The Effects of Acupressure and Massage Following Cesarean Section

February 24, 2026 updated by: Dilek Potur, Marmara University

The Effects of Acupressure and Back Massage on Pain, Fatigue, and Sleep Quality in Cesarean Sections: A Randomized Controlled Study

Cesarean section births have rapidly increased both in our country and worldwide in recent years. According to OECD data, one in four births worldwide and one in two births in our country is a cesarean section. The cesarean section has become one of the most frequently performed surgical interventions. The incision from a cesarean section causes pain, mobilization issues, and delays in mother-infant interaction. The choice of pharmacological methods used after a cesarean section is often limited by concerns about the baby and breastfeeding, leading to inadequate pain management and causing women to experience moderate to high levels of pain. Pain negatively affects individuals' comfort, leading to sleep disturbances, fatigue, and a decreased quality of life. It makes daily activities and responsibilities as individuals more challenging to manage. There is a need for nurses, in their primary caregiver role, to adopt a multidisciplinary approach to pain management and to develop their skills in using non-pharmacological methods. These methods should be clinically applied and proven effective. Acupressure and massage are long-standing, cost-effective, easy-to-apply, and effective methods used to reduce pain. This study aims to reduce pain and fatigue and improve sleep quality in women who have undergone a cesarean section by applying acupressure and massage in the postoperative period, thereby preventing the chronicization of these problems.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Enrolling by invitation

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
111

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Women aged 18-45 years
  • Undergoing cesarean delivery under spinal anesthesia,
  • Having a term, single, and healthy newborn,
  • Gestational age of 37-40 weeks,
  • No communication difficulties,
  • No systemic or chronic diseases,
  • Willing to participate in the study.

Exclusion Criteria:

  • Undergoing cesarean delivery under general or epidural anesthesia,
  • Development of any maternal or neonatal complications during the postpartum period (hypertension, hemorrhage, infants requiring intensive care, etc.),
  • Having chronic fatigue or pain problems,
  • Using caffeine (tea, coffee, chocolate, etc.).

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Supportive Care
  • Allocation: Randomized
  • Interventional Model: Factorial Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
No Intervention: Control
Experimental: Massage
Other: Massage
back massage
Experimental: Acupressure
Other: Acupressure to points HT7, LI4, SP6 and ST36
This point specialized for pain management, fatigue and sleep

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Visual Analog Scale for Pain
Time Frame: Periprocedural (immediately after the intervention or standard care)

Pain intensity was assessed using the Visual Analog Scale for Pain (VAS), a 10-cm horizontal line ranging from 0 to 10, where:

  • 0 = no pain
  • 10 = unbearable pain
Periprocedural (immediately after the intervention or standard care)

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Postpartum Sleep Quality Scale
Time Frame: 15 minutes after completion of the intervention
Sleep quality was measured using the Postpartum Sleep Quality Scale, a 14-item questionnaire scored on a 5-point Likert scale (0 = Never to 4 = Always). Total scores range from 0 to 56, with higher scores indicating poorer sleep quality (worse outcome). The scale has no cut-off value. Assessments were performed before and after the intervention.
15 minutes after completion of the intervention
Postnatal Accumulated Fatigue Scale
Time Frame: 15 minutes after completion of the intervention
Fatigue was assessed using the Postnatal Accumulated Fatigue Scale, a 13-item questionnaire comprising three subdomains (physical fatigue, emotional fatigue, and cognitive fatigue). Each item is scored as 0 = Almost none, 1 = Sometimes, and 3 = Mostly/Often. Total scores range from 0 to 39, with higher scores indicating greater fatigue (worse outcome). The scale has no cut-off value. Assessments were performed before and after the intervention.
15 minutes after completion of the intervention

Other Outcome Measures

Other Outcome Measures

For clinical trials, a planned measurement described in the protocol that is used to determine the effect of an intervention/treatment on participants. For observational studies, a measurement or observation that is used to describe patterns of diseases or traits, or associations with exposures, risk factors, or treatment. Types of outcome measures include primary outcome measure and secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
PERSONAL INFORMATION FORM
Time Frame: Baseline (prior to intervention)
Baseline demographic and obstetric characteristics were collected using a Personal Information Form administered once prior to the intervention.
Baseline (prior to intervention)
Intervention Satisfaction Form
Time Frame: 15 minutes post-intervention

Satisfaction with the intervention was assessed using the Intervention Satisfaction Form, a Visual Analog Scale-based measure ranging from 0 to 10, where:

  • 0 = not satisfied
  • 10 = very satisfied

Higher scores indicate greater satisfaction (better outcome).
15 minutes post-intervention

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Marmara University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
February 20, 2026

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
August 1, 2026

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
March 1, 2027

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
February 10, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
February 24, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
February 25, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
February 25, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
February 24, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
February 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • marmaradeneysel

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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