Effects of auricular acupressure on the quality of sleep and anxiety in patients undergoing cardiac surgery: A single-blind, randomized controlled trial.

AIM: This study aimed to evaluate the effects of auricular acupressure (AA), a non-invasive type of reflexotherapy, on sleep quality and anxiety in patients after cardiac surgery. BACKGROUND: Sleep disturbances and anxiety hinder the recovery of patients after cardiac surgery; thus, appropriate and adequate nursing interventions must be pursued. AA is a complementary therapy suitable for patients with limited pharmacological therapy options. METHOD: A single-blind, randomized controlled trial with a pretest-posttest control group design was applied. The study consisted of 42 patients, comprising an experimental group (n = 21) and a control group (n = 21). AA was applied for six days per trial for a total of 2 trials, while sleep (sleep score, sleep satisfaction) and anxiety (state, trait) were measured at three time points (pre-op, 7 days post-op, and 14 days post-op). RESULTS: The sleep and sleep satisfaction scores of the experimental group were significantly higher than those of the control group. No significant difference was found in anxiety state/trait between the two groups. CONCLUSIONS: We conclude that AA is a safe, effective, noninvasive, and low-risk nursing intervention that can improve sleep quality in patients after cardiac surgery.

Effects of feet reflexology versus segmental massage in reducing pain and its intensity, frequency and duration of the attacks in females with migraine: a pilot study.

OBJECTIVE: To evaluate the effects of feet reflexology versus segmental massage in reducing pain and its intensity, frequency and duration of the attacks in females suffering from migraine. METHODS: Forty eight females aged 33-58, suffering from migraine for 2 to 10 years were included in this study from November 2013 to November 2015. The study protocol was carried out in Department of Chronic Diseases at the Regional Hospital in Zywiec. In the reflexology group (RG) the patients received a series of 10 treatments 2 times per week; in the segmental massage group (SMG) the patients received a series of 15 treatments 3 times per week. Pain during migraine attacks was assessed using the visual analog scale (VAS), and headache features such as intensity (IA), frequency (FA) and duration (DA) of attacks were assessed before the treatment, just after the treatment, 3 months after the treatment. RESULTS: All variables (VAS, IA, FA and DA) decreased within RG and SMG 3 months after the treatment in compare with the baseline values, and the differences were statistically significant. The differences between groups were also statistically significant. CONCLUSION: Feet reflexology and segmental massage provide a safe alternative for the pharmacological treatment of migraine. The patients with migraine obtain significant health benefits with feet reflexology.

[The mechanisms underlying the therapeutic effects of reflexotherapy and drinking mineral waters in the patients presenting with metabolic syndrome]. / Mekhanizmy lechebnogo deistviia akupunktury i pit'evykh mineral'nykh vod pri metabolicheskom sindrome.

Both acupuncture and drinking mineral water can influence the metabolism of carbohydrates and lipids as well as their hormonal regulation, but the possibility of the application of these therapeutic factors for the correction of insulin resistance has not been studied in the patients presenting with metabolic syndrome. AIM: The objective of the present study was to evaluate the effects produced by the intake of drinking mineral water and acupuncture on the various parameters characterizing the patients suffering from metabolic syndrome in combination with altered insulin resistance. MATERIAL AND METHODS: Ninety patients with this condition included in the study underwent the analysis of their the blood pressure, body mass index, blood glucose and lipid levels, insulin and cortisol secretion. RESULTS: We undertook the analysis of the effects of the single and repeated intakes of Essentuki No 17 mineral water included in the combined treatment of the patients with metabolic syndrome and revealed many common responses of the organism to its therapeutic action. Specifically, the stress-type reactions suggested the initiation of the adaptive processes in the system of hormonal regulation of carbohydrate and lipid metabolism. Simultaneously, the manifestations of insulin resistance became less pronounced indicating that both acupuncture and drinking mineral water suppressed the action of the main pathogenic mechanisms underlying the development of metabolic syndrome. Moreover, it was shown that acupuncture had a stronger hypotensive effect in the combination with the decrease of the overproduction of cortisol whereas the intake of the mineral water had a greater metabolic potential and contributed to the intensification of the basal secretion of glucocorticoids. Both reflexotherapy and drinking mineral water have a well apparent effect on the pathogenetic reactions of the metabolic syndrome and therefore can be used in addition to the standard therapy to activate the non-specific, phylogenetically established and enshrined at the genetic level self-healing responses by mainstreaming the adaptation processes and the formation of the adaptive reactions initiated by stressor components. CONCLUSION: The addition of acupuncture or domestic mineral water intake to the standard therapy of the patients suffering from metabolic syndrome significantly enhances the effectiveness of the treatment. The beneficial therapeutic action of acupuncture and drinking mineral water is underlain by their impact on the mechanisms of resistance to insulin that manifests itself as a decrease of the fasting secretion of this hormone and optimization of carbohydrate and lipid metabolism. The therapeutic effect of acupuncture and drinking mineral water is realized through the induction of the stress-initiating reactions which activate the processes of adaptation, with reflexotherapy largely acting on the cardiovascular system and drinking mineral water on the system responsible for insulin regulation of the metabolic processes.

[The application of the acupuncture techniques for the combined treatment of neurotic tics in the children]. / Ispol'zovanie metodov refleksoterapii v kompleksnom lechenii nevroticheskikh tikov u detei.

At present, the frequency of neurosis in the children is growing under the influence of the increasingly intensive stressful factors. The neurotic ticks are one of the manifestations of neurosis in the children characterized by involuntary movements; they are often accompanied by hyperactivity, deficit of attention, fatigue, and headaches. AIM: The objective of the present study was to evaluate the effectiveness of acupuncture used for the treatment of neurotic tics in the children. MATERIAL AND METHODS: The study was carried out at the basis of the department of children's rehabilitation of the Moscow city polyclinic #39. All the children were counselled by a neurologist, psychologist, and acupuncturist. An electroencephalogram was obtained from each patient and a questionnaire study involving the patients' parents was conducted. The patients were treated with the application of reflexotherapy and were given recommendations of a psychologist. A total of 30 children at the age from 6 to 12 years were available for the examination. The participants of the study were allocated to two groups depending on the strategy of the outpatient care. Group 1 was comprised of the patients (n=17) who were given 3 courses of reflexotherapy in addition to pharmacotherapy and psychologist's recommendations. The patients included in group 2 served as controls (n=13) and received only medications and psychotherapy without acupuncture. The effectiveness of the treatment was evaluated based on the dynamics of the patients' complaints. RESULTS AND DISCUSSION: The resullts of the study give evidence of the higher effectiveness of the treatment of the children suffering from neurotic ticks with the application of acupuncture therapy compared with the conventional approach. A few courses of reflexotherapy provided in the combination with pharmacotherapy and the compliance with the recommendations of a psychologist resulted in the more efficient elimination of the neurotic tics together with the associated hyperactivity, deficit of attention, fatigue, and headaches than the use of medication therapy and psychotherapy without acupuncture.

[Complementary methods of rehabilitation in borderline mental disorders].

The article covers treatment results of 417 patients (186 males and 231 females) aged 18 to 71 years, with borderline mental disorders. Findings are that using specified complementary methods, more when treatment complex is applied, causes better psycho-emotional state in patients with borderline mental disorders, that is supported by results of medical diagnostic tests including psychometry tests (abridged minnesota multiphasic personality inventory, Beck depression inventory, Spielberger-Hanin, test "feeling, activity, mood").

[Myofascial meridional reflexotherapy of scapulohumeral periarthrosis in the course of the combined spa and health resort-based treatment].

The authors draw attention to the role of a whiplash injury in the pathogenesis of scapulohumeral periarthrosis (SHP). Peculiarities of the specific pathological biomechanical changes associated with this condition are described. The study included a group of 64 patients in whom the localization of the myofascial trigger points (MFTT) of the shortened muscles is described with reference to the differential techniques for soft-tissue manual therapy. Spatial emphasis is laid on the diagnostic dynamic ischemic compression of trigger points (TT) for their inactivation using the method proposed by J. Travel in the original modifications proposed by the authors of the present article. The results of the application of myofascial meridional reflexotherapy of scapulohumeral periarthrosis are presented and analysed in the context of the combined spa and health resort-based treatment.

[The application of invasive and non-invasive reflexotherapeutic methods for the improvement of tolerance to the influence of seasonal meteorological factors and correction of bronchial asthma].

The present study included 94 patients presenting with bronchial asthma (BA) who underwent the controlled treatment during one year. The treatment consisted of basal anti-asthmatic therapy in combination with acupuncture reflexotherapy or a complex of non-invasive reflexotherapeutic methods (CNIRTM) designed to increase the effectiveness of correction of asthma, to improve the clinical status of the patients, to decrease by more than two-fold the frequency of unstable episodes of the disease showing the well-apparent seasonal dependence, and to diminish the consumption of pharmaceuticals (reduction of the mean daily dose of prednisolone by 31% and 37% in comparison with its 79% increase in the patients receiving the standard treatment). Moreover, it was shown that the achievement of clinical and preventive effect of the application of non-pharmacological methods may be associated with the activation of the mechanisms of adaptation to the stress factors (such as correction of the cortisol blood level and parameters of the immune status, etc.) and the increase of the patient's tolerance to their influence.

[The rehabilitative treatment of chronic pyelonephritis in the children having an environmentally burdened medical history].

The present study involved 40 children aged 7-14 suffering from chronic pyelonephritis and having an environmentally burdened medical history. The combined spa treatment included either traditional peloid therapy applied to the lumbar region or the specially developed treatment using the adaptive-reflexive method that allowed the therapeutic effect to be gradually spread over various reflex zones. Mud applications under the new scheme were shown to be more adequate and sparing because they ensured gradual sequential involvement of different reflex zones that is of special importance for the patients having an environmentally burdened medical history and characterized by the impaired adaptive capacity. The advantage of the proposed peloid-therapeutic modality is confirmed by the reduction in the frequency of the patients' complaints and the more pronounced dynamics of the signs of mikrohematuria, pyuria, and oxaluria combined with the restoration of the anti-crystal-forming urinary activity in response to calcium phosphates in all patients.

[The pathogenetic rationale for the application of reflexotherapy in the rehabilitation of the patients presenting with cognitive disorders].

Cognitive disorders (CD) of variable severity are currently one of the leading causes of disability in the patients presenting with vascular and degenerative diseases of the brain; it is especially true of Alzheimer's disease. The discovery of the universal pathogenetic mechanism underlying the development of CD made it possible to explain the known cases of the successful application of acupuncture in the patients with disorders of seemingly different origin. The results of these studies suggest that acupuncture can affect the key pathogenetic "functional circles" involved in the development of CD. The present article is focused on the description of the humoral, neurotransmitter and electrophysiological mechanisms through which the positive effects of acupuncture on the cognitive function of the patients with various diseases are mediated.

[Prognostication of immunological reactivity and the choice of the variant of reflexotherapy for a newborn infant].

AIM: The objective of the present study was to determine the classification differences in immunological reactivity and to identify its predictors in the newborn infants. MATERIAL AND METHODS: The study involved 115 full-term newborn infants presenting with grade 3 prenatal hypoxic ischemic encephalopathy in the late neonatal period. The features of immunological reactivity under the influence of acupuncture were examined. Statistical processing was carried out by means of discriminant analysis. RESULTS: The assessment and prediction of the effectiveness of acupuncture in the neonates suffering from cerebral ischemia are based on the index of immunological reactivity and the leukocyte index of intoxication, as well as on the ratio of monocytes to band neutrophils content. For generation of the group classifier of immunological predictors in a newborn infant and development of indications for reflex therapy, nine parameters of interest were measured. The group specificity of the child was determined by three variables, viz. leukocyte index of intoxication, monocyte and band neutrophil counts with values of the Fisher's exact test (F) and reliability (Wilks Lambda 0.90894; approximation F (3.144) = 4.809; p < 0.0032). The partial Wilks Lambda values showed that the greatest contribution was provided by the leukocyte index of intoxication and monocytes. Prediction accuracy of the classification matrix in the standard treatment group reached 30.8% and 91.7% respectively when reflex therapy was included in the combined rehabilitation treatment. Overall, classification accuracy amounted to 70.3%. The presence of distinctive changes in the subgroups preconditioned a personalized approach to the prescription of reflex therapy to the newborn infants and the choice of the treatment modality on an individual basis (parent, child, or both) in the "mother-newborn" system. The variant of treatment was determined by comparing the values of the results of the formulas. The newborns were referred to the subgroup with the highest value of the classification function. The predictors made it possible to reliably distinguished the second (p = 0.032) and the third (p = 0.022) subgroups from the first one, with some degree of overlapping between the edge zones of centroids of the second and third subgroups (p = 0.073). Therefore, the sensitivity of classification in the individual subgroups was lower than in the group model and was estimated at 34.4, 71.9, and 65.6% for the first, second and third groups, respectively. CONCLUSION: The mathematical models can discriminatebetween the immunological characteristics and predict them in individual newborn infants; also, they can be helpful for preventing the disruption of their adaptation process.

[Assessment of the effectiveness of laser reflexotherapy in combined treatment of patients with chronic acalculous cholecystitis].

AIM: To study effects of laserpuncture in combined treatment of chronic non-calculous cholecystitis on motor function gallbladder, clinical symptoms. MATERIALS AND METHODS: 73 patients of chronic non-calculous cholecystitis were divided in to groups: 35 patients were received treated only by the means of standard therapy (the control group), 38 patients were received a course laserpuncture as part of complex treatment (the study group). RESULTS: Influence laser radiation on acupuncture points was found to induce positive therapeutic effect, such as: decrease the durations of clinical symptoms, correction of motor function gallbladder. CONCLUSION: Laserpuncture is an effective method of non-calculous cholecystitis treatment and can be included in relevant combined schemes.

Non-pharmacological interventions for fatigue in rheumatoid arthritis.

BACKGROUND: Fatigue is a common and potentially distressing symptom for people with rheumatoid arthritis with no accepted evidence based management guidelines. Non-pharmacological interventions, such as physical activity and psychosocial interventions, have been shown to help people with a range of other long-term conditions to manage subjective fatigue. OBJECTIVES: To evaluate the benefit and harm of non-pharmacological interventions for the management of fatigue in people with rheumatoid arthritis. This included any intervention that was not classified as pharmacological in accordance with European Union (EU) Directive 2001/83/EEC. SEARCH METHODS: The following electronic databases were searched up to October 2012, Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE; EMBASE; AMED; CINAHL; PsycINFO; Social Science Citation Index; Web of Science; Dissertation Abstracts International; Current Controlled Trials Register; The National Research Register Archive; The UKCRN Portfolio Database. In addition, reference lists of articles identified for inclusion were checked for additional studies and key authors were contacted. SELECTION CRITERIA: Randomised controlled trials were included if they evaluated a non-pharmacological intervention in people with rheumatoid arthritis with self-reported fatigue as an outcome measure. DATA COLLECTION AND ANALYSIS: Two review authors selected relevant trials, assessed risk of bias and extracted data. Where appropriate, data were pooled using meta-analysis with a random-effects model. MAIN RESULTS: Twenty-four studies met the inclusion criteria, with a total of 2882 participants with rheumatoid arthritis. Included studies investigated physical activity interventions (n = 6 studies; 388 participants), psychosocial interventions (n = 13 studies; 1579 participants), herbal medicine (n = 1 study; 58 participants), omega-3 fatty acid supplementation (n = 1 study; 81 participants), Mediterranean diet (n = 1 study; 51 participants), reflexology (n = 1 study; 11 participants) and the provision of Health Tracker information (n = 1 study; 714 participants). Physical activity was statistically significantly more effective than the control at the end of the intervention period (standardized mean difference (SMD) -0.36, 95% confidence interval (CI) -0.62 to -0.10; back translated to mean difference of 14.4 points lower, 95% CI -4.0 to -24.8 on a 100 point scale where a lower score means less fatigue; number needed to treat for an additional beneficial outcome (NNTB) 7, 95% CI 4 to 26) demonstrating a small beneficial effect upon fatigue. Psychosocial intervention was statistically significantly more effective than the control at the end of the intervention period (SMD -0.24, 95% CI -0.40 to -0.07; back translated to mean difference of 9.6 points lower, 95% CI -2.8 to -16.0 on a 100 point scale, lower score means less fatigue; NNTB 10, 95% CI 6 to 33) demonstrating a small beneficial effect upon fatigue. For the remaining interventions meta-analysis was not possible and there was either no statistically significant difference between trial arms or findings were not reported. Only three studies reported any adverse events and none of these were serious, however, it is possible that the low incidence was in part due to poor reporting. The quality of the evidence ranged from moderate quality for physical activity interventions and Mediterranean diet to low quality for psychosocial interventions and all other interventions. AUTHORS' CONCLUSIONS: This review provides some evidence that physical activity and psychosocial interventions provide benefit in relation to self-reported fatigue in adults with rheumatoid arthritis. There is currently insufficient evidence of the effectiveness of other non-pharmacological interventions.

The use of risk sharing tools for post adoption surveillance of a non pharmacological technology in routine practice: results after one year.

BACKGROUND: To report results obtained by combining risk sharing tools with post-adoption surveillance mechanisms in order to control quality of care and implement a value-based reimbursement scheme for Neuro-reflexotherapy (NRT), a non-pharmacological treatment proven effective for neck pain (NP), thoracic pain (TP) and low back pain (LBP). METHODS: Pre-post prospective cohort study in routine clinical practice, carried out in primary care centers in the Spanish National Health Service in the Balearic Islands (Ib-Salut). Eight-hundred and seventy-one subacute and chronic NP, TP and LBP patients treated in Ib-Salut, who underwent NRT during 2011. A shared risk contract (SRC) was developed, where payments for NRT were linked to results on patients' clinical evolution, reduction in medication and proportion of patients undergoing spinal surgery. Main outcome measures were local pain (NP, TP or LBP), referred pain, LBP-related disability and NP-related disability, measured using previously validated instruments at referral and 3 months later, use of medication assessed at referral and discharge, and rates of spinal surgery prescription after undergoing NRT. RESULTS: Median improvements at discharge corresponded to 57.1% of baseline value for local pain, 75.0% for referred pain, 53.8% for LBP-related disability and 45.0% for NP-related disability. Patients taking medication at discharge represented 29.0% of those taking it at referral. The proportion of patients in whom spinal surgery was prescribed after undergoing NRT was 0%. These results were consistent with those from previous randomised controlled trials (RCTs) and studies in routine practice, and complied with the standards set in the SRC. CONCLUSIONS: It is feasible and effective to enhance post adoption surveillance methods with risk sharing tools to improve quality control and support value-based reimbursement decisions for NRT. The feasibility of generalising this approach to other settings and to other non-pharmacological treatments should be explored.

[Clinical significance of pointed medicamental and non-medicamental therapy in the staged combined treatment of radiculopathies].

We analysed the results of the treatment of 4205 patients with different forms of vertebrogenic radiculopathy. They suggest the efficacy of differential application of graduated medicamental therapy, reflexo- and physiotherapy depending on the period of clinical course of the disease.

[Syndrome "sickly child"].

Scientific review is devoted to the urgent problem of child health care--Syndrome "sickly child" described in detail the category of "frequently ill children" repeated respiratory diseases, the pathogens that cause diseases of the respiratory tract. Paying attention to factors contributing to re-respiratory morbidity, including genetically determined causes (disturbances in the state of health of the mother), is represented by the genetic determinism of repeated and recurrent diseases related to blood groups. The development of an immune imbalance is manifested by changes in the cellular, humoral immune response and nonspecific resistance factors characterizing the changes of local immunity in this category of children that shape the development of chronic disease. We describe the effect of an allergic component to the severity of respiratory disease and the relationship with the mechanisms of neuroendocrine and immune systems. Correction of the immune resistance of sickly children was conducted cycloferon contributing to reduce the incidence and duration of repeated episodes of acute respiratory infections per year.

[Reflexotherapy in the context of rehabilitative medicine].

The main stages of the history of reflexotheray and its principal methodological aspects are reviewed in the context of the introduction of this approach into rehabilitative medicine. Productive results of such integration find the demonstrative reflection in the defense of 56 theses for the degree of candidate of science and 28 ones for the degree of doctor of science devoted to various aspects of reflexotherapy. The growing tendency toward the more extensive application of non-pharmacological approaches to complementary medicine opens up new prospects for the further development of reflexotherapy in the context of modern health care practices.

[Modern combined technologies for the rehabilitation of the patients presenting with arterial hypertension and its prevention].

The present review describes the modern methods for the combined treatment and rehabilitation of the patients presenting with arterial hypertension and their influence on the key pathogenetic components of this condition in accordance with the currently accepted theories of its origin and evolution. The discovery of specific molecular and cellular mechanisms of the therapeutic action of certain factors that reflect peculiar and unique character of their inherent physical energy provided a basis for the development of highly effective methods for the treatment and prevention of arterial hypertension and rehabilitation of the patients suffering this disease. The most comprehensive clinical effect is produced by the application of scientifically sound therapeutic systems; exclusion of certain therapeutic physical factors from these modalities results in s significant reduction of their curative effectiveness.

[The adaptive mechanisms of cardio- and angioprotective action of reflexotherapy].

The adaptive mechanisms of action of reflexotherapy are analysed. It was shown in physiological and biochemical experiments on the whole organism, the isolated hearts and strips of resistive arteries of animals that stimulation of acupuncture points by different physical factors increased the activity of opioid, antioxidative, and other stress-limiting systems, reduced secretion of corticosteron during stress, stimulated biosynthesis of stress proteins, induced cyto- and cardioprotective effects, prevented or limited functional and structural hyperadrenal damages. Clinical investigations demonstrated significant hypothensive, anti-ishemic and anti-arrhythmic effects of reflexotherapy, improved resistance of healthy subjects and patients with cardiovascular diseases to physical and emotional loadings.

[Experience of continuous educational process in training of doctors specializing in reflexotherapy].

Highlights the experience of the Department of Neurology and Reflexology to organize continuous education process in preparing doctors with specialization reflexology.

[Postgraduate studies on reflexotherapy: prospects of improved methods of rehabilitation].

Formation adaptive effect of reflexology is one of the most important non-specific mechanisms of action to ensure implementation of its sacrificial, sanohenetichnoho and preventive effects. Today, basic education in acupuncture should focus on common international standards, including anatomical, physiological, biochemical and biophysical basis. Based on primary specialization of reflexology should be in continuous improvement of the methods of acupuncture in various fields of clinical medicine aggregate of not less than 350 hours, which is usually carried out intermittently for several years.