A Study on the Effects of Dry Needling in Multiple Sclerosis Patients with Spasticity: Protocol of a Randomized Waitlist-Controlled Trial

Omid Motamedzadeh^1,2, Noureddin Nakhostin Ansari^1,2,3,*, Soofia Naghdi^1,2, Amirreza Azimi⁴, Ashraf Mahmoudzadeh⁵, Sandra Calvo⁶, Pablo Herrero⁷

2021; 14(2): 82-88 https://doi.org/10.51507/j.jams.2021.14.2.82

Abstract : Background: Spasticity is a common symptom in multiple sclerosis (MS). Dry needling (DN) has been considered a useful method for the treatment of spasticity; however, there are no studies on the effects of DN on spasticity in patients with MS. We propose a study protocol aiming to investigate the effects of DN on spasticity in patients with MS. Methods: MS patients with plantar flexor spasticity will be recruited. Participants will be randomly assigned to the DN group, where they will be receiving a single session of DN, one minute for each head of gastrocnemius muscle, or to the waiting list control group with no intervention. Primary outcome measures are the Modified Ashworth Scale (MAS) for gastrocnemius spasticity, passive resistive torque, and podography for foot pressure distribution. The ankle active and passive range of dorsiflexion and Timed Up and Go tests are the secondary outcome measures. All outcomes will be measured at baseline, immediately after the intervention, and one week later. A mixed-model, general linear model, and two-way repeated-measures ANOVA will be used to compare the quantitative variables between groups and within groups at the measurement time points. The MAS ordinal measure of spasticity will be compared between groups using the Kruskal-Wallis test, and both the Friedman test and Wilcoxon test will be used for within-group changes. Discussion: This study will provide primary evidence on the effects of DN on gastrocnemius muscle spasticity and gait in patients with MS. Trial registration: Iranian Registry of Clinical Trials (IRCT): IRCT20190617043918N1.

Effect of Auricular Acupuncture with Semi-Permanent Ear Needles on Controlling Migraine Symptoms: A Single-Blind Randomized Clinical Trial

Mehran Razvani Habibabadi¹, Fereshteh Ashtari², Iman Raeisi^3,*

2021; 14(2): 58-66 https://doi.org/10.51507/j.jams.2021.14.2.58

Abstract : Background: Migraine is a very common neurobiological headache disorder caused by an increased irritability of the central nervous system. Acupuncture as a complementary medicine has been suggested as one of the treatments for migraine headaches; however, the findings are conflicting. Objectives: Therefore, the aim of this study was to evaluate the effect of acupuncture with auricular semi-permanent (ASP) needles on migraine headaches. Methods: In this single-blind randomized controlled trial, 80 patients with migraine were selected and divided into two groups. The intervention group was treated with auricular ASP needles in the active points of the ear, and the control group only received routine treatments. Pain score, frequency of migraine headaches, duration of headaches, severity of nausea and vomiting, and patient satisfaction were compared between the two groups for four weeks after the intervention. Results: Our results showed that the level of pain (4.72 ± 2.53, 2.13 ± 1.76 times) and the frequency of migraine headaches (8.98 ± 8.58 hours) from the second week after the intervention in the ASP group were much lower than those in the control group (p < 0.05). However, pain incidence and ear inflammation in the ASP group were negligible and did not differ significantly from those in the control group (p > 0.05). Conclusion: Auricular acupuncture could be considered as a promising complementary therapy along with other standard migraine therapies for the prevention and treatment of migraine headaches.

The Effect of Acupressure on Clinical Stress Management in Nursing Students: A Randomised Controlled Study

Dilek Yildirim^1,*, Özlem Akman²

J Acupunct Meridian Stud 2021; 14(3): 95-101 https://doi.org/10.51507/j.jams.2021.14.3.95

Abstract : Background: Nursing students experience clinical stress frequently and severely. The application of acupressure is reported to be effective in stress management.Objectives: This study was conducted to determine the effects of acupressure on reducing the stress of nursing students in clinical practice. Methods: This study was carried out using a single-blind randomized controlled experimental design. The experimental and control groups were randomly determined by using a previously prepared randomization checklist. A Participant Information Form, VAS, and the State Anxiety Inventory were applied to all students before practice. Acupressure was performed on the HT7 point and Yintang point (EX-HN3), respectively, every five minutes for a total of 30 minutes in the experimental group. Results: The level of stress experienced by the students in the experimental group before the intervention according to VAS was 6.95 ± 1.57, and it was determined as 2.82 ± 1.94 after the third application (p < 0.05). The mean clinical stress score before the application was 46.54 ± 3.81, and after the 3^rd week of application, it was 25.15 ± 5.26 (p < 0.05). It was observed that the students' stress levels decreased in all measurements made after the acupressure intervention. Conclusion: This study determined that acupressure effectively reduces the stress levels of nursing students, and it may be applied in clinical stress management.

Effect of Acupressure on Primary Dysmenorrhea: Review of Experimental Studies

Aslı Karakuş Selçuk*, Emre Yanikkerem

2021; 14(2): 33-49 https://doi.org/10.51507/j.jams.2021.14.2.33

Abstract : Primary dysmenorrhea is defined as cramping pain in the lower abdomen with no pelvic diseases, and it has a high prevalence in many countries. Acupressure is a widely used complementary treatment method for primary dysmenorrhea. This review examined experimental studies to determine the effects of acupressure on primary dysmenorrhea using the databases PubMed, Google Scholar, and CINAHL with the keywords “Acupressure” and “Dysmenorrhea”. There were 2227 records in the databases, and 330 articles were published between 1989 and March 2020. Experimental studies in the English language were reviewed according to the PRISMA guidelines. This review included 28 published studies that were assessed using the Jadad score for quality. The studies were categorized as studies of acupressure at the LR3 point (n = 4), at the SP6 point (n = 9), at auricular points (n = 5), at multiple points (n = 8), and with devices (n = 2). Moreover, studies of self-acupressure (n = 9) were identified. The studies demonstrated that acupressure could reduce menstrual symptoms, the severity and duration of menstrual pain, distress, and anxiety. Furthermore, it helped improve the quality of life and well-being of patients and provide psychological support and self-care. Acupressure is an inexpensive, easy-to-apply, and non-pharmacological treatment and is useful for reducing primary dysmenorrhea, and women can apply this method anywhere by themselves. However, high-quality randomized controlled trials with larger samples are necessary to establish the evidence for acupressure as an effective intervention.

The Effect of Laser Acupuncture on Spasticity in Children with Spastic Cerebral Palsy

Dian E. Putri ^{1, *}, Adiningsih Srilestari ¹, Kemas Abdurrohim ¹, Irawan Mangunatmadja ², Luh K. Wahyuni ³

2020; 13(5): 152-156 https://doi.org/10.1016/j.jams.2020.09.001

Abstract : Background: Spasticity in cerebral palsy is one of the most common disabilities of children in developing countries. Objectives: The objective of this study was to determine the efficacy of laser acupuncture on spasticity in children with spastic cerebral palsy. Methods: This clinical trial was conducted on 60 patients with spastic cerebral palsy at 2 to 10 years. The patients were categorized into two groups: the control group and treatment group. Laser acupuncture was applied on GV20, GV14, LI4, GB34, and LR3 (power 50 mW, 785 nm, 1 Joule, 40 seconds) three times a week for 12 sessions in the treatment group and placebo laser acupuncture on the same points in the control group. The spasticity was measured using the Modified Ashworth Scale before and after complete sessions. Results: The results showed that there was a significant reduction in the Modified Ashworth Scale score in the treatment group compared with the control group (p = 0.003). Conclusions: This study suggest that laser acupuncture on GV20, GV14, LI4, GB34, and LR3 can reduce spasticity for children with spastic cerebral palsy.