No full-text available
To read the full-text of this research,
you can request a copy directly from the authors.
Abstract
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.
... Acupuncture is accepted and recommended for the treatment of neck pain (Nunes, Moita, 2015;Yuan et al., 2015;Liang et al., 2010;Witt et al., 2006;Vas et al., 2006;He et al., 2004;Irnich et al., 2001). Acupressure reduces neck pain intensity, neck stiffness and stress level (Yuan et al., 2015;Matsubara et al., 2011;Yip, Tse, 2006). ...
... Non-specific neck pain was pain in the area of neck and shoulders experienced by a person on most days in the past two weeks. Non-specific pain was not caused either by any pathologies including systemic rheumatic disorders, spinal tumors, fractures, infections or by any known causes including degenerative changes, trauma or surgical intervention (Yip, Tse, 2006). The patients were excluded who suffered from any systemic disease, neurological disorders, infections, fractures or degenerative disorders as well as those with contraindications to the treatment. ...
... It was shown (Matsubara et al. 2011) that using both local and distal acupuncture points improved pain-related condition. The points chosen proved to be effective in neck pain (Yip, Tse, 2006;Vas et al., 2006;He, Veiersted, Høstmark, Medbø, 2004;Irnich et al., 2001). ...
The aim of the study was to evaluate the effect of electropuncture, i.e. the stimulation of acupuncture points by TENS electrotherapy, on non-specific neck pain and the associated symptoms regularly reported. 16 participants, 10 female and 6 male, completed the study. A TENS machine with a point electrode was used to stimulate a selection of acupuncture points. The primary outcome measure was the intensity of neck pain as measured by changes in scores on pain VAS, the secondary measure was the degree of the associated symptoms regularly reported such as headaches, restriction in daily activities, stress, troubled sleep and general health satisfaction. The results showed that participants who received 3 treatments over 8-14 days experienced a significant short-term reduction in neck pain and restriction in daily activities immediately after the treatment and at 1-month post-intervention follow-up. Our findings also show improvement in the intensity of headaches, degree of stress, quality of sleep and general health satisfaction but the changes were not statistically significant. The present pilot study suggests that stimulation of acupuncture points by the means of TENS electrotherapy may effectively reduce neck pain.
... Acupoint stimulation for relaxation with electrode pads followed by an acupressure massage Treatment as usual 8 sessions of acupoint stimulation followed by acupressure with aromatic lavender oil were an effective method for short-term low back pain relief. Yip and Tse, 2006 [6] Experimental study Neck pain, 28 Acupressure with lavender oil Treatment as usual ...
... One month after the end of treatment, compared to the control group, the manual acupressure group had 23% reduced pain intensity (í µí± = 0.02). Yip, 2004Yip, 2006 Hadi and Hanid, 2011Ou, 2012Sheikhan et al., 2012Ayan et al., 2013Jun et al., 2013Marzouk et al., 2013Kaviani et al., 2014Namazi et al., 2014 D+L overall with estimated predictive interval Bagheri-Nesami et al., 2014Martin, 2006 −1.26 (−1.87, −0.66) the weight of each study. The larger the sample size, the larger the weight and the size of gray box. ...
... The black lines on either side of the box represent a 95% confidence interval. Inflammatory Yip, 2004Yip, 2006Ou, 2012Ayan et al., 2013Marzouk et al., 2013 SMD (95% CI) N, mean (SD); treatment N, mean (SD); control % weight (I-V) I-V subtotal (I 2 = 89.7%, p = 0.000) D+L subtotal with estimated predictive interval I-V subtotal (I 2 = 97.5%, ...
Background. Aromatherapy refers to the medicinal or therapeutic use of essential oils absorbed through the skin or olfactory system. Recent literature has examined the effectiveness of aromatherapy in treating pain. Methods. 12 studies examining the use of aromatherapy for pain management were identified through an electronic database search. A meta-analysis was performed to determine the effects of aromatherapy on pain. Results. There is a significant positive effect of aromatherapy (compared to placebo or treatments as usual controls) in reducing pain reported on a visual analog scale (SMD = −1.18, 95% CI: −1.33, −1.03; p<0.0001 ). Secondary analyses found that aromatherapy is more consistent for treating nociceptive (SMD = −1.57, 95% CI: −1.76, −1.39, p<0.0001 ) and acute pain (SMD = −1.58, 95% CI: −1.75, −1.40, p<0.0001 ) than inflammatory (SMD = −0.53, 95% CI: −0.77, −0.29, p<0.0001 ) and chronic pain (SMD = −0.22, 95% CI: −0.49, 0.05, p=0.001 ), respectively. Based on the available research, aromatherapy is most effective in treating postoperative pain (SMD = −1.79, 95% CI: −2.08, −1.51, p<0.0001 ) and obstetrical and gynecological pain (SMD = −1.14, 95% CI: −2.10, −0.19, p<0.0001 ). Conclusion. The findings of this study indicate that aromatherapy can successfully treat pain when combined with conventional treatments.
... Key data from the included randomized controlled trials [RCTs] are summarized in Tables 1 and 2 (10-13). Of the four RCTs, two originated in China (12,13) and two were from Taiwan (10,11). All four of the included trials adopted a parallel group design and assessed between 61 and 146 patients with LBP (10)(11)(12) or 32 neck pain patients (13). ...
... Of the four RCTs, two originated in China (12,13) and two were from Taiwan (10,11). All four of the included trials adopted a parallel group design and assessed between 61 and 146 patients with LBP (10)(11)(12) or 32 neck pain patients (13). ...
... One RCT tested acupressure with lavender oil plus conventional treatment and compared with conventional treatment in patients with nonspecific neck pain (13). The results showed favorable effects of acupressure on pain and stiffness. ...
Background: Acupressure involves pressing acupuncture points with a finger or a device and can be used for treating several musculoskeletal pain conditions, including osteoarthritis, lower back pain [LBP], and rheumatoid diseases. The aim of this systematic review was to evaluate the effectiveness of acupressure for the treatment of musculoskeletal pain. Findings: A total of 180 relevant articles were identified, and four randomized controlled trials [RCTs] met our inclusion criteria. Two of these RCTs tested the effects of acupressure compared to routine therapies in patients with chronic LBP. Pain was significantly reduced in patients treated with acupressure compared to control [untreated] patients. One RCT compared acupressure using electrical stimulation to conventional treatment and reported favorable effects on pain reduction and function in patients with nonspecific sub-acute LBP. Another RCT tested acupressure using aroma oil on pain conditions compared to conventional treatment and showed favorable effects in patients with neck pain. Conclusion: Our results provide limited evidence for the effectiveness of acupressure in the treatment of LBP and neck pain. However, the methodological caveats prevented us from drawing definitive conclusions.
... This essential oil can be used in massages to treat muscular pain, neck pain (Yip and Tse, 2006), Low back pain (Yip and Tse, 2004), and menstrual pain (Marzouk et al., 2013). In an experimental study, 28 patients with neck pain had manual acupressure with lavender oil. ...
... In an experimental study, 28 patients with neck pain had manual acupressure with lavender oil. After a month of treatment the manual acupressure group had 23% reduced pain intensity compared to the control group (Yip and Tse, 2006). Essential oils have been so common and popular that it has even being used in baths with positive findings (Morris, 2002). ...
The aim of this review was to know the effect, properties and mechanism of action of essential oils in order to enhance their use as a treatment and adjuvant in some neurodegenerative pathologies and others associated to stress and human behavior, based on clinical trials and descriptive research. Some studies suggest that essential oils have been widely used in various applications, mainly in the pharmaceutical, cosmetic, food and agricultural industries since middle age. At the same time, based on human and animal studies has been established the effects of some essential oils about their behavior in the treatment of depression, anxiety, schizophrenic, sleep disorders in the regulation of mood modulating several neurotransmitters such as serotonin, noradrenaline, dopamine, glutamate, and gamma-aminobutyric acid also in some degenerative diseases such as Parkinson's or Alzheimer, as well as in the associated behaviors in depressive disorders, Autism spectrum disorder, ADHD, drugs addictions, people with stress and sleep disorders. It is necessary to know. RESUMEN Esta revisión tiene como objetivo conocer el efecto, propiedades y mecanismo de acción de los aceites esenciales para potenciar su uso como tratamiento y coadyuvante en algunas patologías neurodegenerativas y otras asociadas al estrés y al comportamiento humano, basado en ensayos clínicos y trabajos descriptivos. Algunos estudios sugieren que desde la edad media, los aceites esenciales han sido ampliamente utilizados en diversas aplicaciones, principalmente en las industrias farmacéutica, cosmética, alimentaria y agrícola. Al mismo tiempo, a partir de estudios en humanos y animales se han establecido los efectos de algunos aceites esenciales sobre el comportamiento en el tratamiento de la depresión, ansiedad, esquizofrenia, trastornos del sueño y en en la regulación del estado de ánimo modulando varios neurotransmisores: serotonina, noradrenalina, dopamina, glutamato y ácido gamma-aminobutírico; también en algunas enfermedades degenerativas como el Parkinson o el Alzheimer, así como en los comportamientos asociados en los trastornos depresivos, trastornos del espectro autista, trastorno de déficit de atención con hiperactividad (TDAH) , adicciones a las drogas, personas con estrés y trastornos del sueño.
... This essential oil can be used in massages to treat muscular pain, neck pain (Yip and Tse, 2006), Low back pain (Yip and Tse, 2004), and menstrual pain (Marzouk et al., 2013). In an experimental study, 28 patients with neck pain had manual acupressure with lavender oil. ...
... In an experimental study, 28 patients with neck pain had manual acupressure with lavender oil. After a month of treatment the manual acupressure group had 23% reduced pain intensity compared to the control group (Yip and Tse, 2006). Essential oils have been so common and popular that it has even being used in baths with positive findings (Morris, 2002). ...
The aim of this review was to know the effect, properties and mechanism of action of essential oils in order to enhance their use as a treatment and adjuvant in some neurodegenerative pathologies and others associated to stress and human behavior, based on clinical trials and descriptive research. Some studies suggest that essential oils have been widely used in various applications, mainly in the pharmaceutical, cosmetic, food and agricultural industries since middle age. At the same time, based on human and animal studies has been established the effects of some essential oils about their behavior in the treatment of depression, anxiety, schizophrenic, sleep disorders inthe regulation of mood modulating several neurotransmitters such as serotonin, noradrenaline, dopamine, glutamate, and gamma-aminobutyric acid also in some degenerative diseases such as Parkinson's or Alzheimer, as well as in the associated behaviors in depressive disorders, Autism spectrum disorder, ADHD, drugs addictions, people with stress and sleep disorders.
Keywords:essential oils, behavior, depression, anxiety, autism, ADHD, Parkinson's, Alzheimer
... (lavender), is a commonly used agent in aromatherapy (Sasannejad et al., 2012;Bagheri-Nesami et al., 2014). Lavender oil has been reported to possess several therapeutic effects including anti-anxiety, sedative, spasmolytic, antihypertensive, antimicrobial, antifungal, antiseptic and wound healing properties (Cavanagh and Wilkinson, 2002;Morris, 2002;Gedney et al., 2004;Yip and Tse, 2006;Sasannejad et al., 2012;Bagheri-Nesami et al., 2014). The analgesic effects of lavender oil have been widely studied (Morris, 2002;Gedney et al., 2004;Yip and Tse, 2006;Sasannejad et al., 2012). ...
... Lavender oil has been reported to possess several therapeutic effects including anti-anxiety, sedative, spasmolytic, antihypertensive, antimicrobial, antifungal, antiseptic and wound healing properties (Cavanagh and Wilkinson, 2002;Morris, 2002;Gedney et al., 2004;Yip and Tse, 2006;Sasannejad et al., 2012;Bagheri-Nesami et al., 2014). The analgesic effects of lavender oil have been widely studied (Morris, 2002;Gedney et al., 2004;Yip and Tse, 2006;Sasannejad et al., 2012). It has been shown that lavender oil can relieve the pain associated with different conditions such as labor, needle insertion, dialysis and headache (Sasannejad et al., 2012;Olapour et al., 2013;Bagheri-Nesami et al., 2014). ...
Post-surgical chest tube removal (CTR) is associated with a significant pain and discomfort for patients. Current treatment strategies for reducing CTR-associated pain and anxiety are limited and partially efficacious. To determine the effects of cold application, inhalation of lavender essential oil, and their combination on pain and anxiety during CTR was investigated. This randomized controlled open-label trial was conducted with 80 patients in the cardiac surgery intensive care unit who had a chest tube for duration of at least 24 hours after coronary artery bypass grafting (CABG). Patients were randomized (n=20 in each group) to receive cold application, aromatherapy with lavender oil, cold application in combination with lavender oil inhalation, or none of the above interventions (control group). The intensity and quality of pain and anxiety were evaluated using the visual analogue scale, short form and modified-McGill pain questionnaire (SFM-MPQ) and the Spielberger situational anxiety level inventory (STAII) scale, respectively. Patients in all treatment groups had significantly lower pain intensity and anxiety compared with the control group immediately, 5, 10 and 15 min after CTR. There was no statistically significant difference in the SFM-MPQ total scores between the intervention groups. With respect to anxiety score, there was a significantly reduced anxiety level immediately after CTR in the aromatherapy and cold-aromatherapy combination groups versus the cold application group. The present results suggested the efficacy of cold application and aromatherapy with lavender oil in reducing pain and anxiety associated with post-CABG CTR.
... Moreover, three small studies showed that acupuncture may be more effective than sham-acupuncture in reducing pain in the immediate term for acute or sub-acute LBP (moderate evidence). Acupressure in NP We found one study (32 individuals), which was of fair quality but had a small sample size [70]. ...
... Compared with the control group, reduction in the pain intensity in the intervention group was statistically significant at the 1-month follow-up (approximately a 23% reduction in the VAS, p = 0.02, effect size = 0.43) [70]. ...
Neck pain (NP) and low back pain (LBP) are common symptoms bothering people in daily life. Traditional Chinese medicine (TCM) has been used to treat various symptoms and diseases in China and has been demonstrated to be effective. The objective of the present study was to review and analyze the existing data about pain and disability in TCM treatments for NP and LBP.
Studies were identified by a comprehensive search of databases, such as MEDLINE, EMBASE, and Cochrane Library, up to September 1, 2013. A meta-analysis was performed to evaluate the efficacy and safety of TCM in managing NP and LBP.
Seventy five randomized controlled trials (n = 11077) were included. Almost all of the studies investigated individuals experiencing chronic NP (CNP) or chronic LBP (CLBP). We found moderate evidence that acupuncture was more effective than sham-acupuncture in reducing pain immediately post-treatment for CNP (visual analogue scale (VAS) 10 cm, mean difference (MD) = -0.58 (-0.94, -0.22), 95% confidence interval, p = 0.01), CLBP (standardized mean difference = -0.47 (-0.77, -0.17), p = 0.003), and acute LBP (VAS 10 cm, MD = -0.99 (-1.24, -0.73), p< 0.001). Cupping could be more effective than waitlist in VAS (100 mm) (MD = -19.10 (-27.61, -10.58), p < 0. 001) for CNP or medications (e.g. NSAID) for CLBP (MD = -5.4 (-8.9, -0.19), p = 0.003). No serious or life-threatening adverse effects were found.
Acupuncture, acupressure, and cupping could be efficacious in treating the pain and disability associated with CNP or CLBP in the immediate term. Gua sha, tai chi, qigong, and Chinese manipulation showed fair effects, but we were unable to draw any definite conclusions, and further research is still needed. The efficacy of tuina and moxibustion is unknown because no direct evidence was obtained. These TCM modalities are relatively safe.
... This approach allows us to conclude that if a result is significant with the sum of group SDs, it would certainly be significant had we used the true SDs of within group changes. To calculate the I 2 statistic, we followed Jackson's methodology [49]. Results are presented in rainforest plots [50] where uncertainty is visualized by the height of the raindrops for each individual estimate while the width of the raindrop corresponds to the estimated CI. ...
Essential oils (EOs) are widely used topically in musculoskeletal disorders (MSDs); however, their clinical efficacy is controversial. Our aim was to find evidence that topical EOs are beneficial as an add-on treatment in MSDs. We performed a systematic review and meta-analysis to summarize the evidence on the available data of randomized controlled trials (RCTs). The protocol of this work was registered on PROSPERO. We used Web of Science, EMBASE, PubMed, Central Cochrane Library and Scopus electronic databases for systematic search. Eight RCTs were included in the quantitative analysis. In conclusion, EO therapy had a favorable effect on pain intensity (primary outcome) compared to placebo. The greatest pain-relieving effect of EO therapy was calculated immediately after the intervention (MD of pain intensity = −0.87; p = 0.014). EO therapy had a slightly better analgesic effect than placebo one week after the intervention (MD of pain intensity = −0.58; p = 0.077) and at the four-week follow-up as well (MD of pain intensity = −0.52; p = 0.049). EO therapy had a beneficial effect on stiffness (a secondary outcome) compared to the no intervention group (MD = −0.77; p = 0.061). This systematic review and meta-analysis showed that topical EOs are beneficial as an add-on treatment in reducing pain and stiffness in the investigated MSDs.
... [20] Pouresmail in a study showed that the use of acupressure did not cause any complications [21] and Yip et al., found that it has overall acceptability among the patients. [22] There are some contradictory results regarding the effect of the acupressure on relieving the labor pain. For instance, Akbarzadeh showed that applying the acupressure in the laboring women is associated with labor pain relief versus no intervention. ...
Background:
Numerous studies have been conducted on the effect of acupressure on labor pain, some of which have reported conflicting results. Thus, the present study was performed to critically review the previous studies related to the effect of acupressure administered during labor for relieving labor pain.
Materials and methods:
In this study, databases of the Cochrane Central Register of the Controlled Trials, PubMed/MEDLINE, Scopus, and Web of Science were searched from their establishment until November 5, 2019. All the Randomized Controlled Trials (RCTs) that had compared the use of acupressure with either placebo or nonintervention for relieving the labor pain were included in the study. Meta-analysis was performed using the Comprehensive Meta-Analysis (CMA) software Version 2. The random-effects model was used for pooling the effect sizes across the included studies. The p value <0.05 was considered as statistically significant.
Results:
Totally, 5853 primary papers were identified in the search, which were narrowed down to 22 studies. The results of meta-analysis showed that the acupressure decreased the labor pain in the intervention group vs. control (-1.67 [-2.29 to -1.05], z = -5.25, p < 0. 001) (Q-value = 788.98, p < 0.001, I-squared = 96.83). No publication bias was found in the included studies (Egger's regression intercept = -1.02, p = 0.76).
Conclusions:
Although the findings of this meta-analysis showed that the acupressure significantly reduced the labor pain during the active phase of labor compared to the nonintervention or placebo; considering that the quality of the included studies was generally moderate, rigorous RCTs with better design and higher quality are needed to obtain definitive conclusions.
... To the current authors' knowledge, there are 2 randomized controlled trials in the literature on adult patients that studied the effects of essential-oil application to an acupoint for treating lower-back pain and chronic neck pain, 14,15 and no studies published in the literature on pediatric patients. As AAT is a novel therapeutic approach, there is currently no published peer-reviewed literature on AAT's use with adult or pediatric populations. ...
Objectives: The American Academy of Pediatrics has long recognized a need for more resources for integrative medicine for health care providers and for patients. The aim of this study was to introduce Aroma Acupoint Therapy (AAT)-a relatively new integrative medicine modality using essential oils to activate acupoints-and to describe the early experiences of providers using AAT for adolescents at school-based health centers (SBHCs). Materials and Methods: This was a case series of 15 adolescents treated with 1 of 2 AAT specific protocols plus standard medical therapy between April 2018 and February 2019 at SBHCs. Of these 15 patients, ages 12-19, 14 were female. Clinical characteristics and treatment courses were abstracted by retrospective review of the patients' electronic medical records. The main outcomes and measures for this research were clinical characteristics, treatment courses and pre- and post-treatment pain scores for adolescents treated with AAT. Results: All 15 patients had nonspecific symptoms, including headaches, menstrual cramps, nausea, shortness of breath, chest pain, back pain, or dizziness. Pain scores were recorded in 8 of 15 encounters, and suggested improvements in most patients. Subjective documentation by the providers also suggested that most of these patients had reduced symptoms. Conclusions: With the call for nonopiate and integrative approaches to pain management, there is an urgent need to study the effectiveness of such modalities, such as AAT. It is safe, inexpensive, easy to learn, and is well-received by both health care providers and patients.
... Lavender is used in complementary therapy across the world for its anti-inflammatory and analgesic effects [14]. Yip and Tse found that lavender oil in complementary therapy enhanced the physical functionality among adults with sub-acute non-specific neck pain and adults with sub-acute nonspecific low back pain [15,16]. ...
Background:
Knee osteoarthritis is considered as one of the most prevalent musculoskeletal disorders which leads to joint degeneration and consequently disability in activities of daily living. This study aimed to evaluate the effects of aromatherapy massage with lavender essence on activities of daily living of patients with knee osteoarthritis.
Methods:
This is a single-blinded, randomized clinical trial. A total of 90 patients with osteoarthritis of the knee referring to the outpatient rheumatology clinics affiliated to Birjand University of Medical Sciences were selected via convenience sampling method. The participants were randomly assigned into three groups: intervention group (aromatherapy massage with lavender essential oil), placebo group (massage with almond oil) and control group (without massage). The activities of daily living of patients was evaluated according to the Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) at baseline, immediately after the intervention, 1 week, and 4 weeks after the intervention. Data were analyzed using SPSS statistical software version 16.
Results:
The activities of daily living of patients were significantly improved immediately and 1 week after the intervention in the intervention group compared with their initial status (p < .001) and that of the control group (p < .001 and p = .03 respectively). However, 4 weeks after the intervention, there was no significant difference between the groups according to the Western Ontario and McMaster Universities Osteoarthritis index (p = .95).
Conclusion:
Aromatherapy massage with lavender essential oil may reduce the incidence of activities of daily living disability in patients with osteoarthritis of the knee. However, further studies are required to confirm findings of this study.
... Mediante esse panorama, decidiu-se por uma concentração maior que a observada em alguns trabalhos (YIP, TAM, 2008;OU et al. 2012;KIM et al. 2011;YIP, TSE, 2006.) que propunham baixas diluições (de 1,5% até 3 %) em pacientes idosos e mulheres no puerpério. ...
Introdução: A experiência da dor vivida pelo atleta de alto rendimento é tida como cotidiana e marcador de bom rendimento nos treinos e competições. Há uma crescente procura pelas terapias integrativas e complementares à saúde visando o bem-estar, qualidade de vida, rendimento e, principalmente, uma prática livre do risco de dopping. A aromaterapia, ciência que estuda o uso terapêutico dos óleos essenciais (OEs), tem mostrado resultados positivos empiricamente, porém, fazem-se necessárias pesquisas que validem tais práticas a fim de, com segurança e eficácia, servir àqueles que a necessitam e procuram. Objetivo: Avaliar o efeito dos óleos essenciais (OEs) sobre a dor no atleta de alto rendimento. Métodos: Estudo piloto quasi-experimental, cegado para o participante, com duas fases: a primeira com utilização de placebo (15 dias) denominada grupo Dor A, a segunda com OEs (15 dias) chamada grupo Dor B e um follow-up de sete dias. Amostra de conveniência composta por 26 atletas adultos de alto rendimento. A intervenção foi realizada com uma sinergia de OEs (lavanda, gengibre e sucupira) e como placebo foi utilizado óleo vegetal inerte (OV). Para a coleta de dados foram utilizados um questionário com dados sóciodemográficos e prática do esporte, recordatório de dor e tratamentos durante o período de estudo, e escalas de Humor de Brunel (BRUMS) e Inventário Breve de Dor (IBD). Para análise de dados utilizou-se o modelo de efeitos fixos e o teste de Bonferroni, teste d Cohen, além de medidas descritivas de tendência central e de variabilidade. Resultados: No início do tratamento, os 26 atletas apresentaram médias de dor de 5,2 no grupo Dor A e 5,6 no grupo Dor B. Após o tratamento com o óleo medicado houve redução de 79% na dor logo após os 15 dias de aplicação e de 81% ao final do período de follow-up (p < 0,001). O nível de tensão medido pela Escala de Humor de Brunel indicou melhora de 37%, logo após o período de aplicação do óleo medicado e 49% após o período de follow-up (p < 0,05). Conclusão: Os resultados mostraram que a sinergia de óleos essências em diluição de 10% teve efeito sobre a dor de atletas de alto rendimento em
três aplicações diárias por 15 dias e possuiu efeito residual em sete dias de follow-up (p < 0,05). Observou-se efeito sobre o humor dos atletas, com diminuição da tensão (preocupação e tensão musculoesquelética).
... In addition to fingertips, various body parts (knuckles, forearms, and heels) and blunt devices may also be used 9) . In addition, acupressure can be used in conjunction with other approaches such as lavender oil 10,11) . Acupressure is an ancient healing art, parallel to acupuncture, that is easy to learn and suitable for self-management of pain. ...
[Purpose] Low back pain (LBP) is the leading cause of global disability. Acupressure is a manual approach that can be used for self-management of LBP. The purpose of the study was to determine the effectiveness of acupressure in treating chronic LBP. [Subjects and Methods] The research design was a single system study utilizing an AB design. The subject was recruited using convenience sampling. During phase A, the subject received traditional physical therapy interventions. During phase B, the subject received acupressure in addition to traditional physical therapy interventions. Outcomes included the Visual Analog Scale (VAS), the Patient Specific Functional Scale (PSFS), and the Oswestry Disability Index (ODI). [Results] For the VAS, the pain was 38.8 mm at baseline, decreased to 11.3 mm after phase A, and decreased to 2.5 mm after phase B. For the PSFS, the subject’s function was 5/10 at baseline, remained the same after phase A, and increased to 9/10 after phase B. For the ODI, the subject’s disability was moderate (30%) at the baseline, decreased to minimal (14%) after phase A, and completely resolved (0%) after phase B. [Conclusion] The data indicated that integrating acupressure in physical therapy could reduce pain, increase function, and decrease disability.
... Yapılan çalışmalar incelendiğinde; lavanta yağı kullanılarak akupres uygulanan bir çalışmada, bireylerin bel ağrısı (%39), boyun ağrısı (%23) ve tutukluğunda (%23) azalma olduğu belirlenmiştir [24,25]. Jung'un (2012) yaşlılarda lavanta inhalasyonu yaptığı çalışmada, lavanta inhalasyonunun uyku skorunda yükselme, depresyon, fiziksel stres ve psikolojik stres skorunda ise azalma sağladığı bulunmuştur [26]. ...
... However, the number of side effects associated with these drugs has increased, and cerebrovascular adverse events, including stroke, have been noted in elderly patients with dementia taking first-generation or second-generation antipsychotic drugs [1]. Compared with pharmacological treatments, non-pharmacological treatments, such as acupressure and aromatherapy, have ameliorated agitation and cognitive impairment in dementia patients [2][3][4]. Non-pharmacological treatments are non-invasive, have fewer side effects and are safer to use [5]. Although medical scientists from many backgrounds have used acupressure in their studies to alleviate symptoms such as agitation and sleeplessness [6,7], these studies did not measure the physiological parameters associated with agitation, which weakened their evidence in support of non-pharmacological treatment effects. ...
One of the most common symptoms observed in patients with dementia is agitation, and several non-pharmacological treatments have been used to control this symptom. However, because of limitations in research design, the benefit of non-pharmacological treatments has only been demonstrated in certain cases. The purpose of this study was to compare aroma-acupressure and aromatherapy with respect to their effects on agitation in patients with dementia.
In this experimental study, the participants were randomly assigned to three groups: 56 patients were included in the aroma-acupressure group, 73 patients in the aromatherapy group, and 57 patients in the control group who received daily routine as usual without intervention. The Cohen-Mansfield Agitation Inventory (CMAI) scale and the heart rate variability (HRV) index were used to assess differences in agitation. The CMAI was used in the pre-test, post-test and post-three-week test, and the HRV was used in the pre-test, the post-test and the post-three-week test as well as every week during the four-week interventions.
The CMAI scores were significantly lower in the aroma-acupressure and aromatherapy groups compared with the control group in the post-test and post-three-week assessments. Sympathetic nervous activity was significantly lower in the fourth week in the aroma-acupressure group and in the second week in the aromatherapy group, whereas parasympathetic nervous activity increased from the second week to the fourth week in the aroma-acupressure group and in the fourth week in the aromatherapy group.
Aroma-acupressure had a greater effect than aromatherapy on agitation in patients with dementia. However, agitation was improved in both of the groups, which allowed the patients with dementia to become more relaxed. Future studies should continue to assess the benefits of aroma-acupressure and aromatherapy for the treatment of agitation in dementia patients.
ChiCTR-TRC-14004810 ; Date of registration: 2014/6/12.
... However, there are some limitations as well as side effects in these methods. It has been shown that acupressure is effective for the relief of pains in different patient populations [6], such as short-term neck pain relief and the reduction of dysmenorrheal pain [7,8]. ...
Purpose:
This study compared the therapeutic effects of collateral meridian therapy (CMT) with traditional acupoint pressure therapy (APT) in patients with unilateral upper back pain.
Material and methods:
Forty-nine patients with active myofascial trigger points in upper trapezius muscle were randomly allocated to the control (CTL), APT, or CMT group. Each subject in the CMT and APT groups received 2 sessions of treatment per week over 1 month.
Results:
Patients in the APT and CMT groups showed significant improvements 1 month after treatment in visual analogue scale, range of motion, pain pressure threshold, regional superficial blood flow, and physical health, as compared to the CTL group. No significant differences in outcome measures were found between APT and CMT groups 1 month after treatment.
Conclusion:
Both APT and CMT have comparable therapeutic efficacy in the treatment of unilateral upper back pain with active myofascial trigger points in the upper trapezius muscle.
... Recent studies have indicated interest in using complementary therapies such as heat and cold therapy, hypnotism, music therapy and aromatherapy. Aromatherapy is used for the relief of pain, anxiety, depression, insomnia and fatigue, using the existing oils in different parts of the plant such as Lavandula angustifolia (6)(7)(8)(9)(10)(11). Lavandula is a flowering plant from the Lamiaceae family, native to the western Mediterranean region. ...
Pain is a major problem in patients after cesarean and medication such as aromatherapy which is a complementary therapy, in which the essences of the plants oils are used to reduce such undesirable conditions.
In this study, the effect of aromatherapy using Lavender (Lavandula) essential oil on cesarean postoperative pain was assessed.
In a triple blind, randomized placebo-controlled trial study, 60 pregnant women who were admitted to a general hospital for cesarean section, were divided randomly into two groups. After cesarean, the Lavender group inhaled about 3 drops of 10% Lavender oil essence and the placebo group inhaled 3 drops of placebo after the start of postoperative pain, four, eight and 12 hours later, for 5 minutes from the 10 cm distance. Patient's pain was measured by the VAS (Visual Analog Scale) score before and after each intervention, and vital sign, complications and level of satisfaction of every patient were recorded before and after aromatherapy.
There was no statistically significant difference between groups in age, height, weight, and time to the first analgesic requirement. Patients in the Lavender group had less postoperative pain in four (P = 0.008), eight (P = 0.024) and 12 (P = 0.011) hours after first medication than the placebo group. The decreased heart rate and patients' level of satisfaction with analgesia were significantly higher in the Lavender group (P = 0.001). In the placebo group, the use of diclofenac suppositories for complete analgesia was also significantly higher than the Lavender group (P = 0.008).
The inhaled Lavender essence may be used as a part of the multidisciplinary treatment of pain after cesarean section, but it is not recommended as the sole pain management.
... Four studies on back or neck pain were identified, all RCTs and conducted by two groups of researchers, Hsieh et al [31,32] and Yip and Tse [33,42]. Hsieh et al unusually used a pragmatic design of four weeks of individualised acupressure compared to physical therapy. ...
Background: Shiatsu, similar to acupressure, uses finger pressure, manipulations and stretches, along Traditional Chinese Medicine meridians. Shiatsu is popular in Europe, but lacks reviews on its evidence-base.
... In contrast to these observations, the aroma of essential oil of lavender ease anxiety but not perception of pain during elective cosmetic facial injections of botulinum toxin for the correction of glabellar wrinkle [93]. A course of eight-session manual acupressure with lavender oil (3% lavender oil; used as the massage lubricant) over a three-week period in patients with nonspecific subacute neck pain (32 patients) or low back pain (61 patients) significantly alleviated the neck and back pain and improved movements of the cervical and lumbar spine [94,95]. Inhalation of lavender essential oil is suggested to be an effective and safe treatment modality in acute management of migraine headaches. ...
Lavender is traditionally alleged to have a variety of therapeutic and curative properties, ranging from inducing relaxation to treating parasitic infections, burns, insect bites, and spasm. There is growing evidence suggesting that lavender oil may be an effective medicament in treatment of several neurological disorders. Several animal and human investigations suggest anxiolytic, mood stabilizer, sedative, analgesic, and anticonvulsive and neuroprotective properties for lavender. These studies raised the possibility of revival of lavender therapeutic efficacy in neurological disorders. In this paper, a survey on current experimental and clinical state of knowledge about the effect of lavender on the nervous system is given.
... Four studies on back or neck pain were identified, all RCTs and conducted by two groups of researchers, Hsieh et al [31,32] and Yip and Tse [33,42]. Hsieh et al unusually used a pragmatic design of four weeks of individualised acupressure compared to physical therapy. ...
Shiatsu, similar to acupressure, uses finger pressure, manipulations and stretches, along Traditional Chinese Medicine meridians. Shiatsu is popular in Europe, but lacks reviews on its evidence-base.
Acupressure and Shiatsu clinical trials were identified using the MeSH term 'acupressure' in: EBM reviews; AMED; BNI; CINAHL; EMBASE; MEDLINE; PsycARTICLES; Science Direct; Blackwell Synergy; Ingenta Select; Wiley Interscience; Index to Theses and ZETOC. References of articles were checked. Inclusion criteria were Shiatsu or acupressure administered manually/bodily, published after January 1990. Two reviewers performed independent study selection and evaluation of study design and reporting, using standardised checklists (CONSORT, TREND, CASP and STRICTA).
Searches identified 1714 publications. Final inclusions were 9 Shiatsu and 71 acupressure studies. A quarter were graded A (highest quality). Shiatsu studies comprised 1 RCT, three controlled non-randomised, one within-subjects, one observational and 3 uncontrolled studies investigating mental and physical health issues. Evidence was of insufficient quantity and quality. Acupressure studies included 2 meta-analyses, 6 systematic reviews and 39 RCTs. Strongest evidence was for pain (particularly dysmenorrhoea, lower back and labour), post-operative nausea and vomiting. Additionally quality evidence found improvements in sleep in institutionalised elderly. Variable/poor quality evidence existed for renal disease symptoms, dementia, stress, anxiety and respiratory conditions. Appraisal tools may be inappropriate for some study designs. Potential biases included focus on UK/USA databases, limited grey literature, and exclusion of qualitative and pre-1989 studies.
Evidence is improving in quantity, quality and reporting, but more research is needed, particularly for Shiatsu, where evidence is poor. Acupressure may be beneficial for pain, nausea and vomiting and sleep.
The purpose of this chapter is to provide information about some health care therapies that are typically not considered mainstream. Different forms of complementary medicine are described, so clinical practitioners will be familiar with what they involve.
Background: Since the 1990's aromatherapy has been a popular adjunct to nursing and midwifery care in a variety of health care settings. Objective: The scoping review seeks to identify and confirm the benefits of incorporating aromatherapy into holistic nursing and midwifery practice Design: A scoping review using PRISMA-ScR of experimental studies where care is provided to the patient by a registered nurse or midwife. Settings and participants: Any health care setting where nurses or midwives provide care. Review Methods: A multi- engine search using a range of MeSH and non-MeSH terms with the Boolean search [AND]. Inclusion criteria were; publication date from 2005–2021, study involved aromatherapy as an intervention, conducted in a clinical nursing or midwifery environment and the published article is available in full in English. Excluded were; single patient cases, animal studies, in vitro studies, use of essential oils internally or a whole plant extract was used or use was non-nursing/midwifery related. Results: 124 studies met the inclusion criteria (n = 19188), classified into seven themes. Conclusion: The evidence supports the use of aromatherapy within a range of nursing and midwifery practices enhancing a holistic model of care. Impact: This scoping review contributes evidence to support the inclusion of aromatherapy into holistic nursing and midwifery practice.
Introduction:
Acupressure is known to be effective for some types of chronic pain. However, the effect of acupressure on chronic neck pain has not been investigated. Accordingly, the authors aimed to evaluate effects of the 4-week acupressure treatment on pain, neck function, and substance P in women with chronic neck pain.
Methods:
The acupressure treatment was performed two times a week for 4 weeks in an acupressure group (n = 24), meanwhile a control group (n = 26) was untreated. Before and after intervention, pain intensity and physical disability were measured by visual analogue scale (VAS) and neck disability index (NDI), respectively. In addition, cervical range of motion (CROM) and serum substance P were evaluated.
Results:
Results of two-way analysis of variance with repeated measures revealed that time × group interactions were significant in all outcomes (all p < 0.001) except substance P. These results indicate that after 4 weeks, VAS and NDI significantly decreased in the acupressure group compared with those changes in the control group. The CROM values for six cervical movements significantly increased in the acupressure group compared with those changes in the control group. Serum substance P did not change significantly in both groups. However, when the pre- and postintervention data from all subjects were pooled, substance P was significantly correlated with VAS (r = 20; p < 0.05; n = 100).
Conclusions:
The 4-week acupressure intervention showed significant reduction in pain and improvement in neck disability and flexibility, suggesting that acupressure intervention is an effective treatment for chronic neck pain. This study was registered with the Korean Clinical Trial Registry and WHO Clinical Trial Registry (KCT0005363).
Compression at myofascial trigger points (MTrPs), known as “ischemic compression,” has been reported to provide immediate relief of musculoskeletal pain and reduce the sympathetic activity that exacerbates chronic pain. We conducted a pilot study to investigate the possible involvement of the prefrontal cortex in pain relief obtained by MTrP compression in the present study, and analyzed the relationships among prefrontal hemodynamic activity, activity of the autonomic nervous system, and subjective pain in patients with chronic neck pain, with and without MTrP compression. Twenty-one female subjects with chronic neck pain were randomly assigned to two groups: MTrP compression (n = 11) or Non-MTrP compression (n = 10). Compression for 30 s was conducted 4 times. During the experiment, prefrontal hemodynamic activity [changes in Oxy-hemoglobin (Hb), Deoxy-Hb, and Total-Hb concentrations] and autonomic activity based on heart rate variability (HRV) were monitored by using near infrared spectroscopy (NIRS) and electrocardiography (ECG), respectively. The results indicated that MTrP compression significantly reduced subjective pain compared with Non-MTrP compression. The spectral frequency-domain analyses of HRV indicated that a low frequency (LF) component of HRV was decreased, and a high frequency (HF) component of HRV was increased during MTrP compression, while LF/HF ratio was decreased during MTrP compression. In addition, prefrontal hemodynamic activity was significantly decreased during MTrP compression compared with Non-MTrP compression. Furthermore, changes in autonomic activity were significantly correlated with changes in subjective pain and prefrontal hemodynamic activity. Along with previous studies indicating a role for sympathetic activity in the exacerbation of chronic pain, the present results suggest that MTrP compression in the neck region alters the activity of the autonomic nervous system via the prefrontal cortex to reduce subjective pain.
There is no cure for migraine, but preventive treatments are usually applied to reduce the frequency and severity of headache attacks. The purpose of this study was to investigate the effect of lavender as a prophylactic therapy for migraine in a placebo-controlled clinical trial. This double-blind and placebo-controlled study was conducted over a period of three months. Patients were assessed for migraine impact at the baseline and at the end of the study, using the Migraine Disability Assessment Scores (MIDAS) questionnaire. In the case group, after three months of lavender therapy, the MIDAS score was reduced. At the end of study, the changes in MIDAS score were significant (P = 0.001), when compared to the baseline. During the treatment, participants did not report any complaints or side effects. The results of this present study report that the frequency and severity of migraine incidents were reduced in those participants using lavender therapy during the three month trial.
Introduction: pain is a major problem after cesarean. Aromatherapy with lavender essence and Transcutaneous Electrical Nerve Stimulation (TENS) are non-chemical effective methods in reducing pain. This study was performed with aim to compare two methods of aromatherapy with lavender essence and Transcutaneous Electrical Nerve Stimulation (TENS) on Caesarean postoperative pain Methods: This single-blind randomized clinical trial study was performed on 150 pregnant women who had undergone cesarean section in 2014. The subjects were divided into 3 groups (placebo lavender essence and TENS, placebo lavender essence and TENS, lavender essence and placebo TENS). In the recovery, 100mg of rectal diclofenac suppository was administered for all groups. Then, in the recovery, vital signs and VAS of each case were evaluated and registered. 4,8 and 12 hours after cesarean, before and after the intervention, vital signs and VAS were evaluated and registered. Data analysis was performed by SPSS statistical software (version 19) and statistical tests of Shapiro-wilk and ANOVA. P Results: In the comparison of two methods of aromatherapy with lavender essence and Transcutaneous Electrical Nerve Stimulation (TENS) on cesarean postoperative pain, the results showed that the cases in TENS group had experienced the most pain decrease at 4,8 and12 hours after cesarean (P<0.001). Conclusion: TENS significantly decreases pain during 4, 8 and 12 hours after cesarean section compared to lavender essence and control groups. © 2015, Mashhad University of Medical Sciences. All rights reserved.
The aims of the present study were to explore the effectiveness of an acupressure programme in relieving chronic knee pain and depression by enhancing mobility and activities of daily living among older persons in nursing homes. It was a quasi-experimental pre- and post test control group design. The study was conducted in four nursing homes, where a total of 62 subjects suffering from chronic knee pain were randomly assigned into experimental and control groups. Acupressure sessions were given to the experimental groups twice a week over four weeks, while the control groups continued to receive the conventional care in their own nursing homes. Baseline pain intensity for the experimental and control groups was 4.69 and 4.07 respectively (p>0.05). Upon completion of the acupressure therapy, there was a significant decrease in the mean pain score in the experimental group, from 4.69 to 1.59 (p<0.001), a significantly decreased depression level and improved mobility and activities of daily living (p<0.05). This finding suggests that acupressure is an effective non-pharmacological intervention for relieving chronic knee pain in nursing home residents.
Presently, using complementary therapy such as lavender oil has specific application in medicine. The purpose of this study was to investigate the effect of aromatherapy massage on the severity of primary dysmenorrhea in nursing and midwifery students of Islamic Azad University of Arsanjan, Iran.
This study was performed using clinical trial method on 80 eligible students whose level of pain was measured by visual analogue scale (VAS) before the intervention. Each participant, in the first days of menstruation, randomly received two types of massage with lavender and placebo oil in two consecutive cycles of menstruation. Their level of pain was measured before and 30 min after the intervention. In this study, each group was considered as their self-control group in the next cycle. The data were analyzed by SPSS software.
A significant decrease in VAS score after lavender massage was detected in comparison with placebo massage. There was a statistically significant difference between VAS scores after and before placebo massage. In addition, statistically the effect of lavender massage on the severity of primary dysmenorrhea was higher than that of placebo massage (P < 0.001).
Findings of this study showed that lavender oil massage decreases primary dysmenorrhea and it can be used as an effective herbal drug.
Objectives:
To assess the efficacy of aromatic essential oils on neck pain.
Design:
Sixty participants with a history of neck pain and Neck Disability Index (NDI) score >10% were selected and randomly divided into control and experimental groups.
Setting:
Motion analysis laboratory at Hungkuang University.
Intervention:
For the experimental group, the intervention included 3% concentration cream composed of four essential oils: marjoram, black pepper, lavender, and peppermint. For the control group, only an unscented cream was provided. For 4 weeks, all patients applied 2 g cream directly to the affected area daily after showering or bathing.
Outcome measures:
Assessment was performed by using a visual analogue scale (VAS), NDI, pressure pain threshold (PPT) evaluated with a pressure meter, and neck-joint range evaluated with Motion Analysis System (MAS).
Results:
A t-test statistical analysis by SPSS statistical software indicated that VAS scores improved significantly for both groups (p<0.05). In addition, the experimental group had improved pain tolerance in the left upper trapezius (mean±standard deviation, 2.96±2.54) and right upper trapezius (2.88±2.90) as measured by the PPT. According to the NDI, the experimental group also showed significant improvement (p=0.02). Comparison of MAS values before and after the intervention showed significant improvement in the 10 motion areas in the experimental group. This finding suggests that the experimental group had better results than the control group.
Conclusion:
The essential oil cream developed in this study can be used to improve neck pain. This study appears to be the first to quantify this by using PPT and MAS.
Background:
The prevalence of mechanical neck disorders (MND) is known to be both a hindrance to individuals and costly to society. As such, massage is widely used as a form of treatment for MND.
Objectives:
To assess the effects of massage on pain, function, patient satisfaction, global perceived effect, adverse effects and cost of care in adults with neck pain versus any comparison at immediate post-treatment to long-term follow-up.
Search methods:
We searched The Cochrane Library (CENTRAL), MEDLINE, EMBASE, MANTIS, CINAHL, and ICL databases from date of inception to 4 Feburary 2012.
Selection criteria:
Studies using random assignment were included.
Data collection and analysis:
Two review authors independently conducted citation identification, study selection, data abstraction and methodological quality assessment. Using a random-effects model, we calculated the risk ratio and standardised mean difference.
Main results:
Fifteen trials met the inclusion criteria. The overall methodology of all the trials assessed was either low or very low GRADE level. None of the trials were of strong to moderate GRADE level. The results showed very low level evidence that certain massage techniques (traditional Chinese massage, classical and modified strain/counter strain technique) may have been more effective than control or placebo treatment in improving function and tenderness. There was very low level evidence that massage may have been more beneficial than education in the short term for pain bothersomeness. Along with that, there was low level evidence that ischaemic compression and passive stretch may have been more effective in combination rather than individually for pain reduction. The clinical applicability assessment showed that only 4/15 trials adequately described the massage technique. The majority of the trials assessed outcomes at immediate post-treatment, which is not an adequate time to assess clinical change. Due to the limitations in the quality of existing studies, we were unable to make any firm statement to guide clinical practice. We noted that only four of the 15 studies reported side effects. All four studies reported post-treatment pain as a side effect and one study (Irnich 2001) showed that 22% of the participants experienced low blood pressure following treatment.
Authors' conclusions:
No recommendations for practice can be made at this time because the effectiveness of massage for neck pain remains uncertain.As a stand-alone treatment, massage for MND was found to provide an immediate or short-term effectiveness or both in pain and tenderness. Additionally, future research is needed in order to assess the long-term effects of treatment and treatments provided on more than one occasion.
Lavender essential oil has been used as an anxiolytic drug, a mood stabilizer, a sedative, spasmolytic, antihypertensive, antimicrobial, analgesic agent as well as a wound healing accelerator. We have studied for the first time the efficacy of lavender essential oil inhalation for the treatment of migraine in a placebo-controlled clinical trial.
Forty-seven patients with definite diagnosis of migraine headache were divided into cases and controls. Cases inhaled lavender essential oil for 15 min, whereas the control group used liquid paraffin for the same time period. Patients were asked to record their headache severity and associated symptoms in 30-min intervals for a total of 2 h. We matched the two groups for key confounding factors.
The mean reduction of headache severity in cases was 3.6 ± 2.8 based on Visual Analogue Scale score. The reduction was 1.6 ± 1.6 in controls. This difference between the controls and cases was statistically significant with p < 0.0001. From 129 headache attacks in cases, 92 responded entirely or partially to lavender. In the control group, 32 out of 68 recorded headache attacks responded to placebo. The percentage of responders was significantly higher in the lavender group than the placebo group (p = 0.001).
The present study suggests that inhalation of lavender essential oil may be an effective and safe treatment modality in acute management of migraine headaches.
The aim of this study was to determine the effects of workplace manual technique interventions for female participants on the degree of joint range of motion and on the level of musculoskeletal ache, pain, or discomfort experienced when performing workplace responsibilities.
Nineteen (19) female volunteers were given chair massages on-site twice per week for 1 month.
Participants included individuals in administration and management from a company in Ljubljana, Slovenia.
A total of 19 female volunteers 40-54 years of age enrolled for this study. Fifteen (15) of them completed all measurements.
The Cornell Musculoskeletal Discomfort Questionnaire was used, and range-of-motion measurements in degrees were taken.
Subjects completed a series of self-report questionnaires that asked for information concerning musculoskeletal discomfort for the neck, upper back, and lower back in the form of a body diagram. A range-of-motion test (to compare the change in joint angles) was performed with a goniometer to assess cervical lateral flexion, cervical flexion, cervical extension, lumbar flexion, and lumbar extension.
Between the first and the last measurements, a significant difference (p<0.05) was found in increased range of motion for cervical lateral flexion (28.8%). Wilcoxon signed rank test showed a significant increase (p<0.05) in range of motion for cervical lateral flexion (42.4±6.3 to 48.3±7.3), cervical extension (63.2±12.4 to 67.2±12.3), and a significant decrease (p<0.05) in the Cornell Musculoskeletal Discomfort Questionnaire values for the neck (2.7±0.8 to 1.9±0.6) and the upper back (2.7±0.7 to 2.2±0.8) from the phase 2 to 3. Significant reductions were also shown in the Cornell Musculoskeletal Discomfort Questionnaire values for the neck (2.8±0.8 to 1.9±0.6) and the upper back (2.7±0.8 to 2.2±0.8) from the phase 1 to 3.
On-site massage sessions twice per week for 1 month are the most effective interventions (compared to one session or no massage intervention) for decreasing the duration of musculoskeletal ache, pain, or discomfort and for increasing range of motion.
Musculoskeletal system complaints are one of the most common reasons that patients seek medical care. A significant number of these patients use complementary and alternative medicine. This article discusses the most common musculoskeletal problems for which patients present to a physician's office. These include osteoarthritis, rheumatoid arthritis, low back pain, neck pain, and myofascial pain syndrome.
The purpose of this pilot study was to examine the immediate effects of a manual therapy technique called Inhibitive Distraction (ID) on active range of motion (AROM) for cervical flexion in patients with neck pain with or without concomitant headache. A secondary objective of this study was to see whether patient subgroups could be identified who might benefit more from ID by studying variables such as age, pain intensity, presence of headache, or pre-intervention AROM. We also looked at patients' ability to identify pre- to post-intervention changes in their ability to actively move through a range of motion. Forty subjects (mean age 34.7 years; range 16-48 years) referred to a physical therapy clinic due to discomfort in the neck region were randomly assigned to an experimental and a control group. We used the CROM goniometer to measure pre- and post-intervention cervical flexion AROM in the sagittal plane within a single treatment session. The between-group difference in AROM increase was not statistically significant at P<0.05 with a mean post-intervention increase in ROM of 2.4 degrees (SD 6.2 degrees ) for the experimental group and 1.2 degrees (SD 5.8 degrees ) for the placebo group. We were also unable to identify potential subgroups more likely to respond to ID, although a trend emerged for greater improvement in chronic patients with headaches, lower pain levels, and less pre-intervention AROM. In the experimental group and in both groups combined, subjects noting increased AROM indeed had a significantly greater increase in AROM than those subjects not noting improvement. In conclusion, this study did not confirm immediate effects of ID on cervical flexion AROM but did provide indications for potential subgroups likely to benefit from this technique. Recommendations are provided with regard to future research and clinical use of the technique studied.
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.
We compared the effectiveness of frequently used treatments for nonspecific neck pain in general practice. We found that manual therapy was more effective than continued care, and our results consistently favored manual therapy on almost all outcome measures. Although physical therapy scored slightly better than continued care, most of the differences were not statistically significant. In addition, although manual therapy seemed to be more effective than physical therapy, differences were small for all outcome measures except perceived recovery and were not always statistically significant. The magnitude of the differences between manual therapy and physical therapy, but also between manual therapy and continued care, were most pronounced for perceived recovery. Because perceived recovery combines other outcomes, such as pain, disability, and patient satisfaction, it may be the most responsive outcome measure. For pain intensity, statistically significant differences among the treatment groups ranged from 0.9 to 1.5 on a scale of 0 to 10. Although smaller differences could have been detected with larger sample sizes, they would not have been clinically relevant.
To compare the prevalence of low back pain and associated disability in Hong Kong with that in Britain, and to explore whether differences could be explained by certain known risk factors.
A cross sectional survey with information collected at interview. Findings were compared with those from an earlier survey in Britain.
Two housing blocks in Hong Kong.
Altogether 288 men and 364 women aged 18 years or older, who were resident in the two housing blocks and agreed to interview (response rate = 80%).
Thirty nine per cent (95% confidence interval (CI) 34%, 44%) of interviewees reported having had low back pain at some time, and 21% (95% CI 18%, 25%) had had low back pain in the past 12 months. After standardisation for age and sex, all of the back symptoms examined were substantially less common in Hong Kong than in Britain. The one year period prevalence of low back pain was associated with occupational lifting (in both sexes) and with tall stature (in men only). Subjects tended to carry out less heavy lifting at work and to be shorter than participants in the earlier British study but these differences did not completely explain their lower prevalence of back pain.
The findings indicate a lower prevalence of back symptoms in Hong Kong than Britain that is partly explained by differences in stature and occupational lifting. In addition, Hong Kong people may have a higher threshold for reporting symptoms, or they may differ in their exposure to other, unrecognised risk factors.
Neck pain occurs frequently in western societies. In the majority of cases, no specific cause can be identified. In order to gain insight into the clinical course and prognostic factors of non-specific neck pain, a systematic review was conducted. A computerized literature search was carried out to identify observational studies on non-specific neck pain and randomized clinical trials (RCTs) on conservative treatment of non-specific neck pain. Two reviewers scored independently, the methodological quality of all identified publications, using a standardized set of 13 criteria which were divided into five categories according to: study population, study design, follow-up, outcome measures and analysis/data presentation. To determine prognosis per study, an overall percentage of recovery for the most important outcome measures (pain, general improvement, functional status, health care utilization and lost days of work) was calculated. In total 23 eligible publications were identified (six observational studies and 17 RCTs). Only seven of 23 studies scored 50% or more of the 13 items, indicating a generally poor quality of methods. The most prevalent methodological shortcomings appeared to be selection of the study population, the sample size and analysis techniques. Most information regarding the clinical course is available for the group of patients with complaints for more than 6 months, who are treated in a secondary care or an occupational setting. In this group of patients, 46% (median) had less pain, with a range of 22-79% and a general improvement that ranged between 37 and 95% (47% median). The reduction in the use of analgesics ranged between 32 and 80% (37% median). Six studies reported on prognostic factors. Bearing in mind the limited number of studies and the low methodological quality, there are some indications that the localization (radiation to the arms/neurologic signs) and radiologic findings (degenerative changes in the discs and joints) are not associated with a worse prognosis. A higher severity of pain and a history of previous attacks however, seems to be associated with a worse prognosis.
To establish whether there is evidence for or against the efficacy of acupuncture in the treatment of neck pain.
A systematic literature review was undertaken of studies that compared needle or laser acupuncture with a control procedure for the treatment of neck pain. Two reviewers independently extracted data concerning study methods, quality and outcome.
Overall, the outcomes of 14 randomized controlled trials were equally balanced between positive and negative. Acupuncture was superior to waiting-list in one study, and either equal or superior to physiotherapy in three studies. Needle acupuncture was not superior to indistinguishable sham control in four out of five studies. Of the eight high-quality trials, five were negative.
In conclusion, the hypothesis that acupuncture is efficacious in the treatment of neck pain is not based on the available evidence from sound clinical trials. Further studies are justified.
The development and testing of a new comprehensive measure of neck pain and disability, the Neck Pain and Disability Scale.
To provide an initial evaluation of the Neck Pain and Disability Scale's reliability and validity.
Although several measures exist for generalized pain and disability, none is specific for neck pain. More specific measurements should improve assessment of treatments and clinical research aimed at cervical pain syndromes.
The Neck Pain and Disability Scale was designed using the Million Visual Analogue Scale as a template and consists of 20 items that assess neck pain. In this study, 100 patients with neck pain, 52 patients with lower back and leg pain, and 27 pain-free volunteers were rated by the Neck Pain and Disability Scale. In addition, a subset of the 47 patients with neck pain were rated by several other established psychometric instruments.
An item analysis showed a high degree of internal consistency among the 20 items on the Neck Pain and Disability Scale (r = 0.93), and face validity was established by comparing patients who had neck pain as well as lower back and leg pain with a pain-free group. The Neck Pain and Disability Scale scores correlated with the Oswestry Disability Questionnaire, the Pain Disability Index, and psychological measures of depression and neuroticism.
The results suggest a highly reliable instrument for evaluating neck pain with at least four underlying dimensions. Further work to address the predictive validity of this new tool are under way.
Aromatherapy is becoming increasingly popular; however there are few clear indications for its use. To systematically review the literature on aromatherapy in order to discover whether any clinical indication may be recommended for its use, computerised literature searches were performed to retrieve all randomised controlled trials of aromatherapy from the following databases: MEDLINE, EMBASE, British Nursing Index, CISCOM, and AMED. The methodological quality of the trials was assessed using the Jadad score. All trials were evaluated independently by both authors and data were extracted in a pre-defined, standardised fashion. Twelve trials were located: six of them had no independent replication; six related to the relaxing effects of aromatherapy combined with massage. These studies suggest that aromatherapy massage has a mild, transient anxiolytic effect. Based on a critical assessment of the six studies relating to relaxation, the effects of aromatherapy are probably not strong enough for it to be considered for the treatment of anxiety. The hypothesis that it is effective for any other indication is not supported by the findings of rigorous clinical trials.
To translate and assess the reliability and the construct validity of 3 functional disability scales for neck pain.
Reliability and validity study.
Tertiary care teaching hospital and outpatient clinic.
One hundred one patients (mean age, 49 y).
French translations were obtained by using the "translation-backward translation" method. Adaptations were made after a pilot study.
Impairment outcome measures (visual analog scale [VAS] pain, neck range of motion, morning stiffness, score of neck sensitivity, radiologic score of Kellgren) and patients' perceived handicap (VAS) were recorded at the baseline visit. Three functional disability scales (Neck Disability Index [NDI], Neck Pain and Disability Scale [NPDS], Northwick Park Neck Pain Questionnaire [NPQ]) were recorded twice, at baseline visit and 24 hours later. Reliability was assessed by using the intraclass correlation coefficient (ICC) and the Bland and Altman method. Construct (convergent and divergent) validity was investigated by using the Spearman rank correlation coefficient and a factor analysis was performed.
Test-retest was excellent for the NPDS and NDI (ICC =.91,.93, respectively) and good for the NPQ (ICC =.84). The Bland and Altman method showed no systematic trend. Expected convergent and divergent validity were observed only for the NPDS; 3 main factors were extracted by factor analysis and explained 78% of the cumulative variance.
The 3 translated scales are valid, but the NPDS seems to have the best construct validity.
This study was designed to assess the olfactory impact of the essential oils of lavender (Lavandula angustifolia) and rosemary (Rosmarlnus officinalis) on cognitive performance and mood in healthy volunteers. One hundred and forty-four participants were randomly assigned to one of three independent groups, and subsequently performed the Cognitive Drug Research (CDR) computerized cognitive assessment battery in a cubicle containing either one of the two odors or no odor (control). Visual analogue mood questionnaires were completed prior to exposure to the odor, and subsequently after completion of the test battery. The participants were deceived as to the genuine aim of the study until the completion of testing to prevent expectancy effects from possibly influencing the data. The outcome variables from the nine tasks that constitute the CDR core battery feed into six factors that represent different aspects of cognitive functioning. Analysis of performance revealed that lavender produced a significant decrement in performance of working memory, and impaired reaction times for both memory and attention based tasks compared to controls. In contrast, rosemary produced a significant enhancement of performance for overall quality of memory and secondary memory factors, but also produced an impairment of speed of memory compared to controls. With regard to mood, comparisons of the change in ratings from baseline to post-test revealed that following the completion of the cognitive assessment battery, both the control and lavender groups were significantly less alert than the rosemary condition; however, the control group was significantly less content than both rosemary and lavender conditions. These findings indicate that the olfactory properties of these essential oils can produce objective effects on cognitive performance, as well as subjective effects on mood.
Few treatments for back pain are supported by strong scientific evidence. Conventional treatments, although widely used, have had limited success. Dissatisfied patients have, therefore, turned to complementary and alternative medical therapies and providers for care for back pain.
To provide a rigorous and balanced summary of the best available evidence about the effectiveness, safety, and costs of the most popular complementary and alternative medical therapies used to treat back pain.
MEDLINE, EMBASE, and the Cochrane Controlled Trials Register.
Systematic reviews of randomized, controlled trials (RCTs) that were published since 1995 and that evaluated acupuncture, massage therapy, or spinal manipulation for nonspecific back pain and RCTs published since the reviews were conducted.
Two authors independently extracted data from the reviews (including number of RCTs, type of back pain, quality assessment, and conclusions) and original articles (including type of pain, comparison treatments, sample size, outcomes, follow-up intervals, loss to follow-up, and authors' conclusions).
Because the quality of the 20 RCTs that evaluated acupuncture was generally poor, the effectiveness of acupuncture for treating acute or chronic back pain is unclear. The three RCTs that evaluated massage reported that this therapy is effective for subacute and chronic back pain. A meta-regression analysis of the results of 26 RCTs evaluating spinal manipulation for acute and chronic back pain reported that spinal manipulation was superior to sham therapies and therapies judged to have no evidence of a benefit but was not superior to effective conventional treatments.
Initial studies have found massage to be effective for persistent back pain. Spinal manipulation has small clinical benefits that are equivalent to those of other commonly used therapies. The effectiveness of acupuncture remains unclear. All of these treatments seem to be relatively safe. Preliminary evidence suggests that massage, but not acupuncture or spinal manipulation, may reduce the costs of care after an initial course of therapy.
Aromatherapy is becoming increasingly popular; however there are few clear indications for its use. To systematically review the literature on aromatherapy in order to discover whether any clinical indication may be recommended for its use, computerised literature searches were performed to retrieve all randomised controlled trials of aromatherapy from the following databases: MEDLINE, EMBASE, British Nursing Index, CISCOM, and AMED. The methodological qualify of the trials was assessed using the Jadad score. All trials were evaluated independently by both authors and data were extracted in a pre-defined, standardised fashion. Twelve trials were located: six of them had no independent replication; six related to the relaxing effects of aromatherapy combined with massage. These studies suggest that aromatherapy massage has a mild, transient anxiolytic effect Based on a critical assessment of the six studies relating to relaxation, the effects of aromatherapy are probably not strong enough for it to be considered for the treatment of anxiety. The hypothesis that it is effective for any other indication is not supported by the findings of rigorous clinical trials.
Background
Acupuncture is commonly used to treat back pain, but there is no published meta-analysis of trials of its effectiveness for this condition.Objective
To perform a meta-analysis of trials of acupuncture for the treatment of back pain.Methods
A systematic literature search was conducted to retrieve all randomized controlled trials of any form of acupuncture for any type of back pain in humans. The adequacy of the acupuncture treatment was assessed by consulting 6 experienced acupuncturists. The main outcome measure for the meta-analysis was numbers of patients whose symptoms were improved at the end of treatment.Results
Twelve studies were included, of which 9 presented data suitable for meta-analysis. The odds ratio of improvement with acupuncture compared with control intervention was 2.30 (95% confidence interval, 1.28-4.13). For sham-controlled, evaluator-blinded studies, the odds ratio was 1.37 (95% confidence interval, 0.84-2.25).Conclusion
Acupuncture was shown to be superior to various control interventions, although there is insufficient evidence to state whether it is superior to placebo.
Study Design. The development and testing of a new comprehensive measure of neck pain and disability, the Neck Pain and Disability Scale. Objectives. To provide an initial evaluation of the Neck Pain and Disability Scale’s reliability and validity. Summary of Background data. Although several measures exist for generalized pain and disability, none is specific for neck pain. More specific measurements should improve assessment of treatments and clinical research aimed at cervical pain syndromes. Methods. The Neck Pain and Disability Scale was designed using the Million Visual Analogue Scale as a template and consists of 20 items that assess neck pain. In this study, 100 patients with neck pain, 52 patients with lower back and leg pain, and 27 pain-free volunteers were rated by the Neck Pain and Disability Scale. In addition, a subset of the 47 patients with neck pain were rated by several other established psychometric instruments. Results. An item analysis showed a high degree of internal consistency among the 20 items on the Neck Pain and Disability Scale (r = 0.93), and face validity was established by comparing patients who had neck pain as well as lower back and leg pain with a pain-free group. The Neck Pain and Disability Scale scores correlated with the Oswestry Disability Questionnaire, the Pain Disability Index, and psychological measures of depression and neuroticism. Conclusions. The results suggest a highly reliable instrument for evaluating neck pain with at least four underlying dimensions. Further work to address the predictive validity of this new tool are under way.
ZusammenfassungDie klinische Effektivität der Massage – eine kritische Übersicht Hintergrund: Massagen gehören zu den ältesten Heilverfahren und werden häufig angewandt. Bisher wurde jedoch noch keine Analyse der klinischen Wirksamkeit publiziert. Zielsetzung: Eine kritische Übersicht der verfügbaren Literatur zur klinischen Wirksamkeit von klassischer Massage. Methoden: Computerisierte Medline-Literatursuche (1970-1993).Überprüfung unse-rer eigenen Dokumentation sowie von Literaturangaben in identifizierten Publikationen und Lehrbüchern. Unserer anfänglichen Absicht, nur kontrollierte Studien in die Analyse einzuschliessen, konnte nicht Folge geleistet werden, da kontrollierte klinische Studien in diesem Segment extrem selten sind. Ergebnisse: Die mangelhafte wissenschaftliche Qualität der gefundenen Studien war auffallend. Nur wenige wissenschaftlich erwiesenen Indikationen konnten gefunden werden; sogar diese waren weniger etabliert als es heutige wissenschaftliche Standards erfordern. Dies kontrastiert scharf mit den Indikationslisten, die gewöhnlich für Massagebehandlungen gegeben werden. Schlussfolgerungen: Für Massagebehandlungen herrscht eine offensichtliche Diskre-panz zwischen klinischer Erfahrung und wissenschaftlicher Evidenz.Copyright © 1994 S. Karger AG, Basel
The incidence of low back pain in the United States continues to increase, with four out of five adults experiencing low back pain in their lifetime. This poses a substantial cost to consumers and insurers alike. With more people seeking complementary alternative medicine as a means to a cost-effective treatment, the scientific community is seeking to study the efficacy of these treatments. Approximately $21.2 billion was spent on complementary alternative medicine therapies in 1997. Massage therapy is rapidly becoming a notable part of the complementary approach continuum. To recognize the contribution of massage therapy, a deeper understanding of its approaches and limitations must be clearly delineated. Research into therapeutic massage is limited by lack of a uniform definition of low back pain, lack of a uniform definition of what constitutes massage therapy, difficulty in blinding studies, and variable outcome measures. Despite these research limitations, those studies that have been completed have supported the safe and effective application of massage modalities. To initiate the interface between allopathic physicians and massage therapists, an understanding of the scope of practice, components of safe practice, general precautions and contraindications, and massage techniques with associated benefits must be described thoroughly. To provide a clear example of the application of massage to low back pain, one protocol has been selected as representative. A working relationship between the physician and the massage therapist is good for their patients/clients, which in turn is good medicine for the changing trends in health care provision.
Background. Traditional Chinese acupressure is a noninvasive technique that employs pressure and massage to acupoints in order to stimulate the balance of life energy that promotes health and comfort. Sleep disturbance is common in patients with end-stage renal disease but no intervention studies have addressed this problem.
Aim. The purpose of the present study was to test the effectiveness of acupoints massage for patients with end-stage renal disease and experiencing sleep disturbances and diminished quality of life.
Methods. The study was a randomized control trial. A total of 98 end-stage renal disease patients with sleep disturbances were randomly assigned into an acupressure group, a sham acupressure group, and a control group. Acupressure and sham acupressure group patients received acupoints or no acupoints massage three times a week during haemodialysis treatment for a total of 4 weeks. The measures included the Pittsburgh Sleep Quality Index, Sleep Log, and the Medical Outcome Study – Short Form 36.
Findings. The results indicated significant differences between the acupressure group and the control group in Pittsburgh Sleep Quality Index subscale scores of subjective sleep quality, sleep duration, habitual sleep efficiency, sleep sufficiency, and global Pittsburgh Sleep Quality Index scores. Sleep log data revealed that the acupressure group significantly decreased wake time and experienced an improved quality of sleep at night over the control group. Medical Outcome Study – Short Form 36 data also documented that acupressure group patients experienced significantly improved quality of life.
Conclusion. This study supports the effectiveness of acupoints massage in improving the quality of sleep and life quality of end-stage renal disease patients, and offers a noninvasive therapy for sleep-disturbed patients.
There is widespread belief that the use of aromatherapy and massage in an intensive care environment offers a means of increasing the quality of sensory input that patients receive, as well as reducing levels of stress and anxiety. Despite a wealth of anecdotal evidence in support of these claims, there have been few objective studies to evaluate the effects of these therapies. In this experimental study 122 patients admitted to a general intensive care unit were randomly allocated to receive either massage, aromatherapy using essential oil of lavender, or a period of rest. Both pre- and post-therapy assessments included physiological stress indicators and patients' evaluation of their anxiety levels, mood and ability to cope with their intensive care experience. Ninety-three patients (77%) were able to complete subjective assessments. There were no statistically significant differences in the physiological stress indicators or observed or reported behaviour of patients' ability to cope following any of the three interventions. However, those patients who received aromatherapy reported significantly greater improvement in their mood and perceived levels of anxiety. They also felt less anxious and more positive immediately following the therapy, although this effect was not sustained or cumulative.
Jane Buckle presents the results of a randomised, double-blind trial of two essential oils of two different species of lavender, topically applied on post-cardiotomy patients. The emotional and behavioural stress levels of 28 patients were evaluated pre- and post-treatment on two consecutive days. The therapeutic effects of the two lavenders appeared to be different: one was almost twice as effective as the other, thereby disproving the hypothesis that aromatherapy, using topical application of essential oils, is effective purely because of touch, massage or placebo.
Neck pain has been found to be a prevalent musculoskeletal complaint among Caucasians living in Europe and North America. The prevalence of and risk factors for this condition have not been studied among Chinese living in urbanised cities. The objective of this study was to describe the prevalence of and risk factors for neck pain in Hong Kong Chinese.
A household survey was conducted in two housing blocks, one being government-subvented housing and the other being private housing. Eight hundred men and women who were 30 years and older were interviewed on the occurrence and characteristics of neck pain, occupations and recreational activities. The life-time and one-year prevalence of neck pain were calculated, and the odds ratio (OR) and 95 per cent confidence intervals (95 per cent CI) for various risk factors were derived by logistic regression.
The one-year prevalence of neck pain was 15 per cent and 17 per cent in men and women, respectively. The OR was 1.6 (95 per cent CI = 1.2-2.4) for living in private housing and 2.1 (95 per cent CI = 1.1-4.0) for working as managers and professionals. Subjects with neck pain spent more time reading and a history of trauma to the neck was a significant risk factor for subsequent pain (OR = 5.6, 95 per cent CI = 3.3-9.4).
Neck pain is a prevalent problem in Hong Kong Chinese, particularly among subjects of a high socioeconomic status. There was little association between life-style and neck pain, although subjects with neck pain spent more time in reading.
Acupuncture is commonly used to treat back pain, but there is no published meta-analysis of trials of its effectiveness for this condition.
To perform a meta-analysis of trials of acupuncture for the treatment of back pain.
A systematic literature search was conducted to retrieve all randomized controlled trials of any form of acupuncture for any type of back pain in humans. The adequacy of the acupuncture treatment was assessed by consulting 6 experienced acupuncturists. The main outcome measure for the meta-analysis was numbers of patients whose symptoms were improved at the end of treatment.
Twelve studies were included, of which 9 presented data suitable for meta-analysis. The odds ratio of improvement with acupuncture compared with control intervention was 2.30 (95% confidence interval, 1.28-4.13). For sham-controlled, evaluator-blinded studies, the odds ratio was 1.37 (95% confidence interval, 0.84-2.25).
Acupuncture was shown to be superior to various control interventions, although there is insufficient evidence to state whether it is superior to placebo.
A prospective observational study on the use of the Aberdeen Low Back Pain Disability Scale.
To evaluate the reliability, validity, and responsiveness of the Chinese adaptation of the Aberdeen Low Back Pain Scale in Chinese patients in Hong Kong who have back pain.
Frontline clinicians, researchers, and health care managers in Hong Kong are urgently in need of a Chinese adaptation of a low back pain outcome measure that has been subjected to a rigorous process of psychometric and clinical testing.
Four samples with 473 consecutive adult patients with low back pain from six physiotherapy outpatient departments in Hong Kong who completed the Aberdeen Low Back Pain Scale were observed and measured at time points including the beginning physiotherapy; 10 days, 3 weeks, and 6 weeks after physiotherapy; and when discharged from treatment.
The test-retest reliability coefficient was 0.94 (0.94 in the original English version; figures from the English version are reported in parentheses). The Cronbach alpha coefficient was 0.85 (0.80). The Spearman correlation coefficient, when the Aberdeen score was correlated with that of a generic current 42-item questionnaire regarding the patient's perceived health to establish cross-sectional construct validity, was 0.59 (0.36-0.66, with the Short Form 36 scale). The effect sizes (responsiveness) at weeks 3 and 6 after treatment began were 0.59 and 0.81, respectively (a high of 0.62 reported in the English version).
The Chinese version of the Aberdeen Low Back Pain Disability Scale retained the high levels of reliability, validity, and responsiveness of the original English version when tested in Hong Kong in four samples of Chinese patients with low back pain.
Several types of physical therapy are used in the management of painful musculoskeletal disorders. These treatment modalities can be broadly categorized as electrotherapy modalities (e.g., transcutaneous electrical nerve stimulation), acupuncture, thermal modalities (e.g., moist heat, ultrasound), manual therapies (e.g., manipulation or massage), or exercise. Within each of these broad categories significant variations in treatment parameters are possible.
To consider the evidence base for each of these main categories of physical therapy in the management of musculoskeletal pain.
To consider the available evidence related to clinical effectiveness and then to review evidence from basic science studies evaluating potentially therapeutic effects of the various therapies.
There seems to be evidence from basic science research to suggest that many of the therapies could have potentially therapeutic effects. However, there appears to be limited high-quality evidence from randomized clinical trials to support the therapeutic effectiveness of several of the therapies.
There is some preliminary evidence to support the use of manual therapies, exercise, and acupuncture in the management of some categories of musculoskeletal pain. Limitations of the existing research base are discussed and recommendations for areas of future research are provided.
Essential oils distilled from members of the genus Lavandula have been used both cosmetically and therapeutically for centuries with the most commonly used species being L. angustifolia, L. latifolia, L. stoechas and L. x intermedia. Although there is considerable anecdotal information about the biological activity of these oils much of this has not been substantiated by scientific or clinical evidence. Among the claims made for lavender oil are that is it antibacterial, antifungal, carminative (smooth muscle relaxing), sedative, antidepressive and effective for burns and insect bites. In this review we detail the current state of knowledge about the effect of lavender oils on psychological and physiological parameters and its use as an antimicrobial agent. Although the data are still inconclusive and often controversial, there does seem to be both scientific and clinical data that support the traditional uses of lavender. However, methodological and oil identification problems have severely hampered the evaluation of the therapeutic significance of much of the research on Lavandula spp. These issues need to be resolved before we have a true picture of the biological activities of lavender essential oil.
Chronic pain is prevalent in many Western countries. Its prevalence in a non-Caucasian population is not known. The authors performed this study to measure the prevalence of chronic pain in the Hong Kong Chinese adult population, as well as the pattern of pain and the demographic characteristics, the impact on social and work function, and the help-seeking behavior of those with pain.
Cross-sectional survey using telephone interview with a structured questionnaire. Chronic pain was defined as pain persisting for more than 3 months.
A random sample of over 1,000 persons out of the entire Chinese adult population of Hong Kong.
One thousand fifty-one adults were interviewed. One hundred thirteen (10.8% [95% C.I.: 8.9%-12.7%]) had chronic pain. The median number of pains was two. Of those with chronic pain, 38.3% reported their work was affected, and 19.8% had taken a median of 5 days' sick leave in the past year; 70.8% said the pain had interfered with their daily life, 88.5% had tried self-treatment, and 74.3% had sought medical advice. Only 35.7% considered the treatment definitely helpful. Two risk factors were identified: the female gender (O.R. 1.5, 95% C.I. 1.0-2.3) and age greater than 60 (O.R. 2.2, 95% C.I. 1.3-3.6).
The study showed that the prevalence of chronic pain in Hong Kong adults was approximately 10.8%. Work and daily life are significantly affected and there is considerable demand on the health care system. Despite the ethnic difference, the prevalence, pattern, and demographic characteristics of chronic pain in Hong Kong are very similar to those seen in Western countries.
The purpose of the study is to test the effectiveness of acupressure on sleep quality of end-stage renal disease patients. The study was a randomized controlled trial; qualified patients in the dialysis centers of four major hospitals were randomly assigned into an acupressure group, a sham acupressure group, and a control group. A total of 98 participants were included in the study. The main outcomes measured were the Pittsburgh sleep quality index (PSQI) and the sleep log. Data were collected at pretreatment and following treatment. Primary statistical analysis was by means of Analysis of Covariance, the Kruskal-Wallis Test and repeated measure ANOVA. The results indicated that PSQI scores of the acupressure group have a significantly greater improvement (p < 0.01) than the control group. However, there were no differences between the acupressure group and the sham group or the sham group and the control group (p > 0.05). Subscales of PSQI were further analyzed. Results demonstrated significant differences between the acupressure group and the control group in subjective sleep quality (p = 0.009), sleep duration (p = 0.004), habitual sleep efficiency (p = 0.001), and sleep sufficiency (p = 0.004). Significant differences in the subscale of subjective sleep quality (p = 0.003) between the sham acupressure group and the control group were also observed. Sleep log data showed that the acupressure group significantly decreased awake time and improved quality of sleep over time more than the control group (p < 0.01). The improvement could be seen as soon as the acupoints massage was implemented, and it was maintained through the post intervention.
To compare the effects of real acupuncture to tender points for neck and shoulder pain and stiffness (Japanese: katakori) with those of sham acupuncture.
Randomized-controlled trial.
Thirty-four volunteers from an acupuncture school with complaints of chronic pain and stiffness, who had no arm symptoms and gave informed consent, were randomly allocated to acupuncture or sham groups. Acupuncture or sham acupuncture was applied to the tender points once a week for 3 weeks. In the acupuncture group the acupuncture needle was inserted to the muscle, then the sparrow pecking technique was applied five times. Sham acupuncture was done without insertion of the needle. Dull pain and stiffness were evaluated by visual analog scale (VAS) before, and every 2 days after the first needling for 1 month. Pressure pain threshold on the tender points was measured before and after each treatment.
There was no statistical difference of VAS scores between acupuncture and sham groups 9 days after the last treatment. However, the acupuncture group showed significant reduction of VAS scores immediately after and/or 1 day after the real acupuncture treatments (P<0.01). The effect tended to be prolonged after repeated treatment. Pressure pain thresholds tended to increase after real acupuncture treatment but not after sham acupuncture.
Acupuncture applied to tender points appears to have short-term effects on neck and shoulder pain and stiffness, but this study was unable to demonstrate any long-term superiority over sham acupuncture.
To assess the effect of acupoint stimulation with electrodes combined with acupressure using an aromatic essential oil (lavender) as an add-on-treatment on pain relief and enhancing the physical functional activities among adults with sub-acute or chronic non-specific low back pain.
Randomised controlled trial.
The community centre, Old-Aged Home and Women Workers Association, Hong Kong. Intervention: 8-session relaxation acupoint stimulation followed by acupressure with lavender oil over a 3-week period. The control group received usual care only.
Changes from baseline to the end of treatment were assessed in pain intensity (by Visual Analogue Scale) and duration; lateral fingertip-to-ground distance in centimetres; walking time and interference on daily activities.
The baseline VAS scores for the intervention and control groups were 6.38 (S.E.M. = 0.22) and 5.70 (S.E.M. = 0.37) out of 10, respectively ( P=0.24 ). One week after the end of treatment, the intervention group had 39% greater reduction in VAS pain intensity than the control group ( P=0.0001 ), improved walking time ( P=0.05 ) and greater lateral spine flexion range ( P=0.01 ).
Our results show that 8-sessions of acupoint stimulation followed by acupressure with aromatic lavender oil were an effective method for short-term LBP relief. No adverse effects were reported. To complement mainstream medical treatment for sub-acute LBP, the combined therapy of acupoint stimulation followed by acupressure with aromatic lavender oil may be one of the choices as an add-on therapy for short-term reduction of LBP.
Randomized clinical trial.
To compare the effects of spinal manipulation combined with low-tech rehabilitative exercise, MedX rehabilitative exercise, or spinal manipulation alone in patient self-reported outcomes over a two-year follow-up period.
There have been few randomized clinical trials of spinal manipulation and rehabilitative exercise for patients with neck pain, and most have only reported short-term outcomes.
One hundred ninety-one patients with chronic neck pain were randomized to 11 weeks of one of the three treatments. Patient self-report questionnaires measuring pain, disability, general health status, improvement, satisfaction, and OTC medication use were collected after 5 and 11 weeks of treatment and 3, 6, 12, and 24 months after treatment. Data were analyzed taking into account all time points using repeated measures analyses.
Ninety-three percent (178) of randomized patients completed the 11-week intervention phase, and 76% (145) provided data at all evaluation time points over the two-year follow-up period. A difference in patient-rated pain with no group-time interaction was observed in favor of the two exercise groups [F(2141) = 3.2; P= 0.04]. There was also a group difference in satisfaction with care [F(2143) = 7.7; P= 0.001], with spinal manipulation combined with low-tech rehabilitative exercise superior to MedX rehabilitative exercise (P = 0.02) and spinal manipulation alone (P < 0.001). No significant group differences were found for neck disability, general health status, improvement, and OTC medication use, although the trend over time was in favor of the two exercise groups.
The results of this study demonstrate an advantage of spinal manipulation combined with low-tech rehabilitative exercise and MedX rehabilitative exercise versus spinal manipulation alone over two years and are similar in magnitude to those observed after one-year follow-up. These results suggest that treatments including supervised rehabilitative exercise should be considered for chronic neck pain sufferers. Further studies are needed to examine the cost effectiveness of these therapies and how spinal manipulation compares to no treatment or minimal intervention.
Acupoints massage in improving the quality of sleep and quality of life in patients with end-stage renal disease
- Tsay
- Sl
- Jr
- Lin
- Pf
Tsay SL, Rong JR, Lin PF. Acupoints massage in improving the quality of sleep and quality of life in patients with end-stage renal disease. J Adv Nurs 2003;42(2):134–42.
History of acupuncture
- Maciocia
Maciocia G. History of acupuncture. J Chin Med 1982;9:9–15.
Essential oil safety data manual. Brighton: Tisserand Institute; 1989. ARTICLE IN PRESS 24
- R Tisserand
Tisserand R. Essential oil safety data manual. Brighton: Tisserand Institute; 1989. ARTICLE IN PRESS 24. Buckle K. Aromatherapy. Nurs Times 1993;89:32–5.
Relieving pain with acupressure: healthful alternatives
- Dp Heiken
Heiken DP. Relieving pain with acupressure: healthful alternatives. New York: Sterling Publishing Company, Inc.; 1998.
Nursing research: design, statistics and computer analysis. Philadelphia: Davis
- C Waltz
Waltz C, Bausell RB. Nursing research: design, statistics and computer analysis. Philadelphia: Davis; 1981.
Acupressure: a practical introduc-tion to the benefits of this therapy
- Benesford Cc
- Bright
- Pa
Benesford CC, Bright PA. Acupressure: a practical introduc-tion to the benefits of this therapy. New York: A Simon and Schuster Macmillan Company; 1996.
Advanced aromatherapy: the science of essential oil therapy. Rochester: Vermont
- K Schnaubelt
Schnaubelt K. Advanced aromatherapy: the science of essential oil therapy. Rochester: Vermont; 1998.
Acupoints massage in improving the quality of sleep and quality of life in patients with end-stage renal disease
- Tsay
Two-year follow-up of a randomized clinical trial of spinal manipulation and two types of exercise for patients with chronic neck pain
- Evans