Chen Shu-Mei, Chen Wan-Ling, Tai Chen-Jei, Hsieh Shu-Hua, Lin Che-Kuang, Chen Pin-Yuan, Huang Hui-Chuan, Fan Yen-Chun, Chiu Hsiao-Yean
Department of Neurosurgery, Taipei Medical University Hospital and School of Medicine, Taipei Medical University, Taipei, Taiwan (Dr S. M. Chen); Departments of Nursing (Ms W. L. Chen) and Surgery, Division of Neurosurgery (Dr Lin), Far Eastern Memorial Hospital, New Taipei, Taiwan; School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan (Ms W. L. Chen and Drs Huang, and Chiu); Departments of Traditional Chinese Medicine (Dr Tai) and Nursing (Dr Chiu), Taipei Medical University Hospital, Taipei, Taiwan; Department of Nursing, En Chu Kong Hospital, New Taipei, Taiwan (Ms Hsieh); Department of Neurosurgery, Chang Gung Memorial Hospital and Community Medicine Research Center, Keelung Branch, Keelung, Taiwan (Dr P.Y. Chen); School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan (Dr Fan); and Research Center of Sleep Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan (Dr Chiu).
J Head Trauma Rehabil. 2023;38(6):E404-E413. doi: 10.1097/HTR.0000000000000861. Epub 2023 Mar 23.
Fatigue is a common symptom after a traumatic brain injury (TBI) and may persist for weeks or years. However, nonpharmacological management strategies for fatigue alleviations are almost nonexistent; thus, effective fatigue management programs are needed urgently.
We aimed to evaluate the effects of self-administered acupressure programs on post-TBI fatigue and heart rate variability and identify the possible correlation between the improvements in fatigue symptoms and the changes in heart rate variability.
This randomized controlled trial included 2-point acupressure (TPA; n = 27), 5-point acupressure (FPA; n = 27), and usual care (UC, control; n = 27) groups who underwent several assessments before and after the study intervention. Heart rate variability was evaluated at baseline, weeks 2 and 3, and treatment completion.
The TPA and FPA groups self-administered acupressure (3 minutes per acupoint; bilateral), thrice daily for 4 weeks, whereas the UC group received routine treatment without acupressure.
Both the TPA and FPA groups exhibited substantial improvements in fatigue symptoms compared with the baseline findings in the UC group. In addition, the TPA and FPA groups exhibited increased high-frequency power and mean number of times per hour in which the changes in successive normal sinus intervals (RR) gradually exceeded 50 ms (pNN50). Changes in high-frequency power and pNN50 were correlated with improvements in post-TBI fatigue symptoms.
Acupressure may alleviate chronic fatigue and enhance parasympathetic activity in TBI survivors. The enhancement of parasympathetic activity may be correlated with improvements in post-TBI fatigue symptoms.
Healthcare providers should incorporate self-administered acupressure into the care plans for TBI survivors to improve their fatigue symptoms.
疲劳是创伤性脑损伤（TBI）后常见的症状，可能会持续数周或数年。然而，几乎不存在缓解疲劳的非药物管理策略；因此，迫切需要有效的疲劳管理方案。
我们旨在评估自我按压方案对TBI后疲劳和心率变异性的影响，并确定疲劳症状改善与心率变异性变化之间的可能相关性。
这项随机对照试验包括2点按压（TPA；n = 27）、5点按压（FPA；n = 27）和常规护理（UC，对照组；n = 27）组，这些组在研究干预前后接受了几次评估。在基线、第2周和第3周以及治疗结束时评估心率变异性。
TPA组和FPA组自我进行按压（每个穴位3分钟；双侧），每天3次，共4周，而UC组接受无按压的常规治疗。
与UC组的基线结果相比，TPA组和FPA组的疲劳症状均有显著改善。此外，TPA组和FPA组的高频功率以及连续正常窦性间期（RR）变化逐渐超过50 ms的每小时平均次数（pNN50）均有所增加。高频功率和pNN50的变化与TBI后疲劳症状的改善相关。
按压可能减轻TBI幸存者的慢性疲劳并增强副交感神经活动。副交感神经活动的增强可能与TBI后疲劳症状的改善相关。
医疗保健提供者应将自我按压纳入TBI幸存者的护理计划中，以改善他们的疲劳症状。
