Complementary Therapies in Clinical Practice最新文献

Background and purpose

Materials and methods

Results

Conclusion

Background

Opioid abuse and mortality are ravaging American society, highlighting the need to find alternative effective analgesics with fewer side effects. FDA-approved topical analgesics, including non-steroidal anti-inflammatory drugs (NSAIDs), are commonly used to treat musculoskeletal pain but can cause adverse effects. Natural compounds, including essential oils, are potential therapeutic alternatives for managing musculoskeletal pain. If these compounds can provide comparable analgesia to FDA-approved products, it will increase the available options for people with pain, improving quality of life with minimal morbidity and mortality.

Objective

This study assesses the effectiveness and onset of action of Bonipar, a topical analgesic formulated with camphor, methyl salicylate, and oils of coconut, eucalyptus, nutmeg, and rosemary, in managing musculoskeletal pain compared to 1.5 % diclofenac solution, an FDA-approved topical non-steroidal anti-inflammatory drug.

Methods

One hundred sixty-four adult patients with localized musculoskeletal pain were randomly assigned to twice-daily applications of either Bonipar or Diclofenac for one week. The primary outcome measure was a 50 % reduction in pain after one week. Secondary outcomes included the change in pain from baseline and onset of action, defined as the first reduction in pain by 20 %.

Results

All patients completed the initial pain assessment to determine the onset of action. One-week data was available for 74 patients treated with diclofenac and 72 patients treated with Bonipar. Data for 18 patients were incomplete. The proportion of patients achieving a 50 % reduction in pain was statistically similar between the two groups. The success rates of achieving a 50 % pain reduction with Bonipar were found to be non-inferior to those treated with diclofenac. All follow-up time points showed roughly similar results between the groups. Regression models adjusted for age and sex revealed no significant effects on pain changes. Secondary analyses demonstrated no significant differences between the groups.

Discussion

The topical analgesic Bonipar demonstrates a comparable onset of action, with efficacy non-inferior to diclofenac in the management of musculoskeletal pain, while showing fewer adverse effects compared to diclofenac. These findings highlight the potential of Bonipar as a valuable alternative for the treatment of localized pain.

Background

Cancer survivors with chronic pain experience pain relief with hypnosis and relaxation approaches; however, the effects of hypnosis and relaxation audio recording interventions on chronic pain have not yet been described from the perspective of the cancer survivor. The purpose of this study was to better understand cancer survivors’ experiences using hypnosis and relaxation interventions.

Materials and methods

A randomized controlled trial with 109 cancer survivors experiencing chronic pain were assigned to the hypnosis (n = 55) or relaxation (n = 54) audio recordings. Participants listened to audio recordings daily for four weeks. A structured interview was conducted post-treatment to explore participants’ experience in using either the recorded hypnosis or relaxation intervention. Two reviewers independently conducted thematic analysis on all transcripts and then organized findings to identify salient themes.

Results

Qualitative interviews were completed by 77 (71 %) of the participants. Cancer survivors who listened to either the hypnosis or relaxation audio recordings described similar effects of the interventions. Four major themes were identified: (1) pain relief, (2) control over pain, (3) improvement in other symptoms, and (4) positive experiences. Central to the participants’ experiences, the interventions gave them another tool to manage their pain.

Conclusion

The unique perspectives of cancer survivors with chronic pain add to our understanding of the effectiveness of hypnosis and relaxation audio recordings in the management of chronic pain. These interventions are described as having both physical and psychological benefits for cancer survivors.

Background

Although acupuncture is widely used to treat ischemic stroke, its effects remain uncertain. This systematic review aims to synthesize current evidence on the effects of acupuncture for ischemic stroke and assess whether current randomized controlled trials (RCTs) have sufficient power to detect its effects.

Methods

Seven databases and two registry platforms were searched systematically from inception to June 13, 2023, to identify RCTs comparing the effects of acupuncture on ischemic stroke with control groups (placebo/blank). The Cochrane Risk of Bias 2 (RoB 2) tool was used to evaluate the risk of bias in the included trials. Random effects models through restricted maximum likelihood estimation were further used to estimate the pooled mean differences (MDs) and the corresponding 95 % confidence intervals (CIs). The primary outcome was neurological function (National Institutes of Health Stroke Scale, NIHSS), while secondary outcomes included global disability (modified Rankin Scale, mRS) and activities of daily living (ADLs) (Barthel Index, BI or Modified Barthel Index, MBI). The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) system was used to evaluate the certainty of the evidence. Trial sequential analysis (TSA) was further applied to control random errors and calculate the required information size (RIS).

Results

Forty RCTs involving 4485 patients were included. Acupuncture was found to significantly improve NIHSS (18 trials, 2658 patients; MD = −1.61, 95 % CI [-2.12, −1.09], low certainty evidence), mRS (3 trials, 298 patients; MD = −0.34, 95 % CI [-0.50, −0.19], moderate certainty evidence), and BI/MBI (26 trials, 2562 patients; MD = 8.98, 95 % CI [6.18, 11.77], low certainty evidence). Further, graphs of TSA indicated that the sample size of the trials was sufficient, and the results are robust.

Conclusion

Current evidence suggests that acupuncture can significantly improve neurological function, global disability, and ADLs in patients with ischemic stroke. The results were robust, as confirmed by TSA. However, the certainty of the evidence is moderate to low and should be further verified by more high-quality RCTs.

Background

The use of various adjunctive phototherapies for diabetic foot ulcers (DFUs) makes it difficult to fully understand their roles in current laser-based review studies. Red and infrared light have significant advantages for wound healing. To evaluate the impact of red and infrared light on the healing of DFUs and provide evidence-based recommendations for future clinical adjunctive treatments of DFUs.

Methods

Multiple databases, including PubMed, EMBASE, Cochrane Library, Web of Science, CINAHL, PEDro, CNKI, CBM, Wanfang, and VIP, were systematically searched for articles published until November 2023. The focus of the search was to identify randomised controlled trials that investigated the effects of red and infrared light on the treatment of DFUs. Data extraction, literature screening, and methodological quality assessment were conducted independently by two researchers. A meta-analysis was performed using RevMan5.4 and STATA16.0 software.

Results

A total of 28 studies, involving 1471 patients, were included. The meta-analysis showed that groups treated with red and infrared light had a significantly higher ulcer healing rate [risk ratio (RR) = 1.93, 95 % confidence interval (CI) (1.63, 2.28), P < 0.00001], shorter ulcer healing time [mean difference (MD) = 18.52, 95 % CI (8.58, 28.47), P < 0.00001], increased peak blood flow velocity in the dorsalis pedis artery [mean difference (MD) = 6.54, 95 % CI (4.01,9.08)], P < 0.00001), and reduced wound pain score [mean difference (MD) = −4.33, 95 % CI (−4.94, −3.71)], P < 0.00001) compared to the control group. However, there was no statistically significant difference in the incidence of adverse events [odds ratio (OR) = 0.32, 95 % CI (0.09, 1.17), P = 0.08] between the two methods.

Conclusion

The use of red and infrared light as an adjunctive treatment for DFUs is more beneficial than conventional wound care. However, due to limitations in the quality and sample size of the included studies, further high-quality research is needed to validate these conclusions.

Background and purpose

Fatigue is a pervasive and debilitating symptom of multiple sclerosis (MS) that severely impairs quality of life and daily functioning. This emphasizes the essential need for complementary therapies that go beyond conventional therapies. Although acupuncture is gaining popularity in MS management, there is a critical lack of rigorous research on its effectiveness in alleviating symptoms.

Methods

A comprehensive literature search was conducted across multiple databases, focusing on studies evaluating acupuncture's effectiveness in alleviating fatigue in MS patients. Key outcomes measured in the analysis included fatigue, quality of life, and disability.

Results

Six studies were included in the analysis, consisting of two observational studies and four randomized controlled trials. The analysis focused on evaluating acupuncture's efficacy in alleviating fatigue induced by MS. Despite variations in acupuncture protocols, outcome metrics, and control conditions, our meta-analysis revealed that acupuncture significantly reduces fatigue (MD: −0.92, 95 % CI: −1.36 to −0.47, p < 0.0001) and enhances quality of life (SMD: 0.91, 95 % CI: 0.07–1.74, p = 0.03), underscoring its potential as a therapeutic intervention in the management of MS.

Conclusion

The meta-analysis suggests a notable improvement in MS-related fatigue following acupuncture, both compared to controls and pre-treatment levels, positioning it as a potential adjunct therapy. However, the prevalent risk of bias in these studies necessitates further high-quality research, along with studies involving larger patient cohorts, to definitively ascertain acupuncture's efficacy and safety in this context.

Background

Little is known about how adhering to the health guidelines for physical activity (PA), screen time (ST), and sleep duration (SD) relates to substance use in adolescents. Thus, this study aims to explore the potential association between adherence to the 24-h movement behavior (24-h MB) guidelines and substance use among adolescents.

Methods

Data from the 2019 Youth Risk Behavior Surveillance was analyzed. Participants reported their weekly PA, ST, SD, and substance use (alcohol and smoking) over the past 30 days. The mean age in the total participants was 15.56, and 48.03 % of the participants were females. Logistic regression was used in this study to explore the potential association between 24-h MB and substance use. Odds ratios (ORs) were reported alongside a 95 % confidence interval to enhance understanding of the observed association.

Results

Only 2.22 % participants adhered to all three 24-h MB guidelines, while 47.99 % did not follow any guidelines. Notably, there was no significant difference in the odds of cigarette smoking between participants who followed none of the guidelines and those who followed some or all of them. Nevertheless, adherence to one or more guidelines was found to be associated with higher odds of abstaining from alcohol consumption compared to non-adherence (one guidelines: OR = 1.17 [1.08, 1.28], two guidelines: OR = 1.28 [1.13, 1.44]).

Conclusions

Adhering to 24-h MB guidelines may reduce adolescents’ alcohol consumption, but the adherence was not significantly associated with smoking. Longitudinal studies are needed to confirm these findings. These results can inform adolescent health policies and interventions aimed at reducing substance use from the perspective of healthy time-use behaviors, which can be used for researchers and educator.

Background

This study investigated the association between adherence to 24-h movement guidelines and socioemotional competence among Chinese preschool children.

Methods

A total of 1288 parents of Chinese preschoolers (54.64 % boys, 45.36 % girls; M_age = 4.48, SD = 0.97) reported the time their children spent on physical activity (PA), screen time (ST), and sleep duration (SD), and completed questionnaires measuring socioemotional competence. Multiple logistic regression analyses were used to explore the associations between individual and combined measures of PA, ST, and SD, and the risk of low socioemotional competence.

Results

The risk of low socioemotional competence was significantly lower for children aged 4 (odds ratio [OR] = 0.47, 95 % CI: 0.31–0.71), 5 (OR = 0.23, 95 % CI: 0.15–0.35), and 6 (OR = 0.16, 95 % CI: 0.10–0.25) compared to 3-year-olds. Children with a family income level higher than 20,000CNY had a significantly lower risk of low socioemotional competence than those with a family income level not higher than 3000CNY (OR = 0.21, 95 % CI: 0.08–0.59). Urban residency was associated with significantly lower odds of low socioemotional competence than rural residency (OR = 0.41, 95 % CI: 0.21–0.82). Adherence to the PA-only guidelines (OR = 0.45, 95 % CI: 0.22–0.94), SD-only guidelines (OR = 0.25, 95 % CI: 0.08–0.72), ST + SD guidelines (OR = 0.33, 95 % CI: 0.16–0.67), and PA + ST + SD guidelines (OR = 0.36, 95 % CI: 0.18–0.70) were associated with a lower risk of low socioemotional competence. In addition, among boys, only adherence to the PA + ST + SD guidelines (OR = 0.36, 95 % CI: 0.14–0.90) was associated with a lower risk of low socioemotional competence. Among girls, adherence to SD guidelines only (OR = 0.22, 95 % CI: 0.04–0.90), ST + SD guidelines (OR = 0.17, 95 % CI: 0.06–0.49), and PA + ST + SD guidelines (OR = 0.37, 95 % CI: 0.14–0.91) were all associated with a lower risk of low socioemotional competence.

Conclusions

Adhering to 24-h movement guidelines is crucial for enhancing socioemotional competence in preschool children, especially girls. Interventions should focus on promoting physical activity, reducing screen time, and ensuring adequate sleep.

Background and Purpose

It was aimed to investigate the effects of massage with or without aromatherapy given to patients after colorectal cancer surgery on symptom management in the first three postoperative days.

Materials and methods

This study was carried out with a pretest-posttest randomized controlled design. The study included the aromatherapy massage group (AG; n = 30), the classical massage group (MG; n = 30), and one control group (CG; n = 30). A blend of sweet almond oil, lavender, chamomile, and ginger oil was used in AG. Massage was applied to the foot area, and 20 min of classical massage was performed. Before the pretest, the participants were blinded by not informing them about their group allocations. The analyses were carried out using parametric methods.

Results

Postoperative pain varied significantly over time in all three groups (AG: p = 0.007; η² = 0.150/MG: p = 0.008; η² = 0.559/CG: p = 0.017; η² = 0.132). Anxiety was found to differ between CG and AG and between CG and MG (p < 0.05). In all three groups, nausea-vomiting scores significantly decreased over time (AG: p = 0.002; η² = 0.211/MG: p = 0.004; η² = 0.164/CG: p = 0.021; η² = 0.125). Sleep quality was significantly higher in the massage groups than in the control group only on the second postoperative day (p = 0.011).

Conclusion

Aromatherapy massage had no significant effect on pain, fatigue, nausea, or vomiting compared to MG and CG, and sleep quality was higher in the massage groups compared to CG only on the second postoperative day. On the first three postoperative days, the post-intervention anxiety levels of AG and MG were lower than those of CG.

Clinicaltrials.gov.id

NCT04810299.

Background and purpose

Physical exercise improves physical and psychological health. However, information on the quantitative impact of Traditional Chinese Exercise (TCE) on physical and psychological health remains limited. Therefore, this systematic review and meta-analysis aimed to quantitatively explore the effects of TCE on the physical and psychological health of patients with multiple sclerosis (MS).

Methods

A comprehensive search was conducted across seven electronic databases (PubMed, SCOPUS, CINAHL, Web of Science, Cochrane Library, China National Knowledge Infrastructure, and Wanfang) from their inception to March 7, 2024 using the terms, Taiji, Tai Chi, Tai Chi Chuan, Qigong, Baduanjin, Wuqinxi, Yijinjing, multiple sclerosis, and disseminated sclerosis. Randomized controlled trials (RCTs) and non-RCTs reporting the effects of TCE on physical function or psychological health outcomes in MS patients were included. A random-effects model and 95 % confidence intervals (95 % CI) were used to compute the effect sizes.

Results

Eleven studies, including 461 subjects with MS, were included in this meta-analysis. TCE significantly increased balance (d = 0.88, 95 % CI [0.45, 1.31], p < 0.001, I² = 39.26 %), activities of daily living (d = 1.17, 95 % CI [0.30, 2.04], p < 0.001, I² = 89.15 %), Multiple Sclerosis Impact Scale (MSIS) scores (d = 0.53, 95 % CI [0.12, 0.93], p = 0.01, I² = 0 %), depression (d = 0.66, 95 % CI [0.003, 1.32], p = 0.049, I² = 62.97 %), and Activities-Specific Balance Confidence (ABC) scores (d = 1.30, 95 % CI [0.41, 2.18], p < 0.001, I² = 0 %) compared with control conditions.

Conclusions

This meta-analysis suggests the efficacy of TCE in improving balance, activities of daily living, MSIS scores, depression, and ABC scores in MS patients. However, further high-quality research is warranted to investigate these findings.