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Effects of Self-Administered Acupressure on Fatigue Following Traumatic Brain Injury: A Randomized Controlled Trial
Shu-Mei Chen1, Wan-Ling Chen, Chen-Jei Tai
1Department 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).
Background:
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.
Purposes:
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.
Design:
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.
Methods:
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.
Results:
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.
Conclusion:
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.
Relevance To Clinical Practice:
Healthcare providers should incorporate self-administered acupressure into the care plans for TBI survivors to improve their fatigue symptoms.
