The Effectiveness of Auricular Acupressure on Chronic Musculoskeletal Pain: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Objectives: To assess the effectiveness of auricular acupressure (AA) in managing pain and disability in individuals with chronic musculoskeletal pain. Materials and Methods: A systematic search on six electronic databases was performed from their inception to May 7, 2023, to identified relevant randomized controlled trials (RCTs). Two independent reviewers screened the abstracts and full texts, extracted data, and assessed risk of bias using RoB 2. The primary outcomes were pain intensity and disability. The secondary outcomes were pain pressure thresholds, pain catastrophizing level, and fear avoidance beliefs. A random-effects model was used for meta-analyses. The certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation. Sensitivity analyses were conducted after removing low-quality papers. Results: Of 633 identified records, six studies involving 496 participants were included. All included studies compared the effectiveness of AA with sham controls in treating various chronic musculoskeletal pain. Four meta-analyses were conducted to compare the effectiveness of AA with sham controls. Low-quality evidence supported that AA had a large effect size on postintervention subjective pain reduction (standardized mean difference [SMD] = -0.95; 95% confidence interval [CI]: -1.36 to -0.54; p = 0.00; I2 = 52.61%); moderate-quality evidence substantiated that AA had a large effect size on enhancing postintervention pressure pain threshold (SMD = -0.55; 95% CI: -0.88 to -0.23; p = 0.00; I2 = 0%). There was low-quality evidence that AA had a large effect on reducing postintervention disability (SMD = -0.68; 95% CI: -1.24 to -0.12; p = 0.02; I2 = 51.33%). Our sensitivity analysis reaffirmed the same conclusion regarding pain reduction immediately after the intervention. Fourteen participants reported minimal adverse events, including soreness, tenderness, irritation, and redness, which disappeared within 1-7 days. Discussion: Our systematic review revealed that AA significantly improved pain, pressure pain thresholds, and disability in individuals with various chronic musculoskeletal pain conditions immediately post-treatment compared with sham treatment. Given the paucity of studies and inconsistent protocols, future RCTs are warranted to evaluate the effectiveness of AA in people with chronic musculoskeletal pain at a longer follow-up with detailed protocols, which allows researchers and clinicians to optimize AA intervention. Conclusion: AA has immediate post-treatment benefits for chronic musculoskeletal pain, whereas its effects at the 1- or 6-month follow-up remain uncertain.

The effect of ear acupressure on occupational cognitive failure in nurses after the COVID-19 crisis: a randomized controlled clinical trial.

BACKGROUND: In the aftermath of the COVID-19 pandemic, nurses reported varying degrees of cognitive failure. To prioritize patient safety in clinical settings, it is important and necessary to address and mitigate the symptoms of cognitive failure among nurses. AIM: This study was conducted in Iran to evaluate the impact of ear acupressure on occupational cognitive failure in nurses. METHODS: This randomized controlled clinical trial was conducted with 54 nurses who experienced cognitive failure in 2022. Sampling was performed by convenience. Fifty-six nurses who scored 40 or higher on the occupational cognitive failure questionnaire were randomly assigned to either the intervention group (28 subjects) or the sham group (28 subjects). In the intervention group, pressure was applied to the shen-men point, zero point, hippocampus, master cerebral, brain, and memory 1 and 2 of the earlobes for six weeks using Vaccaria seeds. In the sham group, a sticker without seeds was applied at the same points as in the intervention group, and no pressure was applied. Cognitive failure was assessed at the beginning of the study (T0), at the end of the intervention (sixth week of study, T1), and four weeks after the end of the intervention (tenth week of study, T2). The data were collected using contextual data questionnaires and the Occupational Cognitive Failure Questionnaire (OCFQ). The data obtained from 54 nurses (28 in the sham group and 26 in the intervention group) were analyzed by SPSS v16 using repeated-measures ANOVA. RESULTS: The two groups had no significant differences regarding background variables. The between-group analysis revealed a significant interaction effect of time and intervention on cognitive failure (F = 60.320, p < 0.001, effect size = 0.537). The cognitive failure score in the intervention group was significantly lower at the end of the intervention and one month later than that in the sham group (p < 0.001). Within-group analysis revealed a significant difference in the cognitive failure scores of the intervention group at T0, T1, and T2 (61.231 ± 14.230, 34.000 ± 14.659, and 29.808 ± 14.266, respectively; F = 52.331, p < 0.001, effect size = 0.677). However, in the sham group, the cognitive failure score exhibited a brief but significant increase at T0, T1, and T2 (54.786 ± 11.239, 56.250 ± 10.950, and 56.000 ± 11.337, respectively; F = 6.369, p = 0.006, effect size = 0.191). CONCLUSION: Auriculotherapy has shown promise in improving occupational cognitive failure in nurses. It is recommended that nurses consider incorporating auriculotherapy as a complementary treatment modality, particularly through self-treatment programs, when experiencing symptoms of cognitive impairment. TRIAL REGISTRATION NUMBER (TRN): IRCT20100211003329N10 DATE OF REGISTRATION: 04/11/2022.

Effect of Auriculotherapy on Stress: A Systematic Review and Meta-Analysis.

Background: Auriculotherapy, a form of therapy that involves stimulating specific points on the ear auricle, has garnered attention for its potential in holistic stress management in adults, aligning with broader patient-centered therapeutic approaches. Objective: The aim of this study was to evaluate the effectiveness of auriculotherapy for stress relief in adults. Methods: A comprehensive search of nine databases (PubMed, Scopus, CINAHL, Web of Science, Ovid Medline, Cochrane Library, RISS, KMbase, and KISS) was performed, yielding 553 studies. Of these, 12 were selected for meta-analysis based on the inclusion criteria, which considered demographic data, types of auriculotherapy, intervention characteristics, auricular points, and stress-related outcomes. The risk of bias was also evaluated for each selected study. Results: The meta-analysis results (n = 12) indicated that auriculotherapy was significantly superior to the control group in terms of subjective stress index, blood pressure, heart rate variability, and pulse rate, as well as improving low-frequency (LF) and high-frequency (HF) heart rate components and their ratio (LF/HF) in adults. Additionally, the subgroup analysis indicated a trend where the effect size of acupressure may be larger than that of acupuncture. Conclusions: Our findings underscore auriculotherapy's efficacy in reducing stress in adults, advocating for its integration into nursing curriculums as a viable clinical intervention for stress management. Promoting its application in clinical environments could complement holistic, patient-centric care paradigms.

The effects of auriculotherapy on depression among elderly people: A randomized controlled clinical trial.

BACKGROUND: Given the high prevalence of depression in elderly people, appropriate interventions are essential. This study aimed to assess the effects of auriculotherapy on depression among elderly people. METHODS: This randomized controlled clinical trial was conducted in 2021. Fifty-two elderly were conveniently selected and randomly allocated to the sham (n = 26) and intervention (n = 26) groups through block randomization. The intervention group was subjected to four weeks of auriculotherapy at the Shen-Men, zero, heart, antidepressant, and master cerebral points using Vaccaria seeds fixed with adhesive tape. In the sham group, adhesive tapes were attached to the points with neither seeds nor compression. The elderly and data collector were blinded. The 15-item Geriatric Depression Scale was used to assess depression before, immediately after, and four weeks after the intervention (T1-T3). The statistical methods used were repeated measures analysis of variance and covariance. RESULTS: Groups significantly differed concerning participants' gender, education, and employment (p < 0.05). After adjusting for confounding effects, the time-group interaction significantly affected the mean depression score (p < 0.0001, effect size = 0.54). There was no significant difference between the depression score in the sham and intervention groups at T1 (9.6 ± 2.5 vs 9.5 ± 2.5, p = 0.263); however, this difference was found to be significant at T2 (8.6 ± 2 vs 4.2 ± 1.2, p < 0.0001, effect size = 0.68) and T3 (9.3 ± 2.3 vs 4.3 ± 1.3, p < 0.0001, effect size = 0.65). Within-group analysis revealed significant differences in the depression scores of the intervention group at T1 compared with those at T2 and T3 (p < 0.05). In contrast, the mean depression score in the sham group at T2 was significantly lower than that at T1 (p = 0.003) and greater than that at T3 (p = 0.049). CONCLUSIONS: Auriculotherapy alleviates depression and can be used as a complementary therapy for elderly people with depression.

Bibliometric analysis of auriculotherapy research trends over the past 20 years.

OBJECTIVES: Auriculotherapy has long been used to treat various diseases. We analyzed and visualized auriculotherapy's geographical distribution, key contributors, and thematic trends over the past 20 years to provide current trends in auriculotherapy field and to offer recommendations for future research directions. DESIGN/SETTING: We searched for relevant studies in the Web of Science between January 10, 2003, and December 31, 2022. A bibliometric analysis was performed using VOSviewer for annual publications, journals, countries, institutions, authors, and keywords. RESULTS: A total of 800 studies were included in the analysis, and the number of studies steadily increased over the 20 examined years. In 2018, there was a noteworthy rise in publications, nearly twice as many as the preceding year. Integrative & complementary medicine was the most researched area, with most articles published in Evidence-Based Complementary and Alternative Medicine. China was the country with the most published research, and the most active organization was Guangzhou University of Chinese Medicine in China, followed by Kyung Hee University in South Korea. The most prolific author was Yeh Mei-ling, who reported the effects of auriculotherapy on dysmenorrhea and smoking cessation. Keyword analysis revealed four clusters: pain, mental health, obesity, and smoking cessation. CONCLUSION: Auriculotherapy research primarily focused on clinical studies related to pain, obesity, smoking cessation, and depression. Future research should place greater emphasis on verifying the mechanisms of auriculotherapy for specific ailments and may require efforts to enhance the robustness of clinical trials. Through visual analysis, our study may serve as a foundational resource, offering valuable insights into the trajectory of auriculotherapy research.

The Effect of Ear Acupressure on Behavioral Problems in Children with Attention-Deficit/Hyperactivity Disorder: A Randomized Clinical Trial.

Objective: Due to the limits on treatment for people with attention-deficit/hyperactivity disorder (ADHD), ear acupressure treatment has been considered. This study examined the effect of ear acupressure on behavioral problems of children with ADHD. Materials and Methods: This randomized controlled trial was conducted in 70 children with ADHD who were randomized into 2 groups. The intervention group received ear acupressure in treatment points and the control group received massage at neutral points. Behavioral problems were measured 3 times: (1) baseline; week 4; and week 8. The last timepoint was a follow-up, using the Child Behavior Checklist. Results: The intervention group had fewer behavioral problems at all 3 timepoints than the control group (Cohen's ∂ = 1.49; 95% confidence interval at week 4: 20.97, 47.43).The ear acupressure group had a large effect size with respect to reduction of attention problems at week 4 (∂ = 1.88) and week 8 (∂ = 1.48) than the control group. Conclusions: Ear acupressure induced significant reduction of the behavioral problems of children with ADHD. Further research can evaluate the use and continuity of the effectiveness of this treatment as a complementary treatment in addition to the usual treatments for these children.

Effects of auriculotherapy on nausea and vomiting in pregnant women: A randomized clinical trial.

BACKGROUND: Pregnancy induces physiological changes, commonly marked by nausea and vomiting in the first trimester, posing risks for both mother and baby. This study evaluates the effects of auriculotherapy on nausea and vomiting during the first trimester of pregnancy. MATERIALS AND METHODS: A randomized clinical trial was conducted in two primary health care centers with 56 Brazilian pregnant women who reported nausea or vomiting in the first trimester. The participants were divided into an intervention group (auriculotherapy with seeds) and a placebo group (sham auriculotherapy). The intervention was divided into three moments: pre-intervention with assessment of nausea and vomiting and application of questionnaires, and two follow-ups conducted on the fourth and seventh day of the intervention, with reassessment of nausea and vomiting. RESULTS: Both groups experienced a decrease in nausea and vomiting over time, with no statistically significant differences between groups in the within-group analyses at various time points. The intervention group had a greater reduction in symptoms. Within the intervention group, symptoms were more common among ferrous sulfate users and those without reported dietary disturbances. In addition, a higher incidence of nausea and vomiting was associated with the use of analgesics, morning snacks, and low intake of protein, vegetables, and fruits. CONCLUSIONS: The intervention did not affect the between-group differences in the incidence of nausea and vomiting and vomiting effort in the first trimester of pregnancy. However, a greater reduction was observed in the intervention group.

Laser auriculotherapy associated with cupping therapy in chronic spinal pain: Randomized controlled clinical trial.

BACKGROUND: Musculoskeletal spine disorders are common causes of chronic pain and impair functionality. Laser auriculotherapy and cupping has played a significant role in the treatment of chronic pain. OBJECTIVE: to evaluate the effect of laser auriculotherapy associated with cupping at systemic acupuncture points on chronic spinal pain. METHODS: Randomized controlled clinical trial. Volunteers underwent three evaluations: an initial evaluation, a final evaluation immediately after the last intervention session, and a 15-day follow-up. The pain was identified using the numeric pain scale. The pain threshold was also evaluated against mechanical stimulation using a Digital Dynamometer at specific points in the cervical, thoracic and lumbar regions. Fifty individuals with chronic spinal pain, randomized into groups: experimental (n = 25), submitted to 10 sessions of auriculotherapy with laser and cupping therapy and control (n = 25). RESULTS: The experimental group achieved pain intensity reduction between pre and post and follow-up moments (p < 0.0001), of greatest pain in the last seven days among all moments (p < 0.0001), of least pain in the pre with post moment (p = 0.006) and follow-up (p = 0.002), and an increased pain threshold between pre and post (p = 0.023). The control group achieved a reduction in the nociceptive threshold between pre and post (p = 0.001) and follow-up (p < 0.0001). The experimental group showed reduced pain intensity (p = 0.027) and greater pain (p = 0.005) after intervention and in pain intensity (p = 0.018), greater (p < 0.0001) and less pain (p = 0.025) at follow-up, compared to the control group. CONCLUSION: Auriculotherapy with laser associated with cupping therapy may effectively reduce pain intensity and increase the nociceptive threshold.

Effects of auriculotherapy on muscle fatigue: A randomized crossover trial.

OBJECTIVE: This study aimed investigate the effect of auriculotherapy on exercise-induced muscle fatigue, isometric torque production, and surface electromyographic activity (EMG). METHODS: Design: Randomized Crossover Trial. The sample consisted of 18 males' volunteers who exercised at least twice a week. THE SAMPLE WAS RANDOMLY ASSIGNED TO TWO GROUPS: Placebo Group (n = 9) and Treated Group (n = 9), and after seven days, the groups were crossed. The data analysis included 18 participants in each group. MAIN OUTCOME MEASURE: The muscle fatigue index, force production rate, and EMG of the quadriceps were used for evaluation. The evaluation moments included baseline pre-fatigue, baseline post-fatigue, 48 h post-intervention pre-fatigue, and 48 h post-intervention post-fatigue. Mixed two-way test ANOVA was used to compare times and groups. RESULTS: The fatigue index for peak torque and work showed no significant effect on time, groups, or interaction (p > 0.05). However, for isometric torque, force production rate, and EMG median frequency and average, the results indicate a positive change in values over time (p < 0.05) (with little practical relevance), with no differences observed between the groups or interaction (p > 0.05). CONCLUSIONS: In conclusion, auriculotherapy had no effect on exercise-induced muscle fatigue, isometric torque production, and surface electromyographic activity.

Heart rate variability and cold-induced vascular dilation after stimulation of two different areas of the ear: a prospective, single-blinded, randomized crossover study.

BACKGROUND: Both noninvasive transauricular vagus nerve stimulation (taVNS) and traditional medical practice (TMP), such as auriculotherapy, use the auricle as a starting point for stimulation, but with two different conceptual frameworks: taVNS depends on vagal afferences to account for its effects, whereas TMP requires stimulation of the ear with high topographical accuracy regardless of the afferent nerves. The aim of this study was to measure heart rate variability (HRV) and cold water-induced vasodilation (CIVD) after puncturing two different ear points with the same afference but that should have opposite effects according to TMP. METHODS: Ten healthy subjects were investigated in this single-blinded crossover study over three sessions. In the first session, sympathetic activation was performed via cold water immersion of the right hand, with recordings taken from multiple fingers. HRV was assessed in the time domain (square root of the mean squared differences of NN intervals (RMSSD)) and frequency domain (low (LF) and high frequencies (HF)). In the second and third sessions, the same skin immersion test was performed, and mechanical stimulation was applied to the ear at two different points on the internal surface of the antitragus, one with alleged parasympathetic activity and the other with alleged sympathetic activity. The stimulation was done with semipermanent needles. RESULTS: Stimulation of the point with alleged parasympathetic activity immediately resulted in a significant decrease in RMSSD in 75% of the subjects and in LF in 50% of the subjects, while stimulation of the point with alleged sympathetic activity resulted in an increase in HF and RMSSD in 50% of the subjects. Stimulation of these points did not affect the CIVD reflex. The 20 min cold water immersion induced an immediate decrease in LF and the LF/HF ratio and an increase in HF. The skin temperature of the nonimmersed medius significantly decreased when the contralateral hand was immersed, from 34.4 °C to 31.8 °C. CONCLUSIONS: Stimulation of two different ear points innervated by the same afferent nerves elicited different HRV responses, suggesting somatotopy and a vagal effect beyond vagal afferences. These results are not in accordance with the claims of TMP. TRIAL REGISTRATION: NCT04130893 (18/10/2019) clinicaltrials.com.

Effects of Auriculotherapy on Gestational Hypertension: Randomized Controlled Trial Study.

Background: This study aims to observe how auriculotherapy acts as a nonpharmacological treatment for pregnant women's gestational hypertension. Materials and Methods: This study was a randomized controlled trial. Eighty patients were with gestational hypertension recruited and divided into control (n = 40) and intervention (n = 40) groups. The control group just received the usual perinatal care. The intervention group received one month of auriculotherapy in addition to the usual care. Blood pressure was measured before and 15 minutes after rest in both groups twice a week. The data were analyzed using descriptive statistics and inferential tests. Results: The mean systolic blood pressure, based on the Mann-Whitney test, was not statistically significant between the two groups before the intervention and in the first two weeks after the intervention (p >0.05); however, after the third week of intervention, the mean systolic blood pressure in the intervention group was significantly lower than that in the control group (p <0.001). As per the Mann-Whitney test, the mean diastolic blood pressure was not statistically significant between the two groups before the intervention and the first week after the intervention (p <0.05). However, after the second week of intervention, the mean diastolic blood pressure in the intervention group was significantly lower than that in the control group, and this decrease was highest in the fourth week of the intervention (p <0.001). Conclusions: This study demonstrated that auriculotherapy would reduce blood pressure in pregnant women suffering from hypertension.

Efficacy of auriculotherapy in the control of pain, edema, and trismus following surgical extraction of the lower third molars: a split-mouth, randomized, placebo-controlled, and triple-blind study.

BACKGROUND: The aim of this split-mouth, randomized, placebo-controlled, and triple-blind study was to evaluate whether auriculotherapy had any effect on the post-operative course after the extraction of third molars in terms of the control of pain, edema, and trismus. MATERIALS AND METHODS: The study included 42 patients (84 teeth) who had undergone a surgical extraction of the lower third molars. In each patient, the two extractions were randomly assigned to two study groups. In the therapy group, the patients underwent auriculotherapy with vaccaria seeds applied with patches in 6 ear points. In the control group, the patches were applied, without seeds, to the same ear points. After the extraction, the patients were asked to stimulate the ear points three times a day and whenever they felt pain. The patients were asked to keep a diary in which they assessed their pain by means of the Visual Analog Scale (VAS) for 8 days. Edema and trismus were assessed 1, 2, 3, and 8 days after surgery. RESULTS: The differences between the two groups were statistically significant at the 12-h control (auriculotherapy group (AG) VAS 5.5 [IQR 4.25-6.75], placebo group (PG) VAS 6 [IQR 5-8], p = 0.040), after 24 h (AG VAS 5 [IQR 4-6], PG VAS 6 [IQR 4.25-7], p = 0.024), after 2 days (AG VAS 4 [IQR 3-5], PG VAS 4.5 [IQR 4-6], p = 0.044), and after 3 days (AG VAS 3 [IQR 0-5], PG VAS 4 [IQR 3-5], p = 0.024). Throughout the observation period, the AG took a significantly lower number of painkillers than the PG (AG 6 [IQR 4.25-7]; PG 8 [IQR 8-9], p < 0.001). There were no significant differences in the levels of edema and trismus between the two groups throughout the observation period. CONCLUSIONS: On the basis of the results of the present study, auriculotherapy can be considered as a cost-effective adjuvant pain reliever treatment in patients undergoing an extraction of the lower third molars.

Training in child care and carrying out auriculotherapy techniques for mothers of premature newborns: double-blind clinical trial / Treinamento em cuidados infantis e técnicas de auriculoterapia a mães de recém-nascidos prematuros: ensaio clínico duplo-cego

Abstract Objectives: this study aimed to investigate the effect of education and auriculotherapy on stress, anxiety, and depression, and coping responses in mothers with premature infants. Methods: this is a randomized clinical trial study at Bahar Hospital carried out with 90 mothers with premature infants admitted to the neonatal intensive care unit. Those eligible for hospitalization were included in the study and distributed into three groups before intervention: (30 ones in the control, training, and auriculotherapy groups, respectively). The mean stress, anxiety, depression, and coping responses in mothers were measured both at the beginning of the study and before neonatal discharge. Results: there was no statistically significant difference in terms of anxiety, stress, and depression scores between the three groups before the intervention. However, after the intervention, there was a significant statistical difference between these three groups, which was among the mean scores of anxiety, stress, and depression. In terms of coping responses, the mean emotional and problem-oriented score in all three groups before and after the intervention is statistically significant. Conclusions: educating mothers and auriculotherapy pressure therapy are simple and practical methods in reducing anxiety, stress, depression, and increase coping responses; consequently, they can be used in neonatal intensive care.

Resumo Objetivos: este estudo teve como objetivo investigar o efeito da educação e da auriculoterapia no estresse, ansiedade e depressão e nas respostas de enfrentamento em mães com bebês prematuros. Métodos: este é um estudo de ensaio clínico randomizado no Bahar Hospital realizado com 90 mães de bebês prematuros internados em unidade de terapia intensiva neonatal. Os elegíveis para internação foram incluídos no estudo e distribuídos em três grupos antes da intervenção: (30 nos grupos controle, treinamento e auriculoterapia, respectivamente). O estresse médio, ansiedade, depressão e respostas de enfrentamento em mães foram medidas no início do estudo e antes da alta neonatal. Resultados: não houve diferença estatisticamente significativa nos escores de ansiedade, estresse e depressão entre os três grupos antes da intervenção. No entanto, após a intervenção, houve uma diferença estatística significativa entre esses três grupos, que foi entre a pontuação média de ansiedade, estresse e depressão. Em termos de respostas de enfrentamento, a pontuação média emocional e orientada para o problema em todos os três grupos antes e depois da intervenção é estatisticamente significativa. Conclusões: a educação das mães e a terapia de pressão com auriculoterapia são métodos simples e práticos na redução da ansiedade, estresse, depressão e aumento das respostas de enfrentamento; conseqüentemente, podem ser utilizados em terapia intensiva neonatal.

Auriculoterapia para reducir el dolor crónico de la columna vertebral de los trabajadores de la salud: ensayo clínico / Auriculotherapy for reducing chronic spinal pain in health workers: a clinical trial / Auriculoterapia para redução da dor crônica na coluna vertebral em trabalhadores da saúde: ensaio clínico

Objetivo: evaluar la efectividad de la auriculoterapia para reducir el dolor musculoesquelético crónico de la columna vertebral de los trabajadores de la salud. Método: ensayo clínico aleatorizado, triple ciego, realizado con trabajadores de la salud diagnosticados con dolor crónico en la columna vertebral. Se aplicaron ocho sesiones de auriculoterapia con semillas, dos por semana. Los resultados fueron medidos con la Escala Numérica del Dolor, el Inventario Breve del Dolor, el Cuestionario de Discapacidad de Roland-Morris y los instrumentos SF-36, en la 1.ª, 4.ª, 8.ª sesión y follow-up a los 15 días. Análisis descriptivo e inferencial. Resultados: participaron 34 trabajadores del grupo intervención y 33 del grupo control, ambos mostraron una reducción en la intensidad del dolor (p>0,05). En el follow-up se registró una mayor reducción en el grupo intervención (3,32 ± 0,42) que en el grupo control (5,00 ± 0,43) (p=0,007). En cuanto a la calidad de vida, mejoró la vitalidad (p=0,012) y la limitación por aspectos emocionales (p=0,025). La relación entre auriculoterapia, discapacidad física e interferencia del dolor no difirió entre los grupos (p>0,05). El uso de medicamentos en el follow-up se mantuvo en el grupo control (77,8%) con respecto al grupo intervención (22,2%) (p=0,013). Conclusión: la auriculoterapia tuvo el mismo efecto en ambos grupos sobre la intensidad del dolor y duró más en el follow-up. Hubo una mejora en la calidad de vida y una reducción en el consumo de medicamentos. REBEC: RBR-3jvmdn.

Objective: to evaluate the effectiveness of auriculotherapy in reducing chronic musculoskeletal pain in the spine of health workers. Method: a randomized, triple-blind clinical trial conducted with health workers diagnosed with chronic spinal pain. Eight sessions of auriculotherapy with seeds were applied, two per week. The outcomes were measured with the Numerical Pain Scale, Brief Pain Inventory, Rolland-Morris Disability Questionnaire and SF-36 instruments, in the 1st, 4th and 8th session, and in the 15-day follow-up period. Descriptive and inferential analyses were performed. Results: 34 workers took part in the Intervention Group and 33 in the Control Group, and both presented reduced pain intensity (p>0.05). In the follow-up period, there was a greater reduction in the Intervention Group (3.32 ± 0.42), when compared to the Control Group (5.00 ± 0.43) (p=0.007). In quality of life, there was improved vitality (p=0.012) and limitation due to emotional aspects (p=0.025). The relationship between auriculotherapy, physical disability and pain interference did not differ between the groups (p>0.05). Medication use in the follow-up period remained unchanged in the Control Group (77.8%) when compared to the Intervention Group (22.2%) (p=0.013). Conclusion: auriculotherapy exerted the same effect between the groups on pain intensity, lasting longer in the follow-up period. There was an improvement in quality of life and a reduction in medication use. REBEC: RBR-3jvmdn.

Objetivo: avaliar a eficácia da auriculoterapia na redução da dor musculoesquelética crônica na coluna vertebral de trabalhadores da área da saúde. Método: ensaio clínico randomizado, triplo cego, realizado com trabalhadores da saúde com diagnóstico de dor crônica na coluna vertebral. Aplicaram-se oito sessões de auriculoterapia com sementes, duas por semana. Desfechos mensurados com os instrumentos Escala Numérica da Dor, Inventário Breve de Dor, Questionário de Incapacidade de Rolland-Morris e SF-36, na 1ª, 4ª, 8ª sessão, e follow-up de 15 dias. Análise descritiva e inferencial. Resultados: participaram 34 trabalhadores no grupo intervenção e 33 no controle, ambos apresentaram redução da intensidade da dor (p>0,05). No follow-up, maior redução no grupo intervenção (3,32 ± 0,42), comparado ao controle (5,00 ± 0,43) (p=0,007). Na qualidade de vida, melhorou a vitalidade (p=0,012) e limitação por aspectos emocionais (p=0,025). Relação entre auriculoterapia, incapacidade física e interferência da dor não diferiu entre os grupos (p>0,05). O uso de medicamentos, no follow-up, manteve-se no grupo controle (77,8%) se comparado à intervenção (22,2%) (p=0,013). Conclusão: a auriculoterapia apresentou igual efeito entre os grupos na intensidade da dor, com maior durabilidade deste no follow-up. Houve melhora da qualidade de vida e redução do consumo de medicamentos. REBEC: RBR-3jvmdn.

The Effect of Auriculotherapy on Nausea, Vomiting, and Anxiety in Patients Undergoing Elective Cesarean Section with Spinal Anesthesia: A Clinical Trial Study.

Background: Nausea, vomiting, and anxiety are common complications during and after spinal anesthesia. Auriculotherapy as a complementary medicine can be useful for reducing nausea, vomiting, or anxiety. This study was performed to evaluate the effects of auriculotherapy on nausea, vomiting, and anxiety in patients undergoing elective Cesarean Section (CS) with spinal anesthesia. Materials and Methods: The present study was a clinical trial study that was performed on 56 pregnant women selected as CS candidates in Ommolbanin Hospital in Mashhad during the years 2016-2017. In the intervention group, 1 h before spinal anesthesia, auricular acupoint stimulation was performed at four points bilaterally, for 20-30 seconds at each point. Evaluations were done by the following questionnaires: State-Trait Anxiety Inventory (STAI), Visual Analog Scale (VAS), and Vomiting Assessment Form. Results: The mean anxiety (SD) before the intervention in the intervention group and the control group was 47.88 (8.67) and 47.84 (10.49), respectively, and 4 h after the intervention, it was 40.23 (10.19) and 42.88 (12.18) in the intervention and control groups, respectively. These results were significant in the intervention group (p = 0.008). 30-40 min before and 4 h after the surgery, the severity of nausea and vomiting was low in both groups and no significant difference was observed between the two groups during the surgery and in the recovery room (p > 0.05). Conclusions: According to the results, auriculotherapy could reduce anxiety in CS patients with spinal analgesia. The results also showed that auriculotherapy reduced the severity of nausea and vomiting, but these changes were not significant.

Silver Spike Point Therapy in smoking cessation: What is it and does it work?

Smoking is a global health challenge that causes a myriad of diseases. Smoking cessation services are part of the armamentarium to combat smoking epidemic. In addition to the approved treatments, alternative therapies, including electrical stimulation, have been proposed. The aim of this study is to review and summarize the evidence for the efficacy of electrical stimulation, including Silver Spike Point therapy, in smoking cessation. A historical background and descriptive summary of various acupuncture and related therapies is provided. Systematic reviews and original studies were reviewed, and their results were summarized. In conclusion, the current best available evidence does not support the use of electrical stimulation, including Silver Spike Point therapy, in smoking cessation. Policy makers and healthcare providers should aim to utilize the available resources to provide evidence-based treatment options for patients seeking to quit tobacco use.

Auriculotherapy in prevention of migraine attacks: an open randomized trial.

Use of auriculotherapy to prevent episodic migraine pain has seldom been reported. The aim of this open study was to show that three sessions of auriculotherapy, 1 month apart, using semi-permanent needles decrease frequency and intensity of an attack in patients presenting episodic migraine. A total of 90 patients were randomized to the treatment group (AUR group, n = 58) or the control group (C group, n = 32). Four patients dropped out during the study (three in the AUR group and one in the C group). The number of days with migraine and non-migraine headache was similar when the analysis focused on the 3 months of the study or on the difference in each group of this number between the 3 months preceding the inclusion and the 3 months of the study (p = 0.123). AUR group patients had fewer days with non-migraine headache (p = 0.011) and took less Triptans (p = 0.045) than group C. Number of days with migraine, sum of the pain intensities of all migraines and non-migraine headaches, and total number of analgesics taken, other than triptan, were similar between groups. MIDAS score decreased with time in the AUR group while it increased in the C group whether in absolute values (p = 0.035) or as categories (p = 0.037). These contrasted results should lead to further study of the effectiveness of auriculotherapy for the prevention of migraine. Clinical trail registration: Protocol registered on the Clinicaltrials.gov, website (January 30, 2017, NCT03036761).

Reflexoterapia e auriculoterapia para lombalgia aguda em docentes e discentes universitários: Ensaio clínico duplo-cego / Reflexotherapy and auriculotherapy for acute lumbalgia in university teachers and students: A double-blind clinical trial

Objetivo: comparar os efeitos da auriculoterapia e reflexoterapia podal para lombalgia aguda inespecífica em docentes e discentes universitários da área da saúde. Método: ensaio clínico, randomizado, controlado, duplo-cego, com 189 participantes distribuídos em três grupos: auriculoterapia experimental, reflexoterapia experimental e combinadas. Fora realizados 3 intervenções. Para a coleta foram utilizados: Questionário Sociodemográfico; Escala Visual e Analógica de intensidade na avaliação da dor; e Questionário para Lombalgia. Os dados foram analisados no programa IBM SPSS Statistics versão 18.0 Foram aplicados: teste de normalidade Kolmogorov-Smirnov; testes Qui-quadrado ou Exato de Fisher para comparação entre os grupos, e Análise de variância com post hoc ou Kruskal-Wallis, conforme apropriado. Resultados: evidenciou-se redução significativa da dor nos três protocolos (p=<0,001) para o Questionário de lombalgia, mas na comparaçãoda escala da dor, houve menor eficácia no grupo combinado (p=0,006). Conclusão: Ambas as terapias são eficazes e indicadas para controle da lombalgia aguda(AU)

Objective: to compare the effects of auriculotherapy and foot reflex therapy for nonspecific acute low back pain in university professors and students in the health area. Method: clinical trial, randomized, controlled, double-blind, with 189 participants divided into three groups: experimental auriculotherapy, experimental reflex therapy and combined therapy. Three interventions were performed. For data collection, the following were used: Sociodemographic Questionnaire; Visual and Analog Scale of intensity in pain assessment; and Low Back Pain Questionnaire. Data were analyzed using the IBM SPSS Statistics program, version 18.0. The following were applied: Kolmogorov-Smirnov normality test; Chi-square or Fisher's Exact tests for comparison between groups, and Analysis of variance with post hoc or Kruskal-Wallis, as appropriate. Results: there was a significant reduction in pain in the three protocols (p=<0.001) for the Low Back Pain Questionnaire, but when comparing the pain scale, there was less efficacy in the combined group (p=0.006). Conclusion: Both therapies are effective and indicated for the control of acute low back pain(AU)

Objetivo: comparar los efectos de la auriculoterapia y la terapia refleja podal en el dolor lumbar agudo inespecífico en profesores y estudiantes universitarios del área de la salud. Método: ensayo clínico, aleatorizado, controlado, doble ciego, con 189 participantes divididos en tres grupos: auriculoterapia experimental, terapia refleja experimental y terapia combinada. Se realizaron tres intervenciones. Para la recolección de datos, se utilizaron: Cuestionario Sociodemográfico; Escala Visual y Analógica de intensidad en la valoración del dolor; y Cuestionario de dolor lumbar. Los datos fueron analizados mediante el programa IBM SPSS Statistics, versión 18.0, se aplicaron: prueba de normalidad de Kolmogorov-Smirnov; Pruebas Chi-cuadrado o Exacto de Fisher para comparación entre grupos, y Análisis de varianza con post hoc o Kruskal-Wallis, según corresponda. Resultados: hubo reducción significativa del dolor en los tres protocolos (p=<0,001) para el Low Back Pain Questionnaire, pero al comparar la escala de dolor, hubo menor eficacia en el grupo combinado (p=0,006). Conclusión: Ambas terapias son efectivas e indicadas para el control del dolor lumbar agudo(AU)

Reflexoterapia e auriculoterapia para lombalgia aguda em docentes e discentes universitários: Ensaio clínico duplo-cego / Reflexoterapia y auriculoterapia para la lumbalgia aguda en universitarios: Un ensayo clínico doble ciego / Reflexotherapy and auriculotherapy for acute lumbalgia in university teachers and students: A double-blind clinical trial

Objetivo: comparar os efeitos da auriculoterapia e reflexoterapia podal para lombalgia aguda inespecífica em docentes e discentes universitários da área da saúde. Método: ensaio clínico, randomizado, controlado, duplo-cego, com 189 participantes distribuídos em três grupos: auriculoterapia experimental, reflexoterapia experimental e combinadas. Fora realizados 3 intervenções. Para a coleta foram utilizados: Questionário Sociodemográfico; Escala Visual e Analógica de intensidade na avaliação da dor; e Questionário para Lombalgia. Os dados foram analisados no programa IBM SPSS Statistics versão 18.0 Foram aplicados: teste de normalidade Kolmogorov-Smirnov; testes Qui-quadrado ou Exato de Fisher para comparação entre os grupos, e Análise de variância com post hoc ou Kruskal-Wallis, conforme apropriado. Resultados: evidenciou-se redução significativa da dor nos três protocolos (p=<0,001) para o Questionário de lombalgia, mas na comparaçãoda escala da dor, houve menor eficácia no grupo combinado (p=0,006). Conclusão: Ambas as terapias são eficazes e indicadas para controle da lombalgia aguda(AU)

Objective: to compare the effects of auriculotherapy and foot reflex therapy for nonspecific acute low back pain in university professors and students in the health area. Method: clinical trial, randomized, controlled, double-blind, with 189 participants divided into three groups: experimental auriculotherapy, experimental reflex therapy and combined therapy. Three interventions were performed. For data collection, the following were used: Sociodemographic Questionnaire; Visual and Analog Scale of intensity in pain assessment; and Low Back Pain Questionnaire. Data were analyzed using the IBM SPSS Statistics program, version 18.0. The following were applied: Kolmogorov-Smirnov normality test; Chi-square or Fisher's Exact tests for comparison between groups, and Analysis of variance with post hoc or Kruskal-Wallis, as appropriate. Results: there was a significant reduction in pain in the three protocols (p=<0.001) for the Low Back Pain Questionnaire, but when comparing the pain scale, there was less efficacy in the combined group (p=0.006). Conclusion: Both therapies are effective and indicated for the control of acute low back pain.(AU)

Objetivo: comparar los efectos de la auriculoterapia y la terapia refleja podal en el dolor lumbar agudo inespecífico en profesores y estudiantes universitarios del área de la salud. Método: ensayo clínico, aleatorizado, controlado, doble ciego, con 189 participantes divididos en tres grupos: auriculoterapia experimental, terapia refleja experimental y terapia combinada. Se realizaron tres intervenciones. Para la recolección de datos, se utilizaron: Cuestionario Sociodemográfico; Escala Visual y Analógica de intensidad en la valoración del dolor; y Cuestionario de dolor lumbar. Los datos fueron analizados mediante el programa IBM SPSS Statistics, versión 18.0, se aplicaron: prueba de normalidad de Kolmogorov-Smirnov; Pruebas Chi-cuadrado o Exacto de Fisher para comparación entre grupos, y Análisis de varianza con post hoc o Kruskal-Wallis, según corresponda. Resultados: hubo reducción significativa del dolor en los tres protocolos (p=<0,001) para el Low Back Pain Questionnaire, pero al comparar la escala de dolor, hubo menor eficacia en el grupo combinado (p=0,006). Conclusión: Ambas terapias son efectivas e indicadas para el control del dolor lumbar agudo.(AU)

Effects of photobiomodulation on auriculotherapy points for sleep disorders, anxiety, and temporomandibular dysfunctions.

OBJECTIVE: The purpose of this study was to evaluatephotobiomodulation applied at auriculotherapy points forsleep disorder (SD) and anxiety related to temporomandibulardysfunction (TMD). METHODS: The study consisted of two groups of 20 participants: Auriculotherapy group (A) and Control Group(C). The participants responded to the RDC/TMD, Fletcher & Luckett questionnaires, and the Beck Anxiety Inventory to analyze TMD, SD, and anxiety before and after the treatment. RESULTS: The participants presented scores corresponding to mild to moderateanxiety (MDN = 17; CI = [13.16;22.31]) and after treatment, normalor non-existent anxiety (MDN = 9; CI = [8.76; 17.12]) (p = 0.005). There was no significant difference (p > 0.05) between the controland 20 auriculotherapy groups for TMD and SD. DISCUSSION: The results suggest that auriculotherapy was effective in the treatment of anxiety. However, it did not prove effective with the results of the SD and symptoms of TMD.