The Effects of Acupressure and Massage on Pain, Menstrual Symptoms, and Quality of Life in Primary Dysmenorrhea: A Randomized Controlled Trial

Objective: The study was carried out to determine the effects of acupressure and massage on pain severity, menstrual symptoms, and quality of life in patients with primary dysmenorrhea. Materials and Methods: This randomized controlled trial was conducted between January 2021 and May 2021. The study initially enrolled 309 female students with primary dysmenorrhea studying at a university in the Central Anatolia Region of Türkiye. After exclusions (due to secondary dysmenorrhea diagnosis, study discontinuation, or drug use), the study was completed with a total of 267 students. The students were divided into three groups as follows: (1) the acupressure+massage group, (2) the massage-only group, and (3) the control group. Acupressure + massage and massage-only groups were timed for the first 3 days of three consecutive menstrual cycles. The primary outcome of the study was the mean pain score for primary dysmenorrhea. Data were collected with the Visual Analog Scale, Daily Menstrual Symptom Rating Scale, and Short Form 12 Health Survey. Results: In the first cycle and first day of preintervention measurement, the physical and mental health levels, which are the subscales of pain severity, menstrual symptom intensity, and quality of life, were similar in the three groups (p > 0.05). In other measurements during the three cycles, it was determined that the pain severity and menstrual symptom intensity in the acupressure + massage and massage-only group were lower than the control group (p < 0.05). After the intervention, it was determined that there was no significant difference in all subscales of the Quality of Life Scale (p > 0.05). In the acupressure + massage group, three participants reported having adverse reactions, including pain at the acupoints (n = 1) and shift in menstruation cycle (n = 2); in the massage-only group, four participants reported having adverse reactions, including redness (n = 3) and tingling in a finger (n = 1). Conclusion: It was determined that acupressure and massage applied to those with primary dysmenorrhea were effective methods to reduce the pain level and menstrual symptom intensity, but did not affect their quality of life. Clinical Trials Number: A Clinical trials number was received from ClinicalTrials.gov (NCT04942288).

Effect of adding telerehabilitation home program to pharmaceutical treatment on the symptoms and the quality of life in children with functional constipation: a randomized controlled trial

Painful defecation, the passage of hard stools, unpleasant or irregular bowel deviation/movements from regular rate, and/or the feeling of not enough elimination of stool are common symptoms of functional constipation. The goals in treating constipation are to produce soft, painless stools and to prevent the re-accumulation of feces. This study looked at how the telerehabilitation home program (TRP) affected the symptoms of FC and the children who were constipated in terms of their quality of life. A randomized controlled trial included 400 children aging 4-18 years with functional constipation distributed in two groups: control group consisted of 200 children receiving pharmaceutical treatment and the intervention group consisted of 200 children receiving the telerehabilitation home program in addition to pharmaceutical treatment. Both groups received the interventions for 6 months. The outcomes in terms of functional constipation symptoms and quality of life are measured and compared pre- and post-interventions. Adding the telerehabilitation home program to pharmaceutical treatment of functional constipation in children results in prominent improvement in the condition; there is a significant difference between the intervention and control group in all Rome criteria which assess symptoms of functional constipation except rush to the bath-room to poop which showed non-significant difference; there is also a significant difference between the intervention and control group in all domains of the SF-36 questionnaire which assess quality of life except the mental health domain which showed non-significant difference.

CONCLUSION

Adding the telerehabilitation home program to pharmaceutical treatment of functional constipation in children results in prominent improvement in symptoms of functional constipation and quality of life.

TRIAL REGISTRATION

Our study was registered retrospectively with Clinicaltrials.gov under the identifier NCT06207721 on 5 January 2024.

WHAT IS KNOWN

• Painful defecation, passage of hard stools, unpleasant or irregular bowel movements, feeling of incomplete stool elimination are common symptoms of functional constipation. • Goals in treating constipation include producing soft, painless stools and preventing re-accumulation of feces.

WHAT IS NEW

• Adding telerehabilitation home program to pharmaceutical treatment resulted in significant improvement in functional constipation symptoms and quality of life. • Significant differences between intervention group (200 children receiving telerehabilitation home program in addition to pharmaceutical treatment) and control group (200 children receiving pharmaceutical treatment) were observed in all Rome criteria except for rush to the bathroom to poop, and in all domains of SF36 questionnaire except for the mental health domain.

Complementary and Alternative Medicine (CAM) Practices: A Narrative Review Elucidating the Impact on Healthcare Systems, Mechanisms and Paediatric Applications

While research on complementary and alternative medicine (CAM) for the general population is expanding, there remains a scarcity of studies investigating the efficacy and utilisation of CAM practices, specifically in the paediatric population. In accordance with the World Health Organization (WHO), the prevalence of the parental utilisation of CAM in their dependents is estimated to reach up to 80%. This literature review identified broad, heterogeneous, and inconclusive evidence regarding CAM's applications and effectiveness, primarily attributed to variance in sociodemographic factors and differences in national healthcare systems. Additionally, the review identified a lack of consensus and polarised positions among mainstream professionals regarding the mechanisms of action, applications, and effectiveness of CAM. This narrative review presents varied results concerning the efficacy of most CAM therapies and their applications; however, some evidence suggests potential benefits for acupuncture, yoga, tai chi, and massage in improving physical and mental health. Moreover, the available evidence indicates that meditation may enhance mental health, while reiki may only influence patients' perceptions of comfort. In light of the intricate and multifaceted nature of herbal medicine, it is imperative to assess its efficacy on a case-by-case basis, taking into account the specific compounds and procedures involved. This comprehensive review serves as a valuable resource for health professionals, offering guidance for personalised healthcare approaches that consider the values and beliefs of patients, thereby facilitating integrated, evidence-based practices aimed at enhancing the quality of healthcare services and patient satisfaction.

The Regulation of miR-206 on BDNF: A Motor Function Restoration Mechanism Research on Cerebral Ischemia Rats by Meridian Massage

As a frequent disease affecting the nervous system, cerebral infarction has emerged as a major cause of disability and elicits disorders in motor, sensation, and cognition as sequelae. No clear mechanism has been known in meridian massage despite it having been proved to be an effective therapeutic option. The study was carried out to explore the treatment of meridian massage on cerebral ischemia in rats and its effects on motor function restoration and nerve cell’s ultrastructure in the ischemic territory. The alleviated nerve damages and recovered injured brain tissues were found in the cerebral infarction model of SD rats after meridian massage. Expressions of miR-206 and the brain-derived neurotrophic factor (BDNF) in the gastrocnemius muscle were all well observed. The effects of miR-206 on BDNF were testified by overexpressed and interfered miR-206 in the C2C12 myoblast. Moreover, at the molecular level, meridian massage downregulated miR-206 expression at an elevated level of BDNF. Consequently, meridian massage exerts a vital role in promoting cerebral ischemia restoration, which is expected to provide an addition to the application of traditional Chinese medicine (TCM) in the reconstruction and treatment of cerebral ischemia.

Non-pharmacological management of pediatric functional abdominal pain disorders: Current evidence and future perspectives

Functional abdominal pain disorders (FAPDs) are an important and prevalent cause of functional gastrointestinal disorders among children, encompassing the diagnoses of functional dyspepsia, irritable bowel syndrome, abdominal migraine, and the one not previously present in Rome III, functional abdominal pain not otherwise specified. In the absence of sufficiently effective and safe pharmacological treatments for this public problem, non-pharmacological therapies emerge as a viable means of treating these patients, avoiding not only possible side effects, but also unnecessary prescription, since many of the pharmacological treatments prescribed do not have good efficacy when compared to placebo. Thus, the present study provides a review of current and relevant evidence on non-pharmacological management of FAPDs, covering the most commonly indicated treatments, from cognitive behavioral therapy to meditation, acupuncture, yoga, massage, spinal manipulation, moxibustion, and physical activities. In addition, this article also analyzes the quality of publications in the area, assessing whether it is possible to state if non-pharmacological therapies are viable, safe, and sufficiently well-based for an appropriate and effective prescription of these treatments. Finally, it is possible to observe an increase not only in the number of publications on the non-pharmacological treatments for FAPDs in recent years, but also an increase in the quality of these publications. Finally, the sample selection of satisfactory age groups in these studies enables the formulation of specific guidelines for this age group, thus avoiding the need for adaptation of prescriptions initially made for adults, but for children use.

The Effect of Abdominal Massage with Extra-Virgin Olive Oil on Constipation among Elderly Individuals: A Randomized Controlled Clinical Trial

Background:

Constipation is one of the most prevalent problems during old age. Abdominal massage is a complementary method in controlling constipation. This study is conducted with the aim of determining the effect of abdominal massage with extra-virgin olive oil on constipation among the elderly.

Methods:

In this single-blind randomized controlled clinical trial, 54 old individuals in Shiraz nursing homes during November 2018-March 2019 were selected randomly and then allocated to three groups of 18, based on block randomization. The first group underwent abdominal massage with olive oil for five consecutive days (each day one time for 15 minutes). The second group underwent abdominal massage with water similar to the first group. No specific intervention was applied to the control group. All three groups received their medical treatment. The constipation scores were examined using constipation assessment scale (CAS) before the intervention and on the sixth day. Data analysis was done through SPSS 22 using Chi-square, paired t-test, and ANOVA. P<0.05 was considered as the level of statistical significance.

Results:

There were no statistically significant differences among the three groups before the intervention. The results demonstrated that the mean score of constipation further decreased in the olive oil group (5.62±1.89 to 2.06±0.99) (P≤0.001) than the massage with water (5.05±1.25 to 3.11±0.99) (P=0.02), and the control group (4.44±1.38 to 5.22±1.35) (P=0.006).

Conclusion:

Due to the greater effectiveness of abdominal massage with extra-virgin olive oil, the use of this method is recommended in treatment of constipation among the elderly.

Trial Registration Number:

IRCT20180923041101N

Non-pharmacologic approach to pediatric constipation

Functional constipation (FC) is a pervasive problem in pediatrics. Although pharmaceuticals are commonly used for FC, parents and patients show reluctance or find dissatisfaction with available medications at times. Further, patients often have interest in utilizing nutraceutical supplements and botanicals that are available over the counter. This literature review aims to summarize research studies performed on non-pharmacologic approaches to constipation and to evaluate the safety and efficacy of these modalities. Overall data on non-pharmacologic treatments for childhood constipation were sparse, and though some studies were available for adult populations, pediatrics studies were generally limited, lacking or flawed. Certain supplements, such as prebiotics, probiotics and fiber, are safe and are without significant side effects. Though fiber supplements such as glucomannan, green banana mass, cocao husk and various fiber blends have emerging evidence in children, evidence for psyllium, cellulose and flaxseed only have supportive studies in adults. Other than senna, studies of botanicals indicate significant safety concerns (in particular with Aloe vera with aloin and Cascara sagrada) and insufficient evidence. For patients with a significant behavioral or anxiety component to their FC and exhibit dyssynergia, mind-body interventions (e.g. diaphragmatic breathing, biofeedback, cognitive behavioral therapy, and behavioral modifications) are certainly safe and effective. Finally, movement and manipulative interventions such as abdominal massage, reflexology, acupuncture and transcutaneous nerve stimulation show promise in the field of pediatric constipation, and data is accumulating for efficacy. These modalities require further study to determine mechanisms of action and which populations may benefit the most from these therapies.

The effects of enteral feeding improvement massage on premature infants: A randomised controlled trial

AIMS AND OBJECTIVES

To prove the effects of an enteral feeding improvement massage for premature infants with regard to their feeding, growing and superior mesentery artery blood flow aspect by a randomised controlled trial.

BACKGROUND

Premature infants have feeding-related problems related to eating and absorbing nutrition due to their immature gastrointestinal function. Studies regarding the effectiveness of premature infants' enteral feeding improvement by tactile stimulation massage are rare.

DESIGN

The study group was composed of 55 patients. Of the 55 patients, 26 were randomised into an experimental group and 29 were randomised into a control group.

METHODS

They were all born <34 weeks of gestational age between 1 July 2011 and 30 March 2012. Premature infants in the experimental group received enteral feeding improvement massage twice a day for 14 days, and infants in the control group received a sham exercise. The collected data were analysed by spss 19.0, through t test, chi-square test (Fisher's exact) and ANCOVA.

RESULTS

(i) The experimental group had reached the day of full enteral feeding significantly faster. (ii) The experimental group had a higher superior mesentery artery peak velocity (V_max ) and lower RI (resistant index). (iii) The experimental group of the feeding-intolerant subgroup had a higher superior mesentery artery V_max and V_min . (iv) The experimental group had a heavier weight and larger head circumference after 14 days.

CONCLUSIONS

This study demonstrates that enteral feeding improvement massage can be helpful for achieving earlier full enteral feeding, more increased superior mesentery artery, and faster growing. In particular, it can be a therapeutic, independent and evidence-based nursing intervention for feeding-intolerant premature infants.

RELEVANCE TO CLINICAL PRACTICE

Neonatal nurses in neonatal intensive care unit can apply enteral feeding improvement massage massage for feeding-intolerant infants.

Effects of Auricular Acupressure Therapy on Primary Dysmenorrhea for Female High School Students in South Korea

PURPOSE

To examine the effect of auricular acupressure therapy on primary dysmenorrhea among female high school students in South Korea.

DESIGN

A randomized controlled trial was employed.

METHODS

The study sample consisted of 91 female high school students, with 45 participants in the experimental group and 46 in the control group in two regions of South Korea. The average age of the participants was 16.7 years, and the average age of menarche was 12.2 years. Auricular acupressure therapy including an auricular acupressure needle on skin paper tape was applied on an ear for 3 days during periods of extreme primary dysmenorrhea. The acupoint names were Jagung, Sinmun, Gyogam, and Naebunbi. For the placebo control group, only the skin paper tape without an auricular acupressure needle was applied on the same acupoints. Measures used were the Menstrual Distress Questionnaire to assess primary dysmenorrhea, and the visual analog scale to assess abdominal and back pain of participants.

FINDINGS

There were significant differences on abdominal pain (t = 24.594, p < .001), back pain (t = 22.661, p < .001), and primary dysmenorrhea (t = 32.187, p < .001) between the two groups. Auricular acupressure therapy decreased abdominal pain, back pain, and primary dysmenorrhea of female high school students in South Korea.

CONCLUSIONS

Auricular acupressure therapy was an effective intervention for alleviating abdominal pain, back pain, and primary dysmenorrhea of female high school students in South Korea. For feasibility of the auricular acupressure therapy in practice, it is needed to train and learn the exact positions of acupoints in ear.

CLINICAL RELEVANCE

Health providers should consider providing auricular acupressure therapy as an alternative method for reducing abdominal and back pain, and primary dysmenorrhea in female high school students in South Korea.

Complementary and Alternative Therapies for Chronic Constipation

Chronic constipation, an ancient disease, is prevalent, and costly in the general population. Complementary and alternative therapies are frequently used for constipation. This review introduces various methods of complementary and alternative therapies, including acupuncture, moxibustion, massage, and herbal medicine. Efficacy, safety, influence factors, sham control design, and mechanisms of these therapies are discussed and evaluated. Acupuncture or electroacupuncture was found to be most commonly used for constipation among these complementary and alternative therapies, followed by herbal medicine. Although only a small number of clinical studies are flawless, our review of the literature seems to suggest that acupuncture or electroacupuncture and herbal medicine are effective in treating constipation, whereas findings on massage and moxibustion are inconclusive. More well-designed clinical trials are needed to improve and prove the efficacy of the complementary and alternative therapies for constipation; mechanistic studies that would lead to wide spread use and improvement of the methods are also discussed in this review.