Sham Acupressure Controls Used in Randomized Controlled Trials: A Systematic Review and Critique

Jing-Yu Tan, Lorna K P Suen, Tao Wang, Alexander Molassiotis, Jing-Yu Tan, Lorna K P Suen, Tao Wang, Alexander Molassiotis

Abstract

Objectives: To explore the commonly utilized sham acupressure procedures in existing acupressure trials, and to assess whether different types of sham interventions yield different therapeutic outcomes, and, as far as possible, to identify directions for the future development of an adequate sham acupressure method.

Methods: Randomized controlled trials comparing true acupressure with sham interventions were included. Thirteen electronic databases were adopted to locate relevant studies from inception to July 3, 2014. Meanwhile, eight Chinese journals on complementary and alternative medicine were manually searched to locate eligible articles. In addition, eligible studies listed in the reference lists of the included papers and other related systematic reviews on acupressure were also screened to further search any potentially eligible trials. Methodological quality of the included studies was evaluated using the risk of bias assessment tool developed by the Cochrane Back Review Group. Descriptive analysis was adopted to summarize the therapeutic outcomes.

Results: Sixty-six studies with 7265 participants were included. Methodological quality of the included trials was generally satisfactory. Six types of sham acupressure approaches were identified and "non-acupoint" stimulation was the most frequently utilized sham point while an acupressure device was the most commonly used approach for administering sham treatments. Acupressure therapy was a beneficial approach in managing a variety of health problems and the therapeutic effect was found to be more effective in the true acupressure groups than that in the sham comparative groups. No clear association could be identified between different sham acupressure modalities and the reported treatment outcomes.

Conclusions: A great diversity of sham acupressure controls have been used in clinical practice and research. A solid conclusion whether different sham alternatives are related to different treatment outcomes cannot be derived because of significant clinical heterogeneity among the analyzed trials. Non-acupoints are generally recommended but the definite locations should be identified with caution. For studies using single sham acupoints on hands or legs, it is suggested to apply identical acupressure devices on the same acupoint as in the active intervention without any stimulation. While for studies on pain, stimulation of sham acupoints should be avoided.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1. Flow Chart of Study Selection.
Fig 1. Flow Chart of Study Selection.
CENTRAL: Cochrane Central Register of Controlled Trials, CINAHL: Cumulative Index to Nursing and Allied Health Literature, AMED: Allied and Complementary Medicine, FMJS: Foreign Medical Journal Service, CNKI: China National Knowledge Infrastructure, CQVIP: Chinese Scientific Journal Database, CBM: Chinese Biomedical Literature Database

References

    1. McGovern DPB. Randomized controlled trials In: McGovern DPB, Valori RM, Summerskill WSM, eds. Key topics in evidence based medicine. Oxford: BIOS Scientific Publishers, 2001:pp. 26–29.
    1. Dincer F, Linde K. Sham interventions in randomized clinical trials of acupuncture-a review. Complement Ther Med, 2003, 11(4), 235–242.
    1. Shapiro AK, Morris LA. The placebo effect in medical and psychological therapies In: Garfield SL, Bergin AE, editors. Handbook of psychotherapy and behavior change. New York: Wiley; 1978: p. 371.
    1. Lund I, Näslund J, Lundeberg T. Minimal acupuncture is not a valid placebo control in randomised controlled trials of acupuncture: a physiologist’s perspective. Chin Med, 2009, 4(1), 1.
    1. Vickers AJ, Cronin AM, Maschino AC, Lewith G, MacPherson H, Foster NE et al. Acupuncture for chronic pain: individual patient data meta-analysis. Arch Intern Med, 2012, 172(19), 1444–1453. 10.1001/archinternmed.2012.3654
    1. Zhang HW, Tang JL. Development and selection of sham approaches in clinical trials of acupuncture. Zhongguo Zhong Xi Yi Jie He Za Zhi, 2003, 23(4), 247–250.
    1. Itoh K, Katsumi Y, Hirota S, Kitakoji H. Effects of trigger point acupuncture on chronic low back pain in elderly patients—a sham-controlled randomised trial. Acupunct Med, 2006, 24(1), 5–12.
    1. Sun Y, Gan TJ. Acupuncture for the management of chronic headache: a systematic review. Anesth Analg, 2008, 107(6), 2038–2047. 10.1213/ane.0b013e318187c76a
    1. Molsberger AF, Schneider T, Gotthardt H, Drabik A. German Randomized Acupuncture Trial for chronic shoulder pain (GRASP)—a pragmatic, controlled, patient-blinded, multi-centre trial in an outpatient care environment. Pain, 2010, 151(1), 146–154. 10.1016/j.pain.2010.06.036
    1. Linde K, Streng A, Jürgens S, Hoppe A, Brinkhaus B, Witt C, et al. Acupuncture for patients with migraine: a randomized controlled trial. JAMA, 2005, 293(17), 2118–2125.
    1. Ernst E. Acupuncture as a symptomatic treatment of osteoarthritis. Scand J Rheumatol, 1997, 26(6), 444–447.
    1. Scharf HP, Mansmann U, Streitberger K, Witte S, Krämer J, Maier C, et al. Acupuncture and Knee Osteoarthritis: A Three-Armed Randomized Trial. Ann Intern Med, 2006, 145(1), 12–20.
    1. Furlan AD, Pennick V, Bombardier C, van Tulder M. 2009 updated method guidelines for systematic reviews in the Cochrane Back Review Group. Spine, 2009, 34(18), 1929–1941. 10.1097/BRS.0b013e3181b1c99f
    1. Zhang CS, Yang AW, Zhang AL, May BH, Xue CC. Sham control methods used in ear-acupuncture/ear-acupressure randomized controlled trials: a systematic review. J Altern Complement Med, 2014, 20(3), 147–161. 10.1089/acm.2013.0238
    1. Zhang H, Bian Z, Lin Z. Are acupoints specific for diseases? A systematic review of the randomized controlled trials with sham acupuncture controls. Chin Med, 2010, 5(1). 10.1186/1749-8546-5-1
    1. Tang WR, Chen WJ, Yu CT, Chang YC, Chen CM, Wang CH, et al. Effects of acupressure on fatigue of lung cancer patients undergoing chemotherapy: An experimental pilot study. Complement Ther Med, 2014, 22(4), 581–591. 10.1016/j.ctim.2014.05.006
    1. Atrian MK, Abbaszadeh F, Sarvieh M, Sarafraz N, Jafarabadi MA. Investigating the effect of pressure on third liver point on primary dysmenorrhea: a randomized controlled clinical trial. Iran Red Crescent Med J, 2013, 15(9), 848–853. 10.5812/ircmj.12719
    1. Sehhatie-Shafaie F, Amani F, Heshmat R. The effect of acupressure on Sanyinjiao and Hugo points on labor pain in nulliparous women: a randomized clinical trial. J Caring Sci, 2013, 2(2), 123–129. 10.5681/jcs.2013.015
    1. Chao HL, Miao SJ, Liu PF, Lee HHC, Chen YM, Yao CT, et al. The beneficial effect of ST-36 (Zusanli) acupressure on postoperative gastrointestinal function in patients with colorectal cancer. Oncol Nurs Forum, 2013, 40(2), E61–E68. 10.1188/13.ONF.E61-E68
    1. McFadden KL, Healy KM, Hoversten KP, Ito TA, Hernández TD. Efficacy of acupressure for non-pharmacological stress reduction in college students. Complement Ther Med, 2012, 20(4), 175–182. 10.1016/j.ctim.2011.12.003
    1. Valiee S, Bassampour SS, Nasrabadi AN, Pouresmaeil Z, Mehran A. Effect of acupressure on preoperative anxiety: a clinical trial. J Perianesth Nurs, 2012, 27(4), 259–266. 10.1016/j.jopan.2012.05.003
    1. Rad MN, Lamyian M, Heshmat R, Jaafarabadi MA, Yazdani S. A randomized clinical trial of the efficacy of KID21 point (Youmen) acupressure on nausea and vomiting of pregnancy. Iran Red Crescent Med J, 2012, 14(11), 697–701. 10.5812/ircmj.2153
    1. Chang KKP, Wong TKS, Wong THK, Chung JWY. Leung AWN. Effect of acupressure in treating urodynamic stress incontinence: A randomized controlled trial. Am J Chin Med, 2011, 39(6), 1139–1159.
    1. McFadden KL, Healy KM, Dettmann ML, Kaye JT, Ito TA, Hernández TD. Acupressure as a non-pharmacological intervention for traumatic brain injury (TBI). J Neurotrauma, 2011, 28(1), 21–34. 10.1089/neu.2010.1515
    1. Kashefi F, Khajehei M, Ashraf AR, Jafari P. The efficacy of acupressure at the Sanyinjiao point in the improvement of women's general health. J Altern Complement Med, 2011, 17(12), 1141–1147. 10.1089/acm.2010.0589
    1. Reza H, Kian N, Pouresmail Z, Masood K, Sadat Seyed Bagher M, Cheraghi MA. The effect of acupressure on quality of sleep in Iranian elderly nursing home residents. Complement Ther Clin Pract, 2010, 16(2), 81–85. 10.1016/j.ctcp.2009.07.003
    1. McFadden KL, Hernández TD. Cardiovascular benefits of acupressure (Jin Shin) following stroke. Complement Ther Med, 2010, 18(1), 42–48. 10.1016/j.ctim.2010.01.001
    1. Maa SH, Tsou TS, Wang KY, Wang CH, Lin HC, Huang YH. Self-administered acupressure reduces the symptoms that limit daily activities in bronchiectasis patients: pilot study findings. J Clin Nurs, 2007, 16(4), 794–804.
    1. Shin HS, Song YA, Seo S. Effect of Nei-Guan point (P6) acupressure on ketonuria levels, nausea and vomiting in women with hyperemesis gravidarum. J Adv Nurs, 2007, 59(5), 510–519.
    1. Bertalanffy P, Hoerauf K, Fleischhackl R, Strasser H, Wicke F, Greher M. Korean hand acupressure for motion sickness in prehospital trauma care: a prospective, randomized, double-blinded trial in a geriatric population. Anesth Analg, 2004, 98(1), 220–223.
    1. Chen LL, Hsu SF, Wang MH, Chen CL, Lin YD, Lai JS. Use of acupressure to improve gastrointestinal motility in women after trans-abdominal hysterectomy. Am J Chin Med, 2003, 31(5), 781–790.
    1. Tsay SL, Chen ML. Acupressure and quality of sleep in patients with end-stage renal disease—a randomized controlled trial. Int J Nurs Stud, 2003, 40(1), 1–7.
    1. Kober A, Scheck T, Greher M, Lieba F, Fleischhackl R, Fleischhackl S, et al. Prehospital analgesia with acupressure in victims of minor trauma: a prospective, randomized, double-blinded trial. Anesth Analg, 2002, 95(3), 723–727.
    1. Belluomini J, Litt RC, Lee KA, Katz M. Acupressure for nausea and vomiting of pregnancy: a randomized, blinded study. Obstet Gynecol, 1994, 84(2), 245–248.
    1. Adib-Hajbaghery M, Etri M. Effect of acupressure of Ex-Le7 point on pain, nausea and vomiting after appendectomy: A randomized trial. J Res Med Sci, 2013, 18(6), 482–486.
    1. Alessandrini M, Napolitano B, Micarelli A, De Padova A, Bruno E. P6 acupressure effectiveness on acute vertiginous patients: a double blind randomized study. J Altern Complement Med, 2012, 18(12), 1121–1126. 10.1089/acm.2011.0384
    1. Soltani ARE, Mohammadinasab H, Goudarzi M, Arbabi S, Mohammadinasab A, Mohammadinasab F, et al. Comparing the efficacy of prophylactic p6 acupressure, ondansetron, metoclopramide and placebo in the prevention of vomiting and nausea after strabismus surgery. Acta Med Iran, 2011, 49(4), 208–212.
    1. Bao T, Ye X, Skinner J, Cao B, Fisher J, Nesbit S, et al. The analgesic effect of magnetic acupressure in cancer patients undergoing bone marrow aspiration and biopsy: a randomized, blinded, controlled trial. J Pain Symptom Manage, 41(6), 995–1002. 10.1016/j.jpainsymman.2010.08.012
    1. Majholm B, Møller AM. Acupressure at acupoint P6 for prevention of postoperative nausea and vomiting: a randomised clinical trial. Eur J Anaesthesiol, 2011, 28(6), 412–419. 10.1097/EJA.0b013e32833f6f42
    1. Sinha A, Paech MJ, Thew ME, Rhodes M, Luscombe K, Nathan E. A randomised, double-blinded, placebo-controlled study of acupressure wristbands for the prevention of nausea and vomiting during labour and delivery. Int J Obstet Anesth, 2011, 20(2), 110–117. 10.1016/j.ijoa.2010.10.005
    1. Wang SM, Escalera S, Lin EC, Maranets I, Kain ZN. Extra-1 acupressure for children undergoing anesthesia. Anesth Analg, 2008, 107(3), 811–816. 10.1213/ane.0b013e3181804441
    1. Turgut S, Ozalp G, Dikmen S, Savli S, Tuncel G, Kadiogullari N. Acupressure for postoperative nausea and vomiting in gynaecological patients receiving patient-controlled analgesia. Eur J Anaesthesiol, 2007, 24(1), 87–91.
    1. Heazell A, Thorneycroft J, Walton V, Etherington I. Acupressure for the in-patient treatment of nausea and vomiting in early pregnancy: a randomized control trial. Am J Obstet Gynecol, 2006, 194(3), 815–820.
    1. Wang SM, Gaal D, Maranets I, Caldwell-Andrews A, Kain ZN. Acupressure and preoperative parental anxiety: a pilot study. Anesth Analg, 2005, 101(3), 666–669.
    1. Alkaissi A, Ledin T, Odkvist LM, Kalman S. P6 acupressure increases tolerance to nauseogenic motion stimulation in women at high risk for PONV. Can J Anaesth, 2005, 52(7), 703–709.
    1. Samad K, Afshan G, Kamal R. Effect of acupressure on postoperative nausea and vomiting in laparoscopic cholecystectomy. J Pak Med Assoc, 2003, 53(2), 68–71.
    1. Alkaissi A, Evertsson K, Johnsson VA, Ofenbartl L, Kalman S. P6 acupressure may relieve nausea and vomiting after gynecological surgery: an effectiveness study in 410 women. Can J Anaesth, 2002, 49(10), 1034–1039.
    1. Agarwal A, Pathak A, Gaur A. Acupressure wristbands do not prevent postoperative nausea and vomiting after urological endoscopic surgery. Can J Anaesth, 2000, 47(4), 319–324.
    1. Harmon D, Ryan M, Kelly A, Bowen M. Acupressure and prevention of nausea and vomiting during and after spinal anaesthesia for caesarean section. Br J Anaesth, 2000, 84(4), 463–467.
    1. Harmon D, Gardiner J, Harrison R, Kelly A. Acupressure and the prevention of nausea and vomiting after laparoscopy. Br J Anaesth, 1999, 82(3), 387–390.
    1. Alkaissi A, Stålnert M, Kalman S. Effect and placebo effect of acupressure (P6) on nausea and vomiting after outpatient gynaecological surgery. Acta Anaesthesiol Scand, 1999, 43(3), 270–274.
    1. Fan CF, Tanhui E, Joshi S, Trivedi S, Hong Y, Shevde K. Acupressure treatment for prevention of postoperative nausea and vomiting. Anesth Analg, 1997, 84(4), 821–825.
    1. O'Brien B, Relyea MJ, Taerum T. Efficacy of P6 acupressure in the treatment of nausea and vomiting during pregnancy. Am J Obstet Gynecol, 1996, 174(2), 708–715.
    1. Felhendler D, Lisander B. Pressure on acupoints decreases postoperative pain. Clin J Pain, 1996, 12(4), 326–329.
    1. Bayreuther J, Pickering R, Lewith GT. A double-blind cross-over study to evaluate the effectiveness of acupressure at pericardium 6 (P6) in the treatment of early morning sickness (EMS). Complement Ther Med, 1994, 2(2), 70–76.
    1. Hamidzadeh A, Shahpourian F, Orak RJ, Montazeri AS, Khosravi A. Effects of LI4 acupressure on labor pain in the first stage of labor. J Midwifery Womens Health, 2012, 57(2), 133–138. 10.1111/j.1542-2011.2011.00138.x
    1. Mirbagher-Ajorpaz N, Adib-Hajbaghery M, Mosaebi F. The effects of acupressure on primary dysmenorrhea: a randomized controlled trial. Complement Ther Clin Pract, 2011, 17(1), 33–36. 10.1016/j.ctcp.2010.06.005
    1. Sun JL, Sung MS, Huang MY, Cheng GC, Lin CC. Effectiveness of acupressure for residents of long-term care facilities with insomnia: a randomized controlled trial. Int J Nurs Stud, 2010, 47(7), 798–805. 10.1016/j.ijnurstu.2009.12.003
    1. Kashanian M, Shahali S. Effects of acupressure at the Sanyinjiao point (SP6) on the process of active phase of labor in nulliparas women. J Matern Fetal Neonatal Med, 2010, 23(7), 638–641.
    1. Hjelmstedt A, Shenoy ST, Stener-Victorin E, Lekander M, Bhat M, Balakumaran L, et al. Acupressure to reduce labor pain: a randomized controlled trial. Acta Obstet Gynecol Scand, 2010, 89(11), 1453–1459. 10.3109/00016349.2010.514323
    1. Hsu W, Hsu HY, Sun JL. Effects of shenmen acupressure on improving the condition of institutional residents with insomnia. J Evid Based Nurs, 2006, 2(4), 331–338.
    1. Lee MK, Chang SB, Kang DH. Effects of SP6 acupressure on labor pain and length of delivery time in women during labor. J Altern Complement Med, 2004, 10(6), 959–965.
    1. Nilsson I, Karlsson A, Lindgren L, Bergenheim T, Koskinen LO, Nilsson U. The efficacy of P6 acupressure with sea-band in reducing postoperative nausea and vomiting in patients undergoing craniotomy: a randomized, double-blinded, placebo-controlled Study. J Neurosurg Anesthesiol, 2015, 27(1), 42–50. 10.1097/ANA.0000000000000089
    1. Molassiotis A, Russell W, Hughes J, Breckons M, Lloyd Williams M, Richardson J, et al. The effectiveness and cost-effectiveness of acupressure for the control and management of chemotherapy-related acute and delayed nausea: assessment of Nausea in Chemotherapy Research (ANCHoR), a randomised controlled trial. Health Technol Assess, 2013, 17, 26.
    1. Noroozinia H, Mahoori A, Hasani E, Gerami-Fahim M, Sepehrvand N. The effect of acupressure on nausea and vomiting after cesarean section under spinal anesthesia. Acta Med Iran, 2013, 51(3), 163–167.
    1. Soltanzadeh M, Behaeen K, Pourmehdi Z, Safarimohsenabadi A. Effects of acupressure on nausea and vomiting after gynecological laparoscopy surgery for infertility investigations. Life Sci J, 2012, 9(3), 871–875.
    1. White PF, Zhao M, Tang J, Wender RH, Yumul R, Sloninsky AV, et al. Use of a disposable acupressure device as part of a multimodal antiemetic strategy for reducing postoperative nausea and vomiting. Anesth Analg, 2012, 115(1), 31–37. 10.1213/ANE.0b013e3182536f27
    1. Ho CM, Tsai HJ, Chan KH, Tsai SK. P6 acupressure does not prevent emesis during spinal anesthesia for cesarean delivery. Anesth Analg, 2006, 102(3), 900–903.
    1. Klein AA, Djaiani G, Karski J, Carroll J, Karkouti K, McCluskey S, et al. Acupressure wristbands for the prevention of postoperative nausea and vomiting in adults undergoing cardiac surgery. J Cardiothorac Vasc Anesth, 2004, 18(1), 68–71.
    1. Schultz AA, Andrews AL, Goran SF, Mathew T, Sturdevant N. Comparison of acupressure bands and droperidol for reducing post-operative nausea and vomiting in gynecologic surgery patients. Appl Nurs Res, 2003, 16(4), 256–265.
    1. Dent HE, Dewhurst NG, Mills SY, Willoughby M. Continuous PC6 wristband acupressure for relief of nausea and vomiting associated with acute myocardial infarction: a partially randomised, placebo-controlled trial. Complement Ther Med, 2003, 11(2), 72–77.
    1. Norheim AJ, Pedersen EJ, Fønnebø V, Berge L. Acupressure treatment of morning sickness in pregnancy. A randomised, double-blind, placebo-controlled study. Scand J Prim Health Care, 2001, 19(1), 43–47.
    1. Steele NM, French J, Gatherer-Boyles J, Newman S, Leclaire S. Effect of acupressure by sea-bands on nausea and vomiting of pregnancy. J Obstet Gynecol Neonatal Nurs, 2001, 30(1), 61–70.
    1. Woods RM. Pericardium-6 acupressure for the prevention of postoperative nausea and vomiting. Uniformed Services University of the Health Sciences, 1999.
    1. Duggal KN, Douglas MJ, Peteru EA, Merrick PM. Acupressure for intrathecal narcotic-induced nausea and vomiting after caesarean section. Int J Obstet Anesth, 1998, 7(4), 231–236.
    1. Lewis IH, Pryn SJ, Reynolds PI, Pandit UA, Wilton NCT. Effect of P6 acupressure on postoperative vomiting in children undergoing outpatient strabismus correction. Br J Anaesth, 1991, 67(1), 73–78.
    1. Suh EE. The effects of P6 acupressure and nurse-provided counseling on chemotherapy-induced nausea and vomiting in patients with breast cancer. Oncol Nurs Forum, 39(1), E1–E9. 10.1188/12.ONF.E1-E9
    1. Lang T, Hager H, Funovits V, Barker R, Steinlechner B, Hoerauf K, et al. Prehospital analgesia with acupressure at the Baihui and Hegu points in patients with radial fractures: a prospective, randomized, double-blind trial. Am J Emerg Med, 2007, 25(8), 887–893.
    1. Wu HS, Lin LC, Wu SC, Lin JG. The psychologic consequences of chronic dyspnea in chronic pulmonary obstruction disease: the effects of acupressure on depression. J Altern Complement Med, 2007, 13(2), 253–261.
    1. Wu HS, Wu SC, Lin JG, Lin LC. Effectiveness of acupressure in improving dyspnoea in chronic obstructive pulmonary disease. J Adv Nurs, 2004, 45(3), 252–259.
    1. Nordio M, Romanelli F. Efficacy of wrists overnight compression (HT 7 point) on insomniacs: possible role of melatonin? Minerva Medica, 2008, 99(6), 539–547.
    1. Lundeberg T, Lund I, Sing A, Näslund J. Is placebo acupuncture what it is intended to be?. Evid Based Complement Alternat Med, 2011. Article ID 932407. 10.1093/ecam/nep049
    1. Linde K, Niemann K, Meissner K. Are sham acupuncture interventions more effective than (other) placebos? A re-analysis of data from the Cochrane review on placebo effects. Forsch Komplementarmed, 2010, 17(5), 259–264.
    1. Hróbjartsson A, Gøtzsche PC. Placebo interventions for all clinical conditions. Cochrane Database Syst Rev, 2010, CD003974. 10.1002/14651858.CD003974.pub3
    1. Pan LJ, Chen B, Zhao X, Guo Y. Thinking on designation of sham acupuncture in clinical research. Zhongguo Zhen Jiu, 2014, 34(1), 83–86.
    1. Olausson H, Lamarre Y, Backlund H, Morin C, Wallin BG, Starck G, et al. Unmyelinated tactile afferents signal touch and project to insular cortex. Nat Neurosci, 2002, 5(9), 900–904.
    1. Lundeberg T, Lund I. Are reviews based on sham acupuncture procedures in fibromyalgia syndrome (FMS) valid? Acupunct Med, 2007, 25(3), 100–106.
    1. Wood L, Egger M, Gluud LL, Schulz KF, Jüni P, Altman DG, et al. Empirical evidence of bias in treatment effect estimates in controlled trials with different interventions and outcomes: meta-epidemiological study. BMJ, 2008, 336(7644), 601–605. 10.1136/
    1. Azad A, John T. Do randomized acupuncture studies in patients with cancer need a sham acupuncture control arm? J Clin Oncol, 2013, 31(16), 2057–2058. 10.1200/JCO.2012.47.8750
    1. Kelley JM, Lembo AJ, Ablon JS, Villanueva JJ, Conboy LA, Levy R, et al. Patient and practitioner influences on the placebo effect in irritable bowel syndrome. Psychosom Med, 2009, 71(7), 789–797. 10.1097/PSY.0b013e3181acee12
    1. Kondziolka D, Lemley T, Kestle JR, Lunsford LD, Fromm GH, Jannetta PJ. The effect of single-application topical ophthalmic anesthesia in patients with trigeminal neuralgia: a randomized double-blind placebo-controlled trial. J Neurosurg, 1994, 80(6), 993–997.
    1. Lundeberg T, Lund I, Näslund J, Thomas M. The Emperors sham-wrong assumption that sham needling is sham. Acupunct Med, 2008, 26(4), 239–242.
    1. Hui KK, Liu J, Makris N, Gollub RL, Chen AJ, I Moore C, et al. Acupuncture modulates the limbic system and subcortical gray structures of the human brain: evidence from fMRI studies in normal subjects. Hum Brain Mapp, 2000, 9(1), 13–25.
    1. Hughes JG, Russell W, Breckons M., Richardson J, Lloyd-Williams M, Molassiotis A. (2014). “I assumed that one was a placebo”: Exploring the consent process in a sham controlled acupressure trial. Complement Ther Med, 22(5), 903–908. 10.1016/j.ctim.2014.07.005
    1. Hughes JG, Russell W, Breckons M, Richardson J, Lloyd-Williams M, Molassiotis A. “Until the trial is complete you can’t really say whether it helped you or not, can you?”: exploring cancer patients’ perceptions of taking part in a trial of acupressure wristbands. BMC Complement Altern Med, 2013, 13(1), 1–10.
    1. Moher D, Schulz KF, Altman DG. The CONSORT statement: revised recommendations for improving the quality of reports of parallel group randomized trials. BMC Med Res Methodol, 2001, 1(1), 2.
    1. MacPherson H, Altman DG, Hammerschlag R, Youping L, Taixiang W, et al. Revised STandards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA): Extending the CONSORT Statement. PLoS Med, 2010, 7(6): e1000261 10.1371/journal.pmed.1000261

Source: PubMed

Sponsorit ja yhteistyökumppanit

Sairaudet

Huumeiden interventiot

3
Tilaa