ABSTRACT
Background: 'Frailty' is being increasing recognised as a geriatric syndrome of growing importance in the medical field. Acupressure is a non-pharmacological, non-invasive Traditional Chinese Medicine (TCM) treatment, which may serve to improve the quality of life (QOL) or prevent the progressive advancement of frailty in the aged population. Objective: to investigate the effects of a 12-week, TCM-principle guided acupressure intervention on the QOL of the frail older people living in the community. Methods: this is a randomised controlled trial with waitlist control design. Treatment group received 15 min of acupressure treatment, four times a week from both TCM practitioners and trained caregivers for 12 consecutive weeks. The waitlist control group served as a care-as-usual comparison to the treatment group for the 1st 12 weeks and then received the same treatment. Intention-to-treat principle was followed and mixed-effects models were used for data analysis. Results: the mean age of the participants was 76.12 ± 7.08, with a mean Tilburg frailty index score of 7.13 ± 1.76. Significant between-group differences were found in the change of physical domain score of WHOQOL-BREF (P = 0.001); change of Pittsburgh Sleep Quality Index (P < 0.001) and pain intensity (P = 0.006) with the treatment group demonstrating greater improvement. Within-group effect size analysis also indicated that the acupressure protocol has significant impact on these areas. Conclusions: the study's outcomes indicated that the acupressure protocol, when applied continuously for 12 weeks, 3-4 times a week, could improve the general QOL of frail older people living in community dwellings.
Subject(s)
Acupressure/methods , Frailty/therapy , Independent Living , Acupuncture Points , Age Factors , Aged , Aged, 80 and over , Aging , Female , Frail Elderly , Frailty/diagnosis , Frailty/physiopathology , Frailty/psychology , Geriatric Assessment , Hong Kong , Humans , Male , Pain Measurement , Quality of Life , Sleep , Surveys and Questionnaires , Time Factors , Treatment OutcomeABSTRACT
OBJECTIVES: To review and evaluate the efficacy and safety of tian jiu therapy on san fu tian for adults with asthma. METHODS: A literature search through August 31, 2013, was done to identify comparative studies evaluating effective rate, pulmonary function, immune response, recurrence rate, quality of life, and adverse events. The Cochrane Library, PubMed, EMBASE, and Chinese National Knowledge Infrastructure were searched; only randomized controlled trials with treatment groups using tian jiu therapy were included. Cochrane Collaboration's risk of bias tool and Review Manager software, version 5.2, were used for the data synthesis. RESULTS: Six studies involving 657 patients were identified. tian jiu therapy was more effective than the control intervention (odds ratio [OR], 3.51; 95% confidence interval [CI], 2.05-6.00; p<0.00001; I(2)=18%). The treatment group had a bigger decrease in IgE level (standard mean difference [SMD], -1.40; 95% CI, -2.18 to -0.63; p=0.0004; I(2)=85%) and Eosinophil (Eos) level (SMD, -4.26; 95% CI, -6.28 to -2.23; p<0.00001; I(2)=91%) compared with the control group. Included studies had a high risk of bias. Few adverse effects were reported in the included studies, and no serious adverse responses occurred. Adverse effects did not result in any dropouts. CONCLUSIONS: All studies indicated that tian jiu therapy has a positive effect on adults with asthma and that it is relatively safe because of its noninvasive nature. However, the limitations of the research design of the existing studies resulted in high risk of bias. More randomized controlled trials of better methodologic quality are needed to further confirm efficacy and safety of this therapy.
