the programme on maternal pain perception during labour and birth. To detect any effect of massage during labour, on maternal cortisol and catecholamines, cord venous blood was taken to measure plasma concentrations following birth. Twenty-five nulliparous (N) and 10 multiparous (M) women participated in the study. Cortisol values were similar to published studies following labour without massage but pain scores on a Visual Analogue Scale (VAS), at 90min following birth were significantly lower than scores recorded 2 days postpartum [Capogna G, Alahuhta S, Celleno D, De Vlieger H, Moreira J, Morgan B, et al. Maternal expectations and experiences of labour pain and analgesia: a multi-centre study of nulliparous women. International Journal of Obstetric Anaesthesia 1996;5:229-35]. The mean score was 6.6. Previous studies suggest that a reduction from 8.5 to 7.5 would significantly reduce pharmacological analgesia in labour [Capogna G, Alahuhta S, Celleno D, De Vlieger H, Moreira J, Morgan B, et al. Maternal expectations and experiences of labour pain and analgesia: a multi-centre study of nulliparous women. International Journal of Obstetric Anaesthesia 1996;5:229-35].
 
The purpose of this study was to investigate the use of herbal drugs by pregnant women in relation to concurrent use of conventional drugs, delivery, and pregnancy outcome. 600 women at Stavanger University Hospital Norway were interviewed using a structured questionnaire within five days after delivery. Medical birth charts were reviewed with respect to pregnancy outcome. In all, 39.7% of the women reported having used herbal drugs during pregnancy, most commonly ginger, iron-rich herbs, echinacea and cranberry. Although 86.3% of the women reported having used conventional drugs during pregnancy there were few potential interactions between herbal drugs and conventional drugs. There was a significant association between the use of iron-rich herbs during pregnancy and high birthweight, and use of raspberry leaves and caesarean delivery. Use of herbal drugs is common during pregnancy and indicates a need for documentation about their safety in pregnancy.
 
This study was designed to survey college students about their knowledge and use of Uwhangchungsimwon (UC), a Traditional Oriental herbal remedy for emergency and acute treatment of stroke, numbness, hypertension, epilepsy and arteriosclerosis. Students at three female nursing colleges in Korea completed a questionnaire containing 29 questions about the students' demographics, knowledge and use of UC, and the placebo effect. Of 608 respondents, 217 (36%) had taken UC. Eighty-three per cent reported that UC alleviated examination tension and 28% knew that it is used as an emergency drug for stroke. Forty-two per cent believed that UC has a "placebo effect" and 20% considered its effects were more than that of a placebo. Fifty-eight per cent of those using UC felt that it was effective in inducing psychological relaxation, 4% considered that it increased their energy levels, and 6% felt it was effective in "clearing the head"; 33% reported no effects. Users also reported adverse effects: 30% reported drowsiness, 17% reported a "heavy head" and 15% experienced indigestion. Most respondents (73%) obtained information about UC from family members and friends and 33% from newspapers or the media. These results confirm health practitioner should recognize that UC is used widely for purposes other than its intended purpose (i.e., to treat stroke and hypertension) and that such use can cause adverse effects. More systematic research is needed to increase the safety of consumers when using herbs and herbal supplements.
 
Self-reported, primary complaints by 761 consecutive new patients. 
To describe the profile of patients presenting to a private chiropractic clinic specialising in Neuro Emotional Technique (NET) and to identify trends in the presentation of symptoms from these patients. 761 consecutive new patients presented to a large, multi-doctor chiropractic clinic in which practitioners all adopt a similar philosophical paradigm and practice NET From January 2005 to December 2005, self-referred patients completed a new patient questionnaire, in which they self-reported one primary complaint for why they were visiting the practitioner. Predetermined patient information was entered manually into a database and basic descriptive statistics extracted. 67.3% of participants were female and 32.6% of the participants were between the ages of 31 and 40. 54.8% of patients presented with a primary musculoskeletal complaint and 36.0% a non-musculoskeletal complaint. Of the musculoskeletal complaints, 40.8% of patients presented with back pain, 20.9% with neck pain and 11.5% with shoulder pain. The most common form of non-musculoskeletal complaint was immune and recurrent infections (13.9%), stress and anxiety (12.8%) and depression (10.9%). 41.4% of participants reported a first time complaint, however, of the patients who had had the presenting complaint before 60.7% reported as having the complaint for greater than 1 year. Musculoskeletal and non-musculoskeletal participants had similar pain profiles. This retrospective analysis is the first comprehensive description of the scope of NET patients and their presenting complaints. The patient profile of this NET clinic has a higher degree of non-musculoskeletal patients than that usually reported in non-NET chiropractic offices, and other forms of chiropractic previously described in the literature. Further cross sectional research is required to determine if this particular clinic is indicative of all NET practices and whether the presenting symptoms, especially the non-musculoskeletal, are resolved with NET.
 
The aim of this study was to elucidate the effects of electroacupuncture at abdominal meridian points on various obesity-related parameters: body weight (BW), body fat (BF) percentage, body mass index (BMI), percent ideal body weight (PIBW), and waist (WC) and hip (HC) circumferences. All of these parameters changed significantly compared to pretreatment in this pilot uncontrolled study involving 31 women with obesity. The percent reductions were 5.3% in BW, 1.3% in BF, 4.7% in BMI, 6.0% in PIBW, 4.6% in WC, 6.2% in HC, and 2.1% in the WC/HC ratio. The most affected variable was WC (effect size=0.58). Since this was a pilot study with several limitations, such as a small sample size and absence of a control treatment and appropriate follow-up, further studies that include a randomized design, larger sample sizes, and more detailed data about the subjects are needed to convincingly show the effects of electroacupuncture at abdominal meridian points on overweight and obese patients.
 
To determine the short- and long-term effect of treatment in children with chronic abdominal pain (CAP). A database with the results of H(2) breath test of children with CAP was created. All children with an abnormal test result were included and classified as small intestinal bacterial overgrowth (SIBO) or lactose intolerant (LTI). SIBO was treated with probiotics and LTI with a lactose-restricted diet. CAP was evaluated 5 months and 15 months after the test. 37 children (41%) were included. 17 LTI children (94%) improved after 5 months and 11 children (61%) after 15 months (P<0.05). Seven SIBO children improved after 5 months and 4 children after 15 months. In the combination group all 4 children improved after 5 months and 3 children after 15 months. Children with CAP caused by LTI or SIBO had less CAP after 5 months. This positive effect persists only in half of the children.
 
To describe a massage therapy and training programme in a remote Aboriginal community in Australia and to develop the frameworks, procedures and processes necessary for future research. Self-report health questionnaires (MYMOP and W-BQ12) and an ethnographic enquiry that included participant observation and 15 interviews with clients and key informants. The project was disrupted by typhoons. Baseline questionnaire responses indicate they may be suitable for this context. Qualitative analysis resulted in a conceptual model of the effects of the programme, which is consistent with a system theory approach. People's accounts were rooted in discussions of the community's history, emotional and physical distress, and limited health care resources. Community-level effects included increasing participation; strengthening local health and educational projects; and opening up new opportunities. Individual level effects included improvement in physical and emotional symptoms, improved function and the receipt of preventative care. As a result of this early stage research, future studies have a conceptual model to guide them and evidence that a mixed method and a participatory methodology may be the most appropriate design.
 
Japan is a major tea producing country, and green tea is known for its health benefits which are believed to be due to catechins. However, difficulties in maintaining an adequate amount of catechins in the blood have been reported. Another important health-promoting activity among the Japanese is bathing in hot springs. This pilot study examined whether the combined effects of green tea consumption and hot spring bathing improved absorption of green tea catechins. The study, with a comparative within-subject design involving two different intervention trials-green tea consumption with hot spring bathing and only green tea consumption-was conducted on 2 separate days. Plasma levels of catechin; (-)-epigallocatechin-3-O-gallate (EGCG) were analyzed from four volunteers. Plasma EGCG concentration was found to be higher for the combined trial of green tea consumption and hot spring bathing.
 
The study purpose was to examine dissociation in body therapy for women receiving psychotherapy for childhood sexual abuse. An initial intervention study provided an opportunity to examine dissociation; the sample of 24 women received eight, 1-h body therapy sessions. The Dissociative Experiences Scale served as the predictor variable, and the outcome measures reflected psychological and physical health, and body connection. Repeated measures analysis of variance was used to examine dissociation reduction across time. Pearson correlations were used to describe associations between the relative change in dissociation and outcomes. The results demonstrated that the greatest change was the reduction of dissociation; there was an incremental effect across time and a strong association between change in dissociation and health outcomes. High dissociation at baseline (moderate levels) predicted positive outcomes. The results demonstrated the importance of moderate dissociation as an indicator of distress, and the central role of dissociation reduction in health and healing.
 
There has been a growing emphasis on evaluating and improving the experience of the hospitalized patient. In 2004, the Cardiovascular Surgery team at Mayo Clinic Rochester, though achieving a high level of technical expertise and clinical outcomes, recognized that patients were not rating their overall hospital experience as highly as was expected. After a systematic evaluation of the hospital experience, tension, stress, pain, and anxiety were identified as key challenges for patients. A multidisciplinary team was created to evaluate pain management practices and explore methods for reducing pain, anxiety, and tension. An extensive review of the literature and site visits to other institutions provided the foundation for the program. The term "Healing Enhancement" was coined to identify the goals of this emerging paradigm that focused on all aspects of the patient's experience-mind, body, and spirit. Integrated therapies such as music, massage, guided imagery, and relaxation training were explored to measure their role in patient care.
 
The use of complementary and integrative medicine therapies is steadily becoming an integral part of health care. Massage therapy is increasingly offered to hospitalized patients for various conditions to assist with the management of common symptoms such as pain, anxiety, and tension. This article summarizes a decade of building the massage therapy service at a large tertiary care medical center, from the early pilot studies and research to the current program offerings, and the hopes and dreams for the future. Copyright © 2014 Elsevier Ltd. All rights reserved.
 
Although known primarily for its antioxidant function, zinc appears to be an important modulator for the production of immune cells as well as ensuring the proper action of various leukocytes such as neutrophils, monocytes, macrophages, B and T lymphocytes. The primary study objective was to compare URI incidence between supplemented (zinc gluconate 15mg/day capsules) and non-supplemented (corn-starch placebo) groups. This study was a seven month randomized, double blind, placebo-controlled trial involving 40 cadets to evaluate zinc's effectiveness in reducing the risk of upper respiratory infections (URIs). Self-reported symptoms as recorded by a weekly web site survey revealed that supplemented participants experienced significantly more symptom free episodes than those in the placebo group (p=0.01). No significant differences were found between groups in terms of physician diagnosed cases (p=0.99). Higher zinc dosage may be warranted to confer a protective effect under more challenging immunological conditions.
 
Stage of cancer trajectory when participants availed of complementary therapies.
Complementary therapies and cancer type.
Socio-economic groups of participants availing of complementary therapies.
Quality of life scores before and after complementary therapies.
Advances in cancer diagnosis and treatment have resulted in longer survival, meaning patients are living with a chronic-type condition. Therefore the needs of such patients have changed placing greater emphasis on survivorship, such as impact on quality of life and sleep patterns. Evidence suggests complementary therapies positively impact not only on the cancer patient's quality of life but also on family members and friends. This service evaluation examines self-reported benefits following a course of complementary therapy offered by a local cancer charity. Analysis of self-reported sleep scores and perceived quality of life experiences confirmed a number of trends relating to the demographics of people accessing the complementary therapy service. Results suggest the complementary therapies provided by Action Cancer significantly improved clients' quality of life. Based on these findings the authors make a number of recommendations in relation to the use of complementary therapies by cancer patients. Copyright © 2014 Elsevier Ltd. All rights reserved.
 
The popularity and use of complementary and alternative therapies and medicines (CAM) has remained high in the UK and many other countries over at least the last two decades. Access to such modalities via publicly funded health and welfare systems has remained very limited over the same period. Personal health budgets, designed to offer significant control and personal choice over health care, offer a potential mechanism for some individuals to access publicly funded CAM treatments more directly. This development brings into sharp focus debates about evidence based health care and conflicts between public policy which is geared towards consumer choice and public policy which is based on certain forms of scientific evidence. This paper will examine some of the arguments for allowing access to CAM via personal health budgets, and potential objections and obstacles to this.
 
Carol Edmonston was first diagnosed with breast cancer in 1995. After a lumpectomy and 6 weeks of daily radiation therapy she continued living a full life. Exactly 2 years later she was diagnosed with an unrelated cancer in her other breast following a routine mammogram. She had a lumpectomy, along with lymph node dissection, followed by 6 weeks of daily radiation therapy. Upon completion, she took Tamoxifen for 5 years and is currently cancer free, enjoying a full and rich life. The following story offers a unique insight into one person's spiritual adventure through cancer and the personal transformation that followed using "Doodling" as a therapeutic tool.
 
Acupuncture is a component of Traditional Chinese Medicine, focusing on a holistic, energy-based approach to the individual, rather than a disease-oriented, diagnostic, and treatment model. Nurses are increasingly involving themselves in the use of acupuncture as practitioners and as supporters of acupuncture in mainstream health care. This project described the lived experience of acupuncture treatment, with specific objectives to: inform nurses of people's experiences of having acupuncture; give nurses the language to explain to patients the experience of having acupuncture; and create possibilities for offering acupuncture as an informed choice of treatment in nursing and health care. The phenomenon of experiencing acupuncture was located within the participants' accounts of what it was like for them before, during, and after treatment.
 
Integration of complementary therapies in maternity practice is an ever growing field. Midwives have burgeoning interest in and are increasingly using complementary therapies within their practice. Issues regarding knowledge and safety remain essential within midwifery care. It is possible that the use of complementary therapies during pregnancy is not always based on a foundation of adequate knowledge and therefore may not be completely safe. Risk management is essential, both within conventional maternity care and where there is integration of new practices, to ensure that client safety is paramount. In order for integration of complementary therapies into maternity care to be safe and effective policies must be developed based on a sound evidence base, parameters of practice must be clear institutionally and for individual practitioners, and education and training needs must be met.
 
The effect of omega-3 fatty acids on depression is well documented. The purpose of this study was to determine if and how food is used as medicine in psychiatric care, especially how omega-3 fatty acids are used as a supplement in the treatment of depression. This is a pilot study with a qualitative design using questionnaires and interviews among nursing students, tutor nurses and psychiatrists. Three main categories emerged: 1. Nutrition is considered important but few evaluations are made. 2. There was a lack of knowledge of the effects of Omega 3. 3. There was an unclear division of responsibility among health personnel. A change in knowledge paradigms and clarification of responsibility is called for if food-as-medicine is to take its true place in psychiatric care. It is also necessary to include CAM and holistic perspectives. Further research is needed to determine why health education and health workers do not focus on nutrition therapy in psychiatric care. Further research is also needed to reveal both the patients, the GPs and the CAM practitioners' knowledge and attitude to the use of dietary supplements.
 
While research indicates that women compose the majority of users and practitioners of complementary and alternative medicine, very little is known about their experiences as students of CAM. The following article draws upon ethnographic research conducted at a multidisciplinary institution of CAM education in the United States, which emphasizes an integrated model of medicine, collaboration with allopathic practitioners, and science-based curricula as part of the project of professionalization. Focusing on the first year of a Master of Science in Acupuncture and Oriental Medicine program, I explore women's motivations for pursuing training in CAM; their experiences of learning; and their visions of future practice. Although female students conceive of themselves as pioneers in the field, they also feel constrained by family and relationship obligations, suggesting that there may be female-specific challenges of learning, and ultimately practicing, complementary medicine.
 
The purpose of this study was to gain an insight into nurses' experiences of incorporating aromatherapy into the care of residents suffering from dementia, anxiety and disturbed sleep patterns. Twenty-four residents and twelve nurses from four nursing homes participated in an action research study. The use of lavender augustofolia essential oil diffused nightly was perceived as an effective care modality reducing insomnia and anxiety in this patient cohort. Nurses experienced some negative attitudes among colleagues because they considered aromatherapy as not evidence based. Nurses require greater access to evidence based use of Aromatherapy. Further research is needed to study how smell can enhance dementia care.
 
The purpose of this paper is to explore how mainstream practitioners define and categorize complementary and alternative medicine (CAM) as one component of assessing their views. The following themes emerged from interviews with Canadian physicians, midwives and nurses: epistemological, evidence-based, medical domain, political-regulatory, funding-based, and role-based definitions of CAM. We also assess any possible links to their behaviour vis-à-vis CAM. We found that classifying something as CAM does not appear to inhibit most providers from recommending, referring for, or supporting their patients' use of these treatments. In conclusion, we highlight that despite their clear definitional boundaries around CAM, providers tend to evaluate each individual therapy on its own merits, taking other situational factors into consideration.
 
To compare the efficacy of combined transcutaneous acupoint electrical stimulation (TAES) and electromagnetic millimeter wave (EMMW) therapy as an add-on treatment for pain relief and physical functional activity enhancement among adults with sub-acute non-specific spinal pain in either the low back or neck. A non-blinded study with data obtained before, immediate, one week and three months after intervention. The Telehealth Clinic and Community Centre, Hong Kong. Forty-seven subjects with either sub-acute neck or low back pain. Subjects were randomly allocated to either an intervention group (n=23) or a control group (n=24). These groups were then divided into subgroups according to the site of their spinal pain-neck or back. The intervention group had eight treatments over a three-week period of TAES and EMMW. Changes from baseline to the end of treatment were assessed at intervals of one week and three months on either neck or low back pain intensity [by Visual Analogue Scale (VAS)]; stiffness level; stress level; neck or low back lateral flexion and forward flexion in cm, and interference with daily activities. The baseline VAS scores for the intervention and control groups were 5.34 and 5.18 out of 10, respectively (P value=0.77). At the one week and three month assessments, there were no significant differences between the groups-VAS (P value=0.09 and 0.27, respectively). A further subgroup of chronic pain sufferers (n=31) was identified and these had significantly reduced pain intensity at the one week assessment (P value=0.04) but this was not sustained at post three months after treatment (P value=0.15). Improvements in stiffness level, stress level, and functional disability level in the intervention group were not significant. Our study shows that there was a reduction in pain intensity, stress and stiffness level immediately after the eight sessions of treatment (TAES and EMMW), though the effect is not sustained after a week. No pain relief was found with the neck pain subgroup. However, the reduction in subjective average pain intensity among the chronic pain subgroup was sustained at the post one week assessment for the intervention group but not at the post three month assessment.
 
Presently, acupuncture is a technique considered to be capable of stimulating the regulatory systems of the organism, such as the central nervous system, the endocrine system and the immunological system. The median frequency of the upper trapezium muscle with 40% and 60% of maximal voluntary contraction (MVC) of 15 healthy volunteers, was analyzed after the individuals were submitted to the AA treatment. The non-parametric Friedman test was used to compare median frequency values. In this exploratory study, the level of significance of each comparison was set to p<0.05. The intraclass analyses indicate a significant increase of the median frequency muscle at 60% of the MVC (Wicoxon test). Based on the results found, the AA peripheral stimulus can act as a modulator mechanism of muscle activity and was possible to verify correspondence of the auricular acupoint with the trapezius muscle.
 
The primary objective of this randomized, controlled, open-label study was to compare the efficacy of body acupuncture and Fenglong method in controlling serum lipids in patients with dyslipidemia in Thailand. Patients were randomized into two treatment groups (body acupuncture and Fenglong) and a control group. By the end of intervention period, serum lipid level in both treatment groups was significantly lower than its baseline value while in the control group serum lipid levels significantly increased during the same period. At follow-up visit, total cholesterol and LDL cholesterol were significantly lower in both treatment groups when compared to the control group. The effect of both acupuncture interventions was seen in both obese and non-obese patients. In conclusion, body acupuncture and Fenglong method have a positive impact on the regulation of serum lipids that is sustained after the treatment regardless of patient's baseline weight.
 
Sleep disturbances are very common in elderly people and Traditional Chinese acupressure a noninvasive technique that promotes health and comfort recently has been used in this regard. The purpose of the present study was to evaluate the potential beneficial effects of acupressure on a group of institutionalized elders experiencing sleep disturbances. A randomized controlled clinical trial was conducted to test the effectiveness of acupressure on quality of sleep of elderly residing in a Nursing home. The Pittsburgh Sleep Quality index (PSQI) questionnaire was used as a screening tool to select 90 residents with moderate to marked sleep disturbances. The elders were randomly assigned to an acupressure group, a sham acupressure group and a control group by Balanced randomization method. There were significant differences between the acupressure group and the control group in subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency and sleep disturbance. But no significant differences were found in sleep indices between the sham acupressure group and the control group. Sleep log data showed a significant decrease in nocturnal awakenings in acupressure group compared to other two groups. The findings of this study indicated that acupressure has an effect on improvement of sleep quality and endorsed it as a non-pharmacological and complementary therapy for sleep-disturbed elderly people.
 
The current study was conducted to evaluate the effect of acupressure on primary dysmenorrhea in Iranian medical sciences students. A randomized controlled pre and post-test design was employed to verify the effects of SP6 acupressure on dysmenorrhea. A total of 30 young college female students with primary dysmenorrhea were randomly allocated to intervention (n = 15) and control (n = 15) groups. The intervention group received SP6 acupressure during menstruation cycle and the control group received light touch on the SP6 acupoint. Using a Visual Analog Scale, the severity of dysmenorrhea was assessed prior to and immediately, 30 min, 1, 2, and 3 h following treatment. Data were analyzed using X(2), t-test and ANOVA statistical tests. Significant differences were observed in the scores of dysmenorrhea between the two groups immediately after (3.50 ± 1.42 vs. 5.06 ± 1.43, p = 0.004) and also 3 h after treatment (1.66 ± 1.98 vs. 4.80 ± 1.37, p = 0.000). Acupressure on the SP6 meridian can be an effective non-invasive nursing intervention for alleviating primary dysmenorrhea and its effects last for 3 h post-treatment.
 
We conducted this study to assess the effect of acupressure at the Sanyinjiao point on primary dysmenorrhea. Eighty-six students participated in the study. All participants met the inclusion criteria. The study group received acupressure at Sanyinjiao point, while the control received sham acupressure. The severity of dysmenorrhea was assessed at the following time periods: prior to the intervention, 30 min, 1, 2 and 3h following the intervention. Data were analyzed using SPSS. The acupressure caused decline in the severity of dysmenorrhea immediately after intervention in both groups during their first menstrual cycle, although, there difference was not significant (p>0.05). In addition, during the same cycle, the severity of the dysmenorrhea decreased more in study group rather than control group at 30 min, 1, 2 and 3h after intervention (p<0.05). During the second menstrual cycle, acupressure made dysmenorrhea reduced in both study and control groups; however, the decline was more salient among participants of the study group at all stages after the intervention (p<0.05). Acupressure at Sanyinjiao point can be an effective, feasible, cost-effective intervention for improving primary dysmenorrhea.
 
Unlabelled: This paper sought to determine the efficacy of acupressure application in pregnant women suffering from nausea, with or without associated vomiting, who were unable to receive conventional medication for these symptoms. Sampling consisted of pregnant women complaining of nausea with or without vomiting. The study was controlled by the Maternity and Child Hospital in Istanbul between March 2004 and March 2005. The treatment group comprised 26 women; 25 in the control arm and 24 women were assigned to the placebo arm. The study occurred over a 9-day period. During this time, the treatment group applied acupressure bands to P(6) acupressure point on days 4-6 of the study with the placebo group receiving acupressure bands to a sham acupressure point, on the upper side of their wrists. Results and conclusion: Acupressure would appear to be effective in symptom control, and alleviation and placebo effects in reducing the symptoms of nausea and vomiting during pregnancy.
 
To assess the efficacy of acupressure using an aromatic essential oil (lavender) as an add-on treatment for pain relief and enhancing physical functional activities among adults with sub-acute non-specific neck pain. Experimental study design. The Telehealth clinic and the community centre, Hong Kong. A course of 8-session manual acupressure with lavender oil over a 3 week period. Changes from baseline to the end of treatment were assessed on neck pain intensity [by Visual Analogue Scale (VAS)]; stiffness level; stress level; neck lateral flexion, forward flexion and extension in cm, and interference with daily activities. The baseline VAS score for the intervention and control groups were 5.12 and 4.91 out of 10, respectively (P = 0.72). One month after the end of treatment, compared to the control group, the manual acupressure group had 23% reduced pain intensity (P = 0.02), 23% reduced neck stiffness (P = 0.001), 39% reduced stress level (P = 0.0001), improved neck flexion (P = 0.02), neck lateral flexion (P = 0.02), and neck extension (P = 0.01). However, improvements in functional disability level were found in both the manual acupressure group (P = 0.001) and control group (P = 0.02). Our results show that eight sessions of acupressure with aromatic lavender oil were an effective method for short-term neck pain relief.
 
This study aims to evaluate the effects of Sanyinjiao (SP6) acupressure in reducing the pain level and menstrual distress resulting from dysmenorrhea. Forty participants with dysmenorrhea were assigned to either the acupressure group (n = 19) or the control group (n = 21). The acupressure group received 20 min of SP6 acupressure during the initial intervention session and was taught to perform the technique for them to do twice a day from the first to third days of their menstrual cycle, 3 months subsequent to the first session. In contrast, the control group was only told to rest. Outcomes were measured through (1) the Pain Visual Analogue Scale (PVAS), (2) the Short-Form McGill Pain Questionnaire (SF-MPQ), and (3) the Short-Form Menstrual Distress Questionnaire (SF-MDQ). There was a statistically significant decrease in pain score for PVAS (p = 0.003) and SF-MPQ (p = 0.02) immediately after the 20 min of SP6 acupressure. In the self-care periods, significant reduction of PVAS (p = 0.008), SF-MPQ (p = 0.012), and SF-MDQ (p = 0.024) scores was noted in the third month of post-intervention. SP6 acupressure has an immediate pain-relieving effect for dysmenorrhea. Moreover, acupressure applied to the SP6 acupoint for 3 consecutive months was effective in relieving both the pain and menstrual distress level resulting from dysmenorrhea.
 
Childbirth is arguably one of the most painful experiences women undergo during their lives. This study aimed to compare the effects of ice massage, acupressure and placebo in reducing the intensity of labor pain in pregnant women from selected hospitals in Tehran, Iran. A quasi-experimental study was conducted on 90 pregnant women referred from selected hospitals in Tehran. Mean age of the participants was 27.82 ± 6.20 years. Subjects were randomly divided into three groups (n = 30) to receive ice massage, acupressure or placebo. The intervention was applied at the Hegu point and pain intensity assessed using a visual analogue scale (VAS) before the intervention, immediately 30 min and 1 h after the intervention. Comparing pain intensity immediately, 30 min and 1 h post-intervention across the three groups showed a significant difference between the groups. At 30 min post-intervention (p < 0.05). A Tukey test showed this difference was related to ice massage. Ice massage and acupressure techniques reduced pain during labor. However, ice massage provided more persistent pain relief. Due to high levels of pain intensity and increased pain experienced by the women during the active phase of labor, it is suggested that repeating these techniques during the first stage of labor could be an effective, accessible, cost-effective and non-invasive technique to help reduce the intensity of labor pain.
 
Insomnia is a common sleep disorder with devastating socioeconomic consequences. Even though there are pharmacological and behavioral treatments for insomnia, most of the patients are treated with medications. However, the long-term use of medications to treat insomnia is questioned and has potential side effects. More and more Americans are seeking complementary/alternative treatments for many conditions including insomnia and there are anecdotal reports/case series of use of acupuncture in treating insomnia. To examine critically the role of acupuncture in treatment of insomnia, we performed a systematic review of published literature. Among the selected studies for review many were clinical case series and few open or randomized clinical trails. Even though several of these studies did not clarify the nature of insomnia (primary vs. secondary), it seemed that many of the subjects enrolled in these studies had co-morbid other psychiatric (depression or anxiety disorders) and/or medical conditions (Hemodialysis, Stroke, Pregnancy). Except for few, several of these studies had methodological limitations. Despite the limitations of the reviewed studies, all of them consistently indicate significant improvement in insomnia with acupuncture. Further methodologically strong, randomized controlled studies with large sample size are needed to assess the usefulness of acupuncture in treatment of insomnia and explore the possible mechanisms underlying the effects of acupuncture on sleep and sleep disorders.
 
This study investigated the influence of manual acupuncture on heart rate variability and the role which anxiety can play in modifying physiological outcomes. Analysis of heart rate variability (HRV) was used as a sensitive and a reliable indicator of the balance between sympathetic and parasympathetic regulation of the heartbeat. Two groups of healthy female subjects were recruited into the study. The control group (n=30) attended one experimental session where no acupuncture treatment was used. The experimental group (n=30) attended three sessions in which unilateral manual stimulation of acupuncture points LU7 and KD6 was performed. The stimulation of the acupuncture points LU7 and KD6 was not associated with significant changes in HRV. Previous familiarity with acupuncture did not influence the outcomes but level of anxiety had a strong impact on physiological outcomes. Stimulation of LU7 acupuncture point counterbalanced naturally occurring sympathetic increase over time and had relaxing and harmonizing effect on the heart rhythm without influencing subjective perception of increased anxiety. Stimulation of KD6 acupuncture point had sympathetic influence on HRV in subjects with low "trait" anxiety and this influence was nullified by simultaneous stimulation of LU7 acupuncture point. It seems likely that the level of anxiety can modify HRV during acupuncture treatment and up to 40 min after the treatment. Psychological factors such as anxiety level should be considered as having important influence on physiological response to acupuncture.
 
Change in amplitude of skin potential is one of the physiological indicators of electrodermal activity (EDA) and has been associated with the onset of a variety of sensory, cognitive and emotional stimuli. This study investigated the EDA physiological response to manual acupuncture. A group of 60 healthy female volunteers were recruited into the study of which 30 were randomly assigned to a control group (no acupuncture) and 30 to the experimental group (received acupuncture). The experimental group attended three sessions in which acupuncture intervention consisting of unilateral manual stimulation of acupuncture points LU7 and KD6. Results showed that the insertion, stimulation and withdrawal of the acupuncture needles were associated with significant changes in EDA. The insertion of the needle was associated with the highest change in skin potential while the three consecutive manipulations of the needles showed a decline in EDA amplitude, thought to be consistent with physiological habituation. Anxiety level and previous familiarity with acupuncture did not influence outcomes. It is postulated that the change in EDA during needle insertion is non-specific to the type and the function of acupuncture points; however, EDA response may be associated with the precise location of the acupuncture point. If further studies confirm such findings, then EDA may become a valuable physiological marker for the acupuncture phenomenon.
 
The aim of this study was to analyze the effect of low level laser applied to acupuncture points of patients diagnosed with temporomandibular dysfunction (TMD). Ten patients aged between 20 and 50 years were clinically examined with regard to pain and dysfunction of the masticatory system. They received laser applications (GaAlAs diode laser, 780 nm wavelength; 70 mW power output, 35 j/cm(2)) in acupuncture specific points (Ig4, C3, E6, E7) once a week, for ten sessions. The range of jaw movement was registered after each session and visual analogue scale (VAS) was applied. Results were analyzed (SPSS-15.0-Chicago) during the comparison, before and after treatment. Statistical tests showed significant improvements (p < 0.01) in painful symptoms and electromyographic activities of masseter muscles in maximal habitual occlusion after laser applications but no significant improvements (p = 0.05) in measurements of mandibular movements. The laser therapy in specific acupuncture points promoted improvement of symptoms and it may be used as complementary therapy for TMD.
 
Unlabelled: Patient experience of acupuncture at a GP surgery was evaluated over 18 months. Patients were referred for six acupuncture treatments of 45 min by 10 practising GPs. Measure Your Medical Outcome Profile (MYMOP), was completed before the first treatment and at the start of the final consultation. A patient experience survey was completed immediately after the patient's last appointment. Results: A statistically and clinically significant improvement in the mean MYMOP profile score (1.6 SD 1.3, p < 0.0000) (n = 47); reduction in medication usage; a reduction in pain and stress and improved quality of life. Conclusions: Acupuncture provision was beneficial to patients with predominately chronic conditions. Further studies are needed to assess the cost effectiveness and long term benefit of acupuncture in the NHS.
 
Traditionally acupuncture at four points, Yanglingquan GB-34, Zusanli ST-36, Sanyinjiao SP-6 and Zhiyin BL-67, has been used for pre-birth treatments (Maciocia and West (eds.), Acupuncture in Pregnancy and Childbirth, Churchill Livingston, New York, 2000, pp. 559-575, Chapter 44). These points are specifically used to prepare the woman's body for birth, with an emphasis on preparing the cervix and pelvis for labour. Midwives in one District Health Board region in New Zealand who have had basic training in acupuncture techniques have been providing treatments for their clients prior to the estimated delivery date (EDD). A retrospective audit of the midwives practicing this technique was conducted to cover a 12-month period and a decrease in medical inductions and caesarean sections compared to the overall maternity report figures was apparent. The research was further informed by a literature review. This paper discusses both the audit and the literature review.
 
A retrospective survey was undertaken at the University of Salford Teaching Acupuncture Clinic. A postal questionnaire, exploring patient satisfaction and experience with the treatment and clinic, was sent to all persons who had attended the clinic between September 2001 and 2002. Eighty-four (76%) of the 110 patients returned the questionnaire. Nearly all (88%) gained symptom relief and about a half made changes to their lifestyle. No-one reported any negative effects. More than 90% were satisfied with the treatment given, student practitioners and supervisors, although there were mixed views about the supervisor's role. The study is one of the first studies to explore the satisfaction and experiences in a teaching clinical setting. Further research is needed to provide more in-depth insight into the patient experience and effects of acupuncture in this setting and to explore their experience and effects as the treatment unfolds, and over the longer term.
 
The randomized controlled trial (RCT) is considered the 'gold standard' methodology for evaluating efficacy of an intervention. It has been argued that RCTs cannot be used to examine the effectiveness of acupuncture. The purpose of this paper is to examine the applicability of an RCT study design for acupuncture research. RCTs would be more effective in studying acupuncture if study participants were randomized to groups based on the acupuncture diagnosis and not solely on the Western diagnostic criteria. Treatments must also be standardized somewhat to ensure replicability of the study and the information it provides. Blinding is not absolutely necessary for a good-quality RCT; however, if used, control groups need to be standardized and sham techniques evaluated to ensure accurate interpretation of results. With these factors combined, it is possible to greatly increase internal and external validity in acupuncture RCTs.
 
The aim of this paper was to determine the effect of acupuncture on perceived stress levels in women on the day of embryo transfer (ET), and to determine if perceived stress levels at embryo transfer correlated with pregnancy rates. The study was an observational, prospective, cohort study based at the University IVF center. 57 infertile patients undergoing IVF or IVF/ICSI. Patients were undergoing Embryo Transfer with or without acupuncture as part of their standard clinical care. Perceive Stress Scale scores, pregnancy rates. women who received this acupuncture regimen achieved pregnancy 64.7%, whereas those without acupuncture achieved pregnancy 42.5%. When stratified by donor recipient status, only non-donor recipients potentially had an improvement with acupuncture (35.5% without acupuncture vs. 55.6% with acupuncture). Those who received this acupuncture regimen had lower stress scores both pre-ET and post-ET compared to those who did not. Those with decreased their perceived stress scores compared to baseline had higher pregnancy rates than those who did not demonstrate this decrease, regardless of acupuncture status. The acupuncture regimen was associated with less stress both before and after embryo transfer, and it possibly improved pregnancy rates. Lower perceived stress at the time of embryo transfer may play a role in an improved pregnancy rate.
 
Hot flushes and night sweats are a major problem for women having adjuvant hormonal treatment for breast cancer. We explored using a standardised ear acupuncture protocol delivered in small group clinics as an option to manage these side effects. Qualitative research aimed to elicit the opinions of women who received this treatment. Sixteen women took part in three focus groups, and discussed a range of topics including reasons for joining the study, experience of having acupuncture, effects of the treatment, the possible reasons for these, and their experience of group treatments. Transcripts of the groups were analysed using grounded techniques. The women, who had all been experiencing chronic multiple flushes and sweats, found the acupuncture helpful and relaxing. Many reported reductions in hot flush frequency, as well as improvements in overall emotional and physical well being. The group setting for treatment was regarded as supportive and encouraging.
 
A set of outcome questionnaires has been developed to measure the range of treatment effects of traditional acupuncture. In this descriptive outcome study we validated these questionnaires in a busy National Health Service funded acupuncture clinic serving communities of diverse socio-economic circumstances. Some of the questionnaires performed better than others in this setting but EQ-5D and MYMOP-qual both showed statistically and clinically significant improvement in physical and psychological health after six weeks and six months, in all categories of disease and degrees of chronicity. Both the written qualitative data and the Patient Enablement Instrument (PEI) demonstrated considerable patient enablement and, for some patients, the acquisition of new coping and self-care strategies.The questionnaires were feasible to administer, acceptable to patients and clinic staff, and provided robust and detailed quantitative and qualitative outcome data of use for service provision, future planning, and as a basis for further cost-effectiveness studies.
 
The present study tests whether a combined treatment of acupuncture and transcutaneous electrical nerve stimulation (TENS) is more effective than acupuncture or TENS alone for treating chronic low back pain (LBP). Thirty-two patients with chronic LBP were randomly allocated to four groups. The acupuncture group (ACP) received only acupuncture treatment at selected acupoints for low back pain; the TENS group (TENS) received only TENS treatment at pain areas; the acupuncture and TENS group (A&T) received both acupuncture and TENS treatments; the control group (CT) received topical poultice (only when necessary). Each group received specific weekly treatment five times during the study. Outcome measures were pain intensity in terms of visual analogue scale (VAS) and QOL of low back in terms of Roland-Morris Disability Questionnaire (RDQ). The ACP, TENS and A&T groups all reported lower VAS and RDQ scores. Significant reduction in pain intensity (P<0.008) and significant improvement in QOL (P<0.008) were shown in the A&T group. Combined acupuncture and TENS treatment is effective in pain relief and QOL of low back improvement for the sampled patients suffering from chronic LBP.
 
As U.S. expenditures on acupuncture treatment rise, so does the need to examine specific acupuncture patient subpopulations because their treatment needs and goals vary. This study focused on treatment benefits reported by former obstetric acupuncture patients, which addresses a critical research gap on subjective patient experiences. Of 265 former clinic patients, 137 (51.7%) completed an internet survey with an open-ended question on treatment benefits. Using standard qualitative analytic strategies, we identified five major themes related to benefits, including, for example, treated chief concerns, helped achieve a desired birth experience, and provided holistic benefit. Identified themes and subthemes spoke to benefits of acupuncture on specific pregnancy symptoms and on the birth process. Clinical and research implications for identified themes, including those related to the birth process and birth setting, are discussed.
 
Top-cited authors
Matthew Leach
  • Southern Cross University
Denise Tiran
  • University of Greenwich
M. H. Hashempur
  • Shiraz University of Medical Sciences
Songporn Chuntharapat
  • Prince of Songkla University
Urai - Hatthakit
  • Prince of Songkla University