Training Self-Administered Acupressure Exercise among Postmenopausal Women with Osteoarthritic Knee Pain: A Feasibility Study and Lessons Learned

Abstract

Background. Osteoarthritis (OA) is more prevalent in women, particularly after menopausal age. Women are more likely to seek complementary and alternative medicine (CAM) approaches. We examined the feasibility of training self-administered acupressure exercise and assessed its impact on OA symptoms among women with knee OA. Methods. Thirty-six eligible postmenopausal women were randomly assigned in the acupressure exercise group (n = 15) or the control group (n = 21) for 12 weeks. Feasibility outcomes (e.g., compliance and adverse effects) and clinical outcomes (e.g., pain, stiffness, and physical function) were assessed. Data were collected at baseline, 6 weeks and 12 weeks. Both per-protocol and intention-to-treat analysis were employed. Results. The training materials were well received. The feedback from participants suggests that self-administered acupressure exercise is easy to learn and safe to perform at home, although no statistically significant results of the clinical outcome were observed. Our findings didn't reveal superiority or inferiority of acupressure compared with usual care. Conclusion. Acupressure exercise is feasible to be trained among postmenopausal women with knee osteoarthritis. Due to the limitations of this study such as small sample size and high attrition rate, acupressure's efficacy needs to be further explored in larger scale studies with more rigorous design.

Feasibility of a Randomized Controlled Trial of Self-Administered Acupressure for Symptom Management in Older Adults with Knee Osteoarthritis

“…The low attrition rate, especially in comparison with Zhang and colleagues' study, 16 was likely attributed to two factors. One was that the RA in the current study could address participants' questions during weekly phone calls, an especially important factor in the early weeks of participation.…”

“…16,22 The hand-held device caused some discomfort and adverse events. Future studies should consider using other tools or just fingers to apply pressure.…”

“…15 Recently, Zhang et al reported a pilot study of training postmenopausal women with knee OA pain to self-administer acupressure. 16 Their sample consisted of mostly young-old women (mean age, 61 years), was small (n = 36), and had high dropout rates (33%). They did not report fidelity or adherence, and few previous self-administered acupressure studies have addressed these issues.…”

Self-administered acupressure for symptom management among Chinese family caregivers with caregiver stress: a randomized, wait-list controlled trial

“…TCM theory holds that meridians, which are channels in a network of energy pathways throughout the body, regulate the flow of Qi (vital energy) and the unbalanced flow of Qi results in disease [16]. By applying pressure to acupoints (trigger or active points) on the surface of the skin, acupressure stimulates the meridians, resulting in the opening of the channels and balancing of energy, thus restoring health [14, 16]. Because acupressure uses the application of pressure to acupoints without penetrating the skin, it is non-invasive and painless [17, 18].…”

“…This technique has a number of advantages including flexibility, low cost, and empowerment [18]. Studies have reported on the clinical application of self-administered acupressure [14, 23]. In addition, systematic reviews of the effect of self-administered acupressure for symptom management have been conducted.…”