Cho Yu-Min, Yeh Chao Hsing, Wu Huilin, Huang Xinran, Chen Wanqi, Murphy Thomas J, Kawi Jennifer
Cizik School of Nursing, University of Texas Health Science Center at Houston.
School of Public Health, University of Texas Health Science Center at Houston.
Res Sq. 2024 Dec 4:rs.3.rs-5314308. doi: 10.21203/rs.3.rs-5314308/v1.
Chronic musculoskeletal pain (CMP) affects around 1.7 billion people globally, causing significant physical, psychological, and economic burdens. Current treatments often involve medications with risks, creating an urgent need for accessible alternatives. Interventionist-administered Auricular Point Acupressure (APA) has shown effectiveness in reducing pain. To explore whether this low-risk, non-invasive, non-pharmacologic, and non-opioid pain relief method can be expanded digitally, this study developed a self-managed APA program using mobile health technology and coaching videos, allowing individuals to self-administer APA and evaluate its impact and sustainability.
A 3-group pilot randomized controlled trial was conducted among 37 participants with CMP. The participants were randomly assigned to in-person APA (n=14) with face-to-face APA instruction, self-guided APA (n=12) with remote APA coaching, or control (n=11). All received conventional healthcare, with the APA groups also receiving adjuvant APA intervention for a 4-weeks supplemented with mobile app coaching videos, followed by monthly monitoring for three months. Data on pain intensity, physical disability, physical function, anxiety, depression, fatigue, sleep disturbance, fear avoidance of work, and satisfaction were collected at baseline, immediately following the 4-week APA intervention, and during the 2-month and 3-month follow-ups post-intervention.
Both the in-person and self-guided APA groups experienced a 47% reduction in pain intensity. Over 50% of participants achieved at least a 30% reduction in pain, and more than 17% had a 30% reduction in physical disability. Improvements included an 18% boost in physical function, decreased fatigue, improved sleep disturbance, and less depression (with increases noted in the control group), a 50% reduction in fear-avoidance of work, and only 3.8% reported not being satisfied with the APA at the 3-month follow-up. No adverse effects related to APA were reported.
APA improved physical and mental health in participants with CMP, enhanced readiness to return to work, and demonstrated sustainability for at least three months. Coaching videos delivered via a mobile app proved to be a feasible approach for teaching APA, increasing the accessibility of the intervention. This study highlights the impact of APA and recommends further research into its mechanisms and long-term benefits to support integration into standard practice.
慢性肌肉骨骼疼痛（CMP）在全球约影响17亿人，造成重大的身体、心理和经济负担。当前的治疗方法通常涉及有风险的药物，迫切需要可及的替代方法。由干预者实施的耳穴指压法（APA）已显示出减轻疼痛的效果。为了探索这种低风险、非侵入性、非药物且非阿片类的疼痛缓解方法是否可以通过数字化方式推广，本研究利用移动健康技术和指导视频开发了一个自我管理的APA项目，使个人能够自我实施APA并评估其影响和可持续性。
对37名CMP患者进行了一项3组试点随机对照试验。参与者被随机分配到接受面对面APA指导的面对面APA组（n = 14）、接受远程APA指导的自我指导APA组（n = 12）或对照组（n = 11）。所有参与者都接受常规医疗保健，APA组还接受为期4周的辅助APA干预，并辅以移动应用程序指导视频，随后进行为期三个月的每月监测。在基线、4周APA干预结束后以及干预后的2个月和3个月随访期间，收集有关疼痛强度、身体残疾、身体功能、焦虑、抑郁、疲劳、睡眠障碍、对工作的恐惧回避和满意度的数据。
面对面APA组和自我指导APA组的疼痛强度均降低了47%。超过50%的参与者疼痛至少减轻了30%，超过17%的参与者身体残疾减轻了30%。改善包括身体功能提高18%、疲劳减轻、睡眠障碍改善、抑郁减轻（对照组有增加）、对工作的恐惧回避减少50%，在3个月随访时只有3.8%的人表示对APA不满意。未报告与APA相关的不良反应。
APA改善了CMP患者的身心健康，增强了重返工作岗位的意愿，并显示出至少三个月的可持续性。通过移动应用程序提供的指导视频被证明是教授APA的可行方法，增加了干预措施的可及性。本研究突出了APA的影响，并建议进一步研究其机制和长期益处，以支持将其纳入标准实践。
