Laser auriculotherapy associated with cupping therapy in chronic spinal pain: Randomized controlled clinical trial.

BACKGROUND: Musculoskeletal spine disorders are common causes of chronic pain and impair functionality. Laser auriculotherapy and cupping has played a significant role in the treatment of chronic pain. OBJECTIVE: to evaluate the effect of laser auriculotherapy associated with cupping at systemic acupuncture points on chronic spinal pain. METHODS: Randomized controlled clinical trial. Volunteers underwent three evaluations: an initial evaluation, a final evaluation immediately after the last intervention session, and a 15-day follow-up. The pain was identified using the numeric pain scale. The pain threshold was also evaluated against mechanical stimulation using a Digital Dynamometer at specific points in the cervical, thoracic and lumbar regions. Fifty individuals with chronic spinal pain, randomized into groups: experimental (n = 25), submitted to 10 sessions of auriculotherapy with laser and cupping therapy and control (n = 25). RESULTS: The experimental group achieved pain intensity reduction between pre and post and follow-up moments (p < 0.0001), of greatest pain in the last seven days among all moments (p < 0.0001), of least pain in the pre with post moment (p = 0.006) and follow-up (p = 0.002), and an increased pain threshold between pre and post (p = 0.023). The control group achieved a reduction in the nociceptive threshold between pre and post (p = 0.001) and follow-up (p < 0.0001). The experimental group showed reduced pain intensity (p = 0.027) and greater pain (p = 0.005) after intervention and in pain intensity (p = 0.018), greater (p < 0.0001) and less pain (p = 0.025) at follow-up, compared to the control group. CONCLUSION: Auriculotherapy with laser associated with cupping therapy may effectively reduce pain intensity and increase the nociceptive threshold.

Effect of Ear Acupuncture plus Dry Cupping on Activities and Quality of Life in the Adults with Chronic Back Pain: a Randomized Trial.

Background: Chronic pain is a complex phenomenon that brings physical and emotional impairments negatively impacting people's quality of life. The adoption of interventions such as ear acupuncture and dry cupping can represent a treatment option for people with chronic back pain. Objectives: To investigate the effects of ear acupuncture combined with dry cupping therapy on the interference of pain with the daily activities and quality of life of adults with chronic back pain. Methods: An open-label, randomized, parallel-group controlled clinical trial. One hundred and ninety-eight adults were randomized into control (CG - ear acupuncture) or experimental (EG - ear acupuncture combined with dry cupping) groups. Interventions were performed in five sessions, once a week, lasting five weeks. Evaluations were performed before the first session, after the last session, and seven days after the second evaluation, using the Brief Pain Inventory to assess the impact of pain on daily activities and the World Health Organization Quality of Life-BREF (WHOQOL-BREF) to assess the quality of life. Results: Between the initial and final sessions, there were significant changes in daily activities , activity, work, mood, relationships, sleep, and in the physical, psychological and social relationships domains for both the control and experimental groups. Improved perception of quality of life and satisfaction with health were observed for the participants in the experimental group. Conclusion: Ear acupuncture combined with dry cupping showed better results in terms of perception of quality of life and satisfaction with health when compared to ear acupuncture by itself.

Effects of ear acupuncture combined with cupping therapy on severity and threshold of chronic back pain and physical disability: A randomized clinical trial.

Background and aim: Chronic back pain causes physical, functional, and emotional disabilities. Traditional Chinese Medicine therapies have been shown as interventions to treat chronic back pain. The present study aimed to clinically evaluate the effects of ear acupuncture combined with cupping therapy on people with chronic back pain. Experimental procedure: We conducted an open-label, randomized, parallel-group controlled clinical trial. Following the CONSORT statement recommendations, 198 participants were randomized into 'ear acupuncture' and 'ear acupuncture and cupping therapy' groups. Data were collected in three different points; before the first session (initial) with the patient, after the last session (final), and seven days after the end of the treatment (follow-up). The Brief Pain Inventory, a digital algometer, and the Rolland Morris Disability Questionnaire were used for data collection. Generalized Estimation Equation model was used to examine the association between the interventions and the primary outcome pain severity. Results: Pain severity, pressure pain threshold, and physical disability improved over time in both groups. However, for the patients being treated with both ear acupuncture and cupping therapy, significant changes were seen in pain severity, pain relief, and physical disabilities between the initial and final sessions. For the 'ear acupuncture and cupping therapy' group, significant changes were also seen for pain relief and physical disability in the follow-up session. Conclusion: Ear acupuncture combined with cupping therapy was shown to be more effective in the treatment of chronic back pain when compared to treatment using only ear acupuncture.

Effects of low-power laser auriculotherapy on chronic spinal pain: Randomized clinical trial.

AIMS AND OBJECTIVES: To evaluate the effect of laser auriculotherapy on chronic spinal pain. It is a randomized controlled clinical trial. METHODS: Volunteers with chronic spinal pain underwent three evaluations: an initial evaluation, a final evaluation immediately after the last intervention session, and a 15-day follow-up. Pain intensity, nociceptive threshold in relation to mechanical stimulus, and degree of pain (the greatest and least pain) in the last seven days were the assessed variables. The experimental group (EG, n = 24) underwent 10 sessions of laser auriculotherapy twice a week, while the control group (CG, n = 23) did not receive any intervention. RESULTS: The EG showed great clinical improvement in relation to the variable pain intensity between pre- and post-interventions (65.2%) and pre-intervention and follow-up (58.62%) compared to the CG. There was a significant increase in the nociceptive threshold for the EG. In contrast, the CG showed a significant reduction in the nociceptive threshold. The intergroup analysis indicated an improvement in pain intensity for the EG (0.006). This result remained at the follow-up (0.012). The nociceptive threshold increased over time for the EG (0.016). In contrast, the CG showed a reduction in this variable with a significant difference over time (<0.001). CONCLUSION: The results of this clinical trial suggest that the proposed intervention may be effective in reducing pain intensity and increasing the nociceptive threshold. The effect of the intervention remained 15 days after the end of the treatment, when the volunteers were re-evaluated.

Relação entre dor crônica nas costas, incapacidade e qualidade de vida após auriculoacupuntura e ventosaterapia e satisfação com o tratamento: estudo transversal / Relationship between chronic back pain, disability and quality of life after auriculoacupuncture and cupping therapy and satisfaction with treatment: across-sectional study / La relación entre el dolor de espalda crónico, la discapacidad y la calidad de vida después de la acupuntura auricular y la terapia con ventosas y la satisfacción con el tratamiento: un estudio transversal

OBJETIVO: avaliar a relação da intensidade da dor, incapacidade física e qualidade devida após tratamento de auriculoacupuntura e ventosaterapia com a satisfação com o tratamento, necessidade dele para controle da dor, percepção de melhora e consumo de medicação. MÉTODO: estudo transversal conduzido com 198 pessoas com dor crônica nas costas. Foram investigadas: intensidade da dor, incapacidade física, qualidade de vida, satisfação com o tratamento, necessidade da intervenção para o controle da dor, percepção de melhora e consumo de medicação. Foi realizada correlação de Spearman a 5% de significância. RESULTADOS: Houve correlações negativas de fraca magnitude da intensidade da dor e da incapacidade física com a satisfação com o tratamento, necessidade da intervenção, percepção de melhora após o tratamento e consumo de medicamentos, e correlações positivas de fraca magnitude da percepção da qualidade de vida com a satisfação com o tratamento, necessidade da intervenção, e percepção de melhora. CONCLUSÃO: A melhora da intensidade da dor, da incapacidade física e da qualidade de vida ocasionou melhor estado geral de saúde, satisfação com o tratamento e menor consumo de medicamentos entre os participantes do estudo.

OBJECTIVE: to evaluate the relationship between pain intensity, physical disability and quality of life after auriculoacupuncture and cupping therapy with satisfaction with treatment, need for it to control pain, perception of improvement and medication consumption. METHOD: cross-sectional study conducted with 198 people with chronic back pain. The following were investigated: painintensity, physical disability, quality of life, satisfaction with treatment, need for intervention to control pain, perception of improvement and medication consumption. Spearman's correlation was performed at 5% of significance. RESULTS: There were low magnitude negative correlations of pain intensity and physical disability with treatment satisfaction, need for intervention, perception of improvement after treatment and medication consumption, and low magnitude positive correlations of quality of life perception with satisfaction with treatment, need for intervention, and perception of improvement. CONCLUSION: The improvement in pain intensity, physical disability and quality of life resulted in better general health status, satisfaction with treatment and lower consumption of medication among study participants.

OBJETIVOS: evaluar la relación de la intensidad del dolor, la discapacidad física y la calidad de vida después de la acupuntura auricular y la terapia con ventosas con la satisfacción con el tratamiento, la necesidad del mismo para controlar el dolor, la percepción de mejoría y el consumo de medicamentos. MÉTODO:estudio transversal realizado con 198 personas con dolor de espalda crónico. Se investigó: la intensidad del dolor, la discapacidad física, la calidad de vida, la satisfacción con el tratamiento, la necesidad de intervención para el control del dolor, la percepción de mejoría y el consumo de medicamentos. Se realizó la correlación de Spearman al 5% de significancia. RESULTADOS: Hubo correlaciones negativas de baja magnitud de la intensidad del dolor y de la discapacidad física con la satisfacción con el tratamiento, necesidad de intervención, percepción de mejoría después del tratamiento y consumo de medicamentos, y correlacion espositivas de baja magnitud de la percepción de la calidad de vida con la satisfacción con el tratamiento, necesidad de intervención y percepción de mejora. CONCLUSIÓN: La mejora en la intensidad del dolor, la discapacidad física y la calidad de vida llevaron aun mejor estado general de salud, satisfacción con el tratamiento y menor consumo de medicamentos entre los participantes del estudio.

Intercessory Prayer on Spiritual Distress, Spiritual Coping, Anxiety, Depression and Salivary Amylase in Breast Cancer Patients During Radiotherapy: Randomized Clinical Trial.

The goal of this study was to assess the effect of intercessory prayer in the psychological, spiritual and biological scores of breast cancer patients who are undergoing radiotherapy. Double-blind RCT comprising a sample of 31 participants (15 in the Control Group and 16 in the Intervention Group). Data collection was performed in three time points (T0, T1 and T2). Significant changes have been identified in the intra-group analysis, concerning the decrease in spiritual distress score; negative religious/spiritual coping prevailed, while the total religious/spiritual coping increased between the posttest T2 to T0. Intercessory prayer was effective in religious and spiritual scores.

Religious/spiritual coping and spiritual distress in people with cancer / El coping religioso/espiritual y la angustia espiritual en individuos con cáncer / Coping religioso/espiritual e a angústia espiritual em pessoas com câncer

ABSTRACT Objective: To investigate the relation between the presence of spiritual distress and use of RSC and sociodemographic, clinical and religious/spiritual variables in people with cancer. Method: Cross-sectional study conducted in an association for support to people with cancer. The data obtained with the tools were analyzed using the Spearman's correlation coefficient and the Mann-Whitney Test. Results: 129 volunteers participated in the study, of which 57% showed moderate spiritual distress, 96% used medium and high positive religious/spiritual coping. Spiritual distress showed positive correlation with negative religious/spiritual coping (P<0.001) and inverse correlation with age (p 0.002). The use of positive religious coping was statistically significant in people who have religious practices (p 0.001). Conclusão: Spiritual distress is a phenomenon that is present in the lives of people with cancer and has significant relation with the use, in a negative manner, of religion/spirituality as a way of coping with the disease.

RESUMEN Objetivo: Examinar la relación entre la presencia de angustia espiritual y el uso del coping religioso/espiritual con variables sociodemográficas, clínicas y de aspectos religioso/espiritual en individuos con cáncer. Método: Estudio transversal, realizado en una asociación de apoyo a la persona con cáncer. En el análisis de datos recolectados se utilizó el coeficiente de correlación de Spearman y el test de Mann-Whitney. Resultados: En el estudio participaron 129 voluntarios; el 57% presentó moderada angustia espiritual, y el 96% utilizaba medio y elevado coping religioso/espiritual positivo. La angustia espiritual presentó una correlación positiva con el coping religioso/espiritual negativo (P < 0,001) e inversa con la edad (p 0,002). Se observó que el uso del coping religioso positivo fue estadísticamente significativo en los sujetos que participan en prácticas religiosas (p 0,001). Conclusión: La angustia espiritual es un fenómeno presente en la vida de los individuos con cáncer y tiene una significativa relación con el uso negativo de la religión/espiritualidad como forma de luchar contra la enfermedad.

RESUMO Objetivo: Investigar a relação entre presença de angústia espiritual e uso do coping religioso/espiritual com variáveis sociodemográficas, clínicas e de aspectos religioso/espiritual em pessoas com câncer. Método: Estudo transversal, realizado em uma associação de apoio à pessoa com câncer. Os dados obtidos dos instrumentos foram analisados por meio do coeficiente de correlação de Spearman e do teste Mann-Whitney. Resultados: Participaram do estudo 129 voluntários; 57% apresentaram moderada angústia espiritual, e 96% faziam uso de médio e alto coping religioso/espiritual positivo. A angústia espiritual apresentou correlação positiva com o coping religioso/espiritual negativo (P < 0,001) e inversa com a idade (p 0,002). O uso do coping religioso positivo foi estatisticamente significativo em pessoas que desenvolvem práticas religiosas (p 0,001). Conclusão: A angústia espiritual é um fenômeno presente na vida de pessoas com câncer e tem significativa relação com o uso, de maneira negativa, da religião/espiritualidade como forma de enfrentamento da doença.

Acupuntura auricular para dor crônica nas costas em adultos: revisão sistemática e metanálise / Acupuntura auricular para dolor crónico en la espalda: revisión sistemática y metaanálisis / Auricular acupuncture for chronic back pain in adults: a systematic review and metanalysis

RESUMO Objetivo Investigar os ensaios clínicos randomizados sobre a ação da acupuntura auricular para a dor crônica nas costas em adultos, identificar os desfechos mais utilizados para avaliar essa condição, o protocolo utilizado para aplicar a intervenção e identificar nos estudos qual o efeito da terapia sobre a intensidade da dor. Método Revisão sistemática e metanálise, conduzidas entre junho de 2017 e maio de 2018, nas bases de dados PubMed, CINAHL, PEDro, Embase, Scopus e na Biblioteca Virtual em Saúde. Listas de referências de revisões sistemáticas também foram exploradas. Resultados Foram localizados 427 estudos, 15 incluídos na análise qualitativa, e sete na análise quantitativa. A acupuntura auricular obteve resultados positivos em 80% dos estudos. Os desfechos mais utilizados foram a intensidade e a qualidade da dor, consumo de medicação, incapacidade física e qualidade de vida. Não há padronização no protocolo de acupuntura auricular para dor crônica nas costas. Os resultados da metanálise apontaram que a acupuntura auricular foi eficaz em reduzir os escores de intensidade da dor (p=0,038). Conclusão A acupuntura auricular é uma prática promissora para o tratamento da dor crônica nas costas em adultos.

RESUMEN Objetivo Investigar los ensayos clínicos randomizados sobre la acción de la acupuntura auricular para dolor crónico en la espalda en adultos, identificar los resultados más utilizados para evaluar dicha condición, el protocolo utilizado para aplicar la intervención e identificar en los estudios cuál es el efecto de la terapia sobre la intensidad del dolor. Método Revisión sistemática y metaanálisis, conducidas entre junio de 2017 y mayo de 2018, en las bases de datos PubMed, CINAHL, PEDro, Embase, Scopus y en la Biblioteca Virtual en Salud. Listas de referencias de revisiones sistemáticas también fueron exploradas. Resultados Se localizaron 427 estudios, 15 incluidos en el análisis cualitativo, y siete en el análisis cuantitativo. La acupuntura auricular obtuvo resultados positivos en el 80% de los estudios. Los resultados más utilizados fueron la intensidad y la calidad del dolor, consumo de fármacos, incapacidad física y calidad de vida. No existe estandarización en el protocolo de acupuntura auricular para dolor crónico en la espalda. Los resultados del metaanálisis señalaron que la acupuntura auricular fue eficaz en reducir los scores de intensidad de dolor (p=0,038). Conclusión La acupuntura auricular es una práctica prometedora para el tratamiento del dolor crónico en la espalda en adultos.

ABSTRACT Objective To investigate randomized clinical trials on the action of auricular acupuncture for chronic back pain in adults, and to identify the most commonly used outcomes for assessing this condition, the protocol used for applying the intervention, and the efficacy of the therapy on pain intensity. Method A systematic review and a metanalysis were carried out between June 2017 and May 2018, based on the PubMed, CINAHL, PEDro, Embase, Scopus, and the Virtual Health Library databases. Reference lists of systematic reviews were also explored. Results 427 studies were located, 15 included in the qualitative analysis, and seven in the quantitative analysis. Auricular acupuncture led to positive results in 80% of the studies. The most commonly used outcomes were pain intensity and quality, medication consumption, physical disability, and quality of life. There is a lack of protocol standardization for auricular acupuncture for chronic back pain. The metanalysis results showed that auricular acupuncture was effective in reducing pain intensity scores (p=0.038). Conclusion Auricular acupuncture is a promising practice for the treatment of chronic back pain in adults.

Religious/spiritual coping and spiritual distress in people with cancer.

OBJECTIVE: To investigate the relation between the presence of spiritual distress and use of RSC and sociodemographic, clinical and religious/spiritual variables in people with cancer. METHOD: Cross-sectional study conducted in an association for support to people with cancer. The data obtained with the tools were analyzed using the Spearman's correlation coefficient and the Mann-Whitney Test. RESULTS: 129 volunteers participated in the study, of which 57% showed moderate spiritual distress, 96% used medium and high positive religious/spiritual coping. Spiritual distress showed positive correlation with negative religious/spiritual coping (P<0.001) and inverse correlation with age (p 0.002). The use of positive religious coping was statistically significant in people who have religious practices (p 0.001). CONCLUSÃO: Spiritual distress is a phenomenon that is present in the lives of people with cancer and has significant relation with the use, in a negative manner, of religion/spirituality as a way of coping with the disease.

Auriculotherapy to control chemotherapy-induced nausea and vomiting in patients with cancer: protocol of a systematic review.

BACKGROUND: Due to the worldwide rise in cancer incidence, and therefore the rise in the need for antineoplastic chemotherapy, it is important for both healthcare professionals and patients alike that the side effects of chemotherapy, such as chemotherapy-induced nausea and vomiting (CINV), are treated and prevented. Auriculotherapy is a type of acupuncture and may be a low-cost and safe antiemetic measure to control the side effects of chemotherapy. The goal of this systematic review is to synthesize the available evidence in the literature regarding the auriculotherapy effects to treat CINV in people with cancer. METHODS: The review will only include randomized controlled trials (RCTs) that compare the clinical effects of the auriculotherapy intervention (used alone or as an add-on), with sham auriculotherapy, routine treatment with antiemetic drugs, or other non-pharmacological interventions in patients with cancer with CINV who are undergoing chemotherapy. The outcomes to be evaluated are nausea and vomiting: in acute, delayed, or anticipated stages, when induced by chemotherapy. A comprehensive search for studies will be carried out in these databases: MEDLINE via PubMed, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, ICTRP, LILACS, CUMED, IBECS, BVS MTCI Americas, Web of Science, Scopus, PEDro, CNKI, and CBMdisc up until December 31, 2018. Only articles in English, Portuguese, and Spanish will be selected. Two independent reviewers will evaluate full texts, extract data, and assess the risk of bias of eligible articles. The quality of evidence will be assessed using Grading of Recommendations, Assessment, Development and Evaluation (GRADE). A meta-analysis will be undertaken to assess the interventions and outcomes' homogeneity, assessing statistical heterogeneity using the Cochran's Q test and quantified using Higgins' inconsistency index. If there is insufficient data for a meta-analysis, a narrative synthesis will be presented. This protocol has been prepared according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines. DISCUSSION: The results of this systematic review will summarize the strength of evidence for the use of auriculotherapy in the control of CINV of patients with cancer and will be used to identify evidence gaps. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42018117513.

Auricular acupuncture for chronic back pain in adults: a systematic review and metanalysis. / Acupuntura auricular para dor crônica nas costas em adultos: revisão sistemática e metanálise.

OBJECTIVE: To investigate randomized clinical trials on the action of auricular acupuncture for chronic back pain in adults, and to identify the most commonly used outcomes for assessing this condition, the protocol used for applying the intervention, and the efficacy of the therapy on pain intensity. METHOD: A systematic review and a metanalysis were carried out between June 2017 and May 2018, based on the PubMed, CINAHL, PEDro, Embase, Scopus, and the Virtual Health Library databases. Reference lists of systematic reviews were also explored. RESULTS: 427 studies were located, 15 included in the qualitative analysis, and seven in the quantitative analysis. Auricular acupuncture led to positive results in 80% of the studies. The most commonly used outcomes were pain intensity and quality, medication consumption, physical disability, and quality of life. There is a lack of protocol standardization for auricular acupuncture for chronic back pain. The metanalysis results showed that auricular acupuncture was effective in reducing pain intensity scores (p=0.038). CONCLUSION: Auricular acupuncture is a promising practice for the treatment of chronic back pain in adults.

Contribution of Chinese and French ear acupuncture for the management of chronic back pain: A randomised controlled trial.

AIMS AND OBJECTIVES: To compare the efficacy of Chinese and French ear acupuncture in people with chronic back pain. BACKGROUND: Chronic back pain is a common public health problem worldwide. An intervention for this condition is ear acupuncture. Several approaches are used for ear acupuncture, particularly the Chinese and French guidelines. METHODS: An open, randomised and controlled clinical trial, followed the recommendations of the CONSORT Checklist. One hundred and eleven people were selected and randomised into three groups: Chinese ear acupuncture, French ear acupuncture and Control. Evaluations were performed before the first intervention session (initial), 1 week after the fifth session (final) and after a fifteen-day follow-up period (follow-up), using the Brief Pain Inventory, Rolland Morris Disability Questionnaire, and a thermal imaging camera. For data analysis, the Generalized Estimating Equation Model was applied, with significance level set at 5%. RESULTS: Pain severity was significantly decreased by Chinese ear acupuncture throughout intervention period. Both types of ear acupuncture affected pain interference with daily activities. However, in the comparison between initial and final evaluations, only Chinese ear acupuncture produced statistically significant results. A reduction in physical disability was observed in both ear acupuncture-treated groups during the intervention period and, although Chinese ear acupuncture failed to induce significant changes in tissular temperature at individual time points, a significant increase in cutaneous temperature was detected after the follow-up period in the dorsal region of individuals treated with Chinese ear acupuncture. Importantly, at this time point, the mean difference between Chinese and French ear acupuncture revealed a more benefic effect of Chinese procedure on this parameter. CONCLUSIONS: The individualised treatment based on the Chinese precepts showed, in an overall evaluation, better results for management of chronic back pain in the present study. RELEVANCE TO CLINICAL PRACTICE: Ear acupuncture can be implemented in the nurse's clinical practice to assist the treatment of people with chronic back pain.

Effects of auricular acupuncture on chronic pain in people with back musculoskeletal disorders: a randomized clinical trial.

OBJECTIVE: To evaluate the effects of auricular acupuncture on pain intensity, its impact on daily activities, the relief provided by the intervention, and the pain threshold in people with back musculoskeletal disorders. METHODS: Randomized clinical trial carried out with people randomly allocated into three groups: treatment, placebo, and control. Evaluations were performed using the Brief Pain Inventory and a digital algometer before (initial) and after (final) the treatment and after a 15-day follow-up period. RESULTS: The sample was 110 people. There was a decrease in pain intensity in the treatment and placebo groups as revealed by the comparison between the initial and final evaluations (p<0.05), and in the treatment group in the comparison between the initial and follow-up evaluations (p<0.05). A decreased impact of pain on daily activities in the treatment and placebo groups over time was found (p<0.05). At the final evaluation, the impact of pain was lower in the treatment group (p<0.05). Auricular acupuncture did not increase the pain threshold. CONCLUSION: Auricular acupuncture presented positive effects by reducing the chronic pain intensity and its impact on daily activities in people with back musculoskeletal disorders. Brazilian Clinical Trials Registry: RBR-5X69X2.

Effects of auricular acupuncture on chronic pain in people with back musculoskeletal disorders: a randomized clinical trial / Efectos de la auriculoacupuntura en el dolor crónico en personas con disturbios musculoesqueléticos en la espalda: ensayo clínico randomizado / Efeitos da auriculoacupuntura na dor crônica em pessoas com distúrbios musculoesqueléticos nas costas: ensaio clínico randomizado

ABSTRACT Objective: To evaluate the effects of auricular acupuncture on pain intensity, its impact on daily activities, the relief provided by the intervention, and the pain threshold in people with back musculoskeletal disorders. Methods: Randomized clinical trial carried out with people randomly allocated into three groups: treatment, placebo, and control. Evaluations were performed using the Brief Pain Inventory and a digital algometer before (initial) and after (final) the treatment and after a 15-day follow-up period. Results: The sample was 110 people. There was a decrease in pain intensity in the treatment and placebo groups as revealed by the comparison between the initial and final evaluations (p<0.05), and in the treatment group in the comparison between the initial and follow-up evaluations (p<0.05). A decreased impact of pain on daily activities in the treatment and placebo groups over time was found (p<0.05). At the final evaluation, the impact of pain was lower in the treatment group (p<0.05). Auricular acupuncture did not increase the pain threshold. Conclusion: Auricular acupuncture presented positive effects by reducing the chronic pain intensity and its impact on daily activities in people with back musculoskeletal disorders. Brazilian Clinical Trials Registry: RBR-5X69X2

RESUMEN Objetivo: Evaluar los efectos de la auriculoacupuntura sobre la intensidad del dolor, su interferencia en las actividades cotidianas, el alivio proporcionado por la intervención y el umbral de dolor en personas con disturbios musculoesqueléticos en la espalda. Método: Ensayo clínico randomizado, realizado con personas aleatorizadas en tres grupos: tratado, placebo y control. Las evaluaciones se llevaron a cabo usando el Breve Inventario del Dolor y un algómetro digital antes (inicial) y tras el tratamiento (final), en un período de seguimiento de 15 días (follow-up). Resultados: Participaron 110 personas. Hubo reducción en la intensidad del dolor en los grupos tratado y placebo entre las evaluaciones inicial y final (p<0,05), y en el grupo tratado entre la evaluación inicial y el follow-up (p<0,05). También ocurrió disminución de la interferencia del dolor en las actividades cotidianas en los grupos tratado y placebo a lo largo del tiempo (p<0,05). En la evaluación final, la interferencia del dolor fue menor en el grupo tratado (p<0,05). La auriculoacupuntura no fue suficiente para aumentar el umbral de dolor. Conclusión: La auriculoacupuntura presentó efectos positivos al reducir la intensidad del dolor crónico y su interferencia en las actividades cotidianas en personas con disturbios musculoesqueléticos en la espalda. Registro Brasileño de Ensayos Clínicos: RBR-5X69X2

RESUMO Objetivo: Avaliar os efeitos da auriculoacupuntura sobre a intensidade da dor, a sua interferência nas atividades cotidianas, o alívio proporcionado pela intervenção e o limiar de dor em pessoas com distúrbios musculoesqueléticos nas costas. Método: Ensaio clínico randomizado, realizado com pessoas randomizadas em três grupos: tratado, placebo e controle. As avaliações foram realizadas usando o Inventário Breve de Dor e um algômetro digital antes (inicial) e após o tratamento (final), em um período de seguimento de 15 dias (follow-up). Resultados: Participaram 110 pessoas. Houve redução na intensidade da dor nos grupos tratado e placebo entre as avaliações inicial e final (p<0,05), e no grupo tratado entre a avaliação inicial e o follow-up (p<0,05). Também ocorreu diminuição da interferência da dor nas atividades cotidianas nos grupos tratado e placebo ao longo do tempo (p<0,05). Na avaliação final, a interferência da dor foi menor no grupo tratado (p<0,05). A auriculoacupuntura não foi suficiente para aumentar o limiar de dor. Conclusão: A auriculoacupuntura apresentou efeitos positivos ao reduzir a intensidade da dor crônica e sua interferência nas atividades cotidianas em pessoas com distúrbios musculoesqueléticos nas costas. Registro Brasileiro de Ensaios Clínicos: RBR-5X69X2

Complementary and integrative therapies in the scope of nursing: legal aspects and academic-assistance panorama / Prácticas integradoras y complementarias en el ámbito de la enfermería: aspectos legales y panorama académico-asistencial / Práticas integrativas e complementares no âmbito da enfermagem: aspectos legais e panorama acadêmico-assistencial

ABSTRACT Objective: to carry out a documentary study on the legal aspects that support the nurses' performance in the Integrative and Complementary Practices (PIC) and to discuss the panorama of teaching, research, extension and nursing activities in front of PICs. Method: documentary study, whose units of analysis were normative, guidelines, recommendations and clarification notes (n = 17). The data were organized into two categories: "Legal aspects of nurses' performance in ICP and acupuncture" and "Overview of the use of ICPs by nursing in the areas of teaching, research, extension and assistance activities". Results: nurses stand out in the implementation of PIC since the principles of training are congruent to the paradigms of this science, besides having legal support for acting in public and private services in Brazil. There is an incipient movement of nurses working in research and extension in universities, which contributes to the diffusion of knowledge and application of therapies in the community. Conclusion: the institutionalization of PICs in the Unified Health System has increased access and contributed to the provision of comprehensive and multidisciplinary health services. Implications for practice: with ICPs, nurses have achieved autonomy and the possibility of expanding their performance, aiming at a better quality of care.

RESUMEN Objetivo: realizar un estudio documental sobre los aspectos legales que respaldan la actuación del enfermero en las Prácticas Integradoras y Complementarias (PIC) y discurrir sobre el panorama de la enseñanza, investigación, las actividades extensionistas y asistenciales de la Enfermería frente a las PIC. Método: estudio documental, cuyas unidades de análisis fueron normativas, directrices, recomendaciones y notas de aclaración (n = 17). Se organizaron los datos en dos categorías: "Aspectos legales de la actuación del Enfermero en las PIC y en la acupuntura" y "Panorama de la utilización de las PIC por la enfermería en las áreas de enseñanza, investigación, actividades extensionistas y asistenciales". Resultados: los enfermeros se destacan en la implementación de las PIC, ya que los principios de formación son congruentes a los paradigmas de esta ciencia, además de poseer respaldo legal para actuación en servicios públicos y privados en Brasil. Hay un movimiento incipiente de enfermeros actuando en investigaciones y extensión en las universidades, lo que contribuye a la difusión del conocimiento e implementación de terapias en la comunidad. Conclusión: la institucionalización de las PIC en el Sistema Único de Salud amplió el acceso y contribuye a una disponibilidad de servicios de salud integral y multidisciplinar. Implicaciones para la práctica: con las PIC los enfermeros han alcanzado autonomía y la posibilidad de expandir su actuación, con vistas a una mejor calidad del cuidado.

RESUMO Objetivo: Realizar estudo documental sobre os aspectos legais que respaldam a atuação do enfermeiro nas Práticas Integrativas e Complementares (PIC) e discorrer sobre o panorama do ensino, pesquisa, atividades extensionistas e assistenciais da Enfermagem frente às PIC. Método: Estudo documental, cujas unidades de análise foram normativas, diretrizes, recomendações e notas de esclarecimento (n=17). Os dados foram organizados em duas categorias: "Aspectos legais da atuação do Enfermeiro nas PIC e na acupuntura" e "Panorama da utilização das PIC pela enfermagem nas áreas de ensino, pesquisa, atividades extensionistas e assistenciais". Resultados: Os enfermeiros se destacam na implementação das PIC uma vez que os princípios de formação são congruentes aos paradigmas dessa ciência, além de possuírem respaldo legal para atuação em serviços públicos e privados no Brasil. Há um movimento incipiente de enfermeiros atuando em pesquisas e extensão nas universidades, o que contribui para difusão do conhecimento e aplicação das terapias na comunidade. Conclusão: A institucionalização das PIC no Sistema Único de Saúde ampliou o acesso e tem contribuído para disponibilização de serviços de saúde integral e multidisciplinares. Implicações para prática: Com as PIC os enfermeiros têm alcançado autonomia e possibilidade de expansão de sua atuação, com vistas à melhor qualidade do cuidado.

Cupping therapy and chronic back pain: systematic review and meta-analysis.

OBJECTIVES: to evaluate the evidence from the literature regarding the effects of cupping therapy on chronic back pain in adults, the most used outcomes to evaluate this condition, the protocol used to apply the intervention and to investigate the effectiveness of cupping therapy on the intensity of chronic back pain. METHOD: systematic review and meta-analysis carried out by two independent researchers in national and international databases. Reference lists of systematic reviews were also explored. The quality of evidence was assessed according to the Jadad scale. RESULTS: 611 studies were identified, of which 16 were included in the qualitative analysis and 10 in the quantitative analysis. Cupping therapy has shown positive results on chronic back pain. There is no standardization in the treatment protocol. The main assessed outcomes were pain intensity, physical incapacity, quality of life and nociceptive threshold before the mechanical stimulus. There was a significant reduction in the pain intensity score through the use of cupping therapy (p = 0.001). CONCLUSION: cupping therapy is a promising method for the treatment of chronic back pain in adults. There is the need to establish standardized application protocols for this intervention.

Action of ear acupuncture in people with chronic pain in the spinal column: a randomized clinical trial1.

OBJECTIVES: to assess the action of ear acupuncture on disability and tissue temperature in people with chronic pain in the spinal column. METHOD: a clinical trial with a sample of 110 people, randomized into three groups: Treatment, Placebo and Control. The assessment instruments were the Rolland Morris Disability Questionnaire (RMDQ) and a thermographic camera, administered before the first treatment session, one week after and 15 days after (follow-up) the fifth session of ear acupuncture. In the analysis of the data, the Kruskal Wallis, Student-Newman Keuls and Wilcoxon tests were applied. RESULTS: there was a significant reduction in disability in the Treatment and Placebo groups between the initial and final assessments (p<0.05) and between the initial assessments and follow-up (p<0.05). In the final assessment, the Treatment group presented improvement of disability when compared with the Placebo and Control groups (p<0.05). There was an increase in mean tissue temperature of the dorsal region between the initial and follow-up assessments in Treatment and Control groups (p<0.05), and between the final assessments and follow-up in the Treatment and Placebo groups (p<0.05). CONCLUSION: ear acupuncture was efficacious in reducing disability and increasing tissue temperature in people with chronic pain in the spinal column. Brazilian Register of Clinical Trials (RBR-5X69X2).

Action of ear acupuncture in people with chronic pain in the spinal column: a randomized clinical trial / Ação da auriculoacupuntura em pessoas com dor crônica na coluna vertebral: ensaio clínico randomizado / Acción de la auriculoacupuntura en personas con dolor crónico en la columna vertebral: ensayo clínico aleatorio

ABSTRACT Objectives: to assess the action of ear acupuncture on disability and tissue temperature in people with chronic pain in the spinal column. Method: a clinical trial with a sample of 110 people, randomized into three groups: Treatment, Placebo and Control. The assessment instruments were the Rolland Morris Disability Questionnaire (RMDQ) and a thermographic camera, administered before the first treatment session, one week after and 15 days after (follow-up) the fifth session of ear acupuncture. In the analysis of the data, the Kruskal Wallis, Student-Newman Keuls and Wilcoxon tests were applied. Results: there was a significant reduction in disability in the Treatment and Placebo groups between the initial and final assessments (p<0.05) and between the initial assessments and follow-up (p<0.05). In the final assessment, the Treatment group presented improvement of disability when compared with the Placebo and Control groups (p<0.05). There was an increase in mean tissue temperature of the dorsal region between the initial and follow-up assessments in Treatment and Control groups (p<0.05), and between the final assessments and follow-up in the Treatment and Placebo groups (p<0.05). Conclusion: ear acupuncture was efficacious in reducing disability and increasing tissue temperature in people with chronic pain in the spinal column. Brazilian Register of Clinical Trials (RBR-5X69X2).

RESUMO Objetivos: avaliar a ação da auriculoacupuntura na incapacidade e na temperatura tissular de pessoas com dor crônica na coluna vertebral. Método: ensaio clínico com amostra de 110 pessoas, randomizadas em três grupos: Tratado, Placebo e Controle. Os instrumentos de avaliação foram o Questionário de Incapacidade de Rolland Morris e uma câmera termográfica, aplicados antes da primeira sessão de tratamento, uma semana após e 15 dias após (follow up) à quinta sessão de auriculoacupuntura. Na análise dos dados, aplicaram-se os testes Kruskal-Wallis, Student-Newman-Keuls e Wilcoxon. Resultados: houve redução significativa da incapacidade nos grupos Tratado e Placebo entre as avaliações inicial e final (p<0,05) e entre as avaliações inicial e follow up (p<0,05). Na avaliação final, o grupo Tratado apresentou melhora da incapacidade se comparado ao Placebo e ao Controle (p<0,05). Houve aumento na temperatura média tissular da região dorsal entre as avaliações inicial e follow up no Tratado e Controle (p<0,05). Entre as avaliações final e follow up no Tratado e Placebo (p<0,05). Conclusão: a auriculoacupuntura foi eficaz para reduzir a incapacidade e aumentar a temperatura tissular em pessoas com dor crônica na coluna vertebral. Registro Brasileiro de Ensaios Clínicos (RBR-5X69X2).

RESUMEN Objetivos: evaluar la acción de la auriculoacupuntura en la incapacidad y en la temperatura del tejido de personas con dolor crónico en la columna vertebral. Método: ensayo clínico con muestra de 110 personas, asignadas aleatoriamente en tres grupos: Tratado, Placebo y Control. Los instrumentos de evaluación fueron el Cuestionario de Incapacidad de Rollad Morris y una cámara termográfica, aplicados antes de la primera sesión de tratamiento, una semana después y quince días después (follow up) de la quinta sesión de auriculoacupuntura. En el análisis de los datos se aplicaron las pruebas Kruskal-Wallis, Student-Newman Keuls y Wilcoxon. Resultados: hubo reducción significativa de la incapacidad en los grupos Tratado y Placebo, entre las evaluaciones inicial y final (p<0,05) y entre las evaluaciones inicial y follow up (p<0,05). En la evaluación final, el grupo Tratado presentó mejoría de la incapacidad si comparado al Placebo y al Control (p<0,05). Hubo aumento en la temperatura media del tejido de la región dorsal entre las evaluaciones inicial y follow up en el Tratado y Control (p<0,05), y entre las evaluaciones final y follow up en el Tratado y Placebo (p<0,05). Conclusión: la auriculoacupuntura fue eficaz en reducir la incapacidad y en aumentar la temperatura del tejido en personas con dolor crónico en la columna vertebral. Registro Brasileño de Ensayos Clínicos (RBR-5X69X2).

Cupping therapy and chronic back pain: systematic review and meta-analysis / Ventosaterapia e dor crônica nas costas: revisão sistemática e metanálise / Ventosaterapia y dolor crónico en la espalda: revision sistemática y metanálisis

ABSTRACT Objectives: to evaluate the evidence from the literature regarding the effects of cupping therapy on chronic back pain in adults, the most used outcomes to evaluate this condition, the protocol used to apply the intervention and to investigate the effectiveness of cupping therapy on the intensity of chronic back pain. Method: systematic review and meta-analysis carried out by two independent researchers in national and international databases. Reference lists of systematic reviews were also explored. The quality of evidence was assessed according to the Jadad scale. Results: 611 studies were identified, of which 16 were included in the qualitative analysis and 10 in the quantitative analysis. Cupping therapy has shown positive results on chronic back pain. There is no standardization in the treatment protocol. The main assessed outcomes were pain intensity, physical incapacity, quality of life and nociceptive threshold before the mechanical stimulus. There was a significant reduction in the pain intensity score through the use of cupping therapy (p = 0.001). Conclusion: cupping therapy is a promising method for the treatment of chronic back pain in adults. There is the need to establish standardized application protocols for this intervention.

RESUMO Objetivos: avaliar as evidências da literatura a respeito dos efeitos da ventosoterapia sobre a dor crônica nas costas em adultos, os desfechos mais utilizados para avaliar essa condição, o protocolo utilizado para aplicação da intervenção e investigar a eficácia da ventosaterapia sobre a intensidade dor crônica nas costas. Método: revisão sistemática e metanálise, realizadas por dois pesquisadores independentes, em bases de dados nacionais e internacionais. Listas de referências de revisões sistemáticas também foram exploradas. A qualidade das evidências foi avaliada através da escala Jadad. Resultados: foram identificados 611 estudos e 16 foram incluídos na análise qualitativa e 10 na análise quantitativa. A ventosaterapia demonstrou resultados positivos sobre a dor crônica nas costas. Não há uma padronização no protocolo de tratamento. Os principais desfechos avaliados foram a intensidade da dor, a incapacidade física, a qualidade de vida e o limiar nociceptivo perante o estímulo mecânico. Houve redução significativa do escore de intensidade da dor mediante uso da ventosaterapia (p=0.001). Conclusão: a ventosaterapia é um método promissor para o tratamento da dor crônica nas costas em adultos. Faz-se necessário estabelecer protocolos de aplicação padronizados para a intervenção.

RESUMEN Objetivos: evaluar las evidencias de la literatura al respecto de los efectos de la ventosoterapia sobre el dolor crónico en la espalda en adultos, los resultados más utilizados para evaluar esa condición, el protocolo utilizado para la aplicación de la intervención e investigar la eficacia de la ventosaterapia sobre la intensidad de dolor crónico en la espalda. Método: revisión sistemática y metanálisis, realizadas por dos investigadores independientes, en bases de datos nacionales e internacionales. Listas de referencias de revisiones sistemáticas también fueron exploradas. La calidad de las evidencias fue evaluada por la escala Jadad. Resultados: fueron identificados 611 estudios y 16 fueron incluidos en el análisis cualitativo y 10 en el análisis cuantitativo. La ventosaterapia demostró resultados positivos sobre el dolor crónico en la espalda. No hay una estandarización en el protocolo de tratamiento. Los principales resultados evaluados fueron la intensidad del dolor, la incapacidad física, la calidad de vida y el umbral nociceptivo frente al estímulo mecánico. Hubo reducción significativa del puntaje de intensidad del dolor mediante uso de la ventosaterapia (p=0.001). Conclusión: la ventosaterapia es un método promisor para el tratamiento del dolor crónico en la espalda en adultos. Es necesario establecer protocolos de aplicación estandarizados para la intervención.

Spiritual needs of patients with cancer in palliative care: an integrative review.

PURPOSE OF REVIEW: The experience of a life crisis, such as the experience of end-of-life terminality whenever facing cancer can make the spiritual needs of patients clear. The goal of this revision was to synthesize the existing evidence regarding the spiritual needs of patients with cancer in palliative care. RECENT FINDINGS: An integrated revision of the literature was conducted regarding the database sources from PubMed, CINAHL, EMBASE, LILACS and Scopus, without publishing year restrictions. There were 16 primary studies included. A total of 1469 patients have been evaluated, whereas eight groups of spiritual needs have been identified: finding the meaning and purpose of life; finding the meaning in experiencing the disease; being connected to other people, God and nature; having access to religious/spiritual practices; physical, psychological, social and spiritual wellbeing; talking about death and the experience of dying; making the best out of their time; being independent and being treated like a normal person. SUMMARY: It is essential to pay attention to patients' spiritual dimensions regarding palliative care. Therefore, patients' spiritual needs must be identified and remedied or mitigated. It is necessary to develop studies that find specific strategies and interventions for the treatment of these needs.