Auricular Vagus Nerve Acupressure for Patients with Emotional Distress under the COVID-19 Pandemic: A Smartphone-based, Randomized，Controlled Trial (Preprint)

Abstract

BACKGROUND The global spread of the 2019 coronavirus diseases (COVID-19) has caused emotional distress. However, whether auricular vagus nerve acupressure (AVNA) is effective in improving emotional distress under the COVID-19 has not been well-documented. OBJECTIVE To confirm whether AVNA is effective in improving emotional distress under the COVID-19 pandemic. METHODS A smartphone-based online, randomized, controlled trial was designed in four study sites, including Wuhan, Beijing, Shenyang, and Guangzhou of China, from 26 February 2020 to 28 April 2020. Participants were randomly assigned to three times of AVNA (n = 191) or usual care (UC, n = 215) for 14 days. The primary outcome was the response rate, which was the proportion of participants whose Hospital Anxiety and Depression Scale (HADS) score reduced from baseline by ≥ 50%. The assessment was conducted at baseline, 3 days, and 14 days. RESULTS The AVNA group had a markedly higher response rate than the UC group at 3 days (35.6% vs. 24.9%, P = 0.02) and at 14 days (70.7% vs. 60.6%, P = 0.02). The AVNA group showed significantly greater reduction in score of HADS at the two measurement points and BAI at 3 days (P ≤ 0.03), with average respective effect size of 0.217 and 0.195. Participants with AVNA spent less time falling asleep and rated their sleep quality being remarkably higher than those with UC at endpoint. CONCLUSIONS AVNA can be recommended for patients with emotional distress under the current COVID-19 pandemic and other emergent events. CLINICALTRIAL www.chictr.org.cn Identifier: ChiCTR2000030078.

Use of Information and Communication Technologies to Enhance Self-Acupressure: a Literature Review

“…Among them, one study that was not a clinical study, five studies that did not use self-acupressure, seven studies that did not combine ICTs with self-acupressure, and two studies that used the same data as published journal articles (conference abstracts) were excluded. Finally, 12 studies [20][21][22][23][24][25][26][27][28][29][30][31] were included in this review (Fig. 1).…”

“…The 12 included studies were published between 2018 and 2021. In terms of study design, five RCTs [20,[23][24][25]28], three pilot studies with one group [22,27,30], two RCT protocols [26,31], one focus group and online survey [21], and one qualitative study [29] were included. Among the included studies, the rationale for four studies [25,[28][29][30] was the COVID-19 era (4/12, 33.33%).…”

“…In terms of study design, five RCTs [20,[23][24][25]28], three pilot studies with one group [22,27,30], two RCT protocols [26,31], one focus group and online survey [21], and one qualitative study [29] were included. Among the included studies, the rationale for four studies [25,[28][29][30] was the COVID-19 era (4/12, 33.33%). There were six kinds of target populations or conditions, and musculoskeletal injuries or pain was the most common (5/12, 41.67%), followed by cancer-related symptoms (2/12, 16.67%), dysmenorrhea (2/12, 16.67%), mental health issues (2/12, 16.67%), obesity (1/12, 8.33%), and other (1/12, 8.33%) (Fig.…”

“…Among the 12 studies [20][21][22][23][24][25][26][27][28][29][30][31], seven studies (7/12, 58.33%) [20,21,23,25,26,29,31], four studies (4/12, 33.33%) [24,27,28,30], and one study (1/12, 8.33%) [22] described the self-acupressure type as manual stimulation on body acupoints, AA, and self-applicable smartphone-controlled kneepad, respectively. Only three studies [20,21,26] reported the stimulation time per acupoint, ranging from 1 to 3 minutes, with an average of 1.67.…”

“…The studies included in this mini review mainly conducted interventions that combined acupressure and ICTs for pain, cancer-related symptoms, dysmenorrhea, mental health issues, and obesity. Among the included studies, more than half were published after the declaration of the COVID-19 pandemic [25][26][27][28][29][30][31], and in four studies [25,[28][29][30], the research rationale was the COVID-19 era. The most commonly used ICT to support self-acupressure was smartphone applications [20,22,24,[26][27][28]30,31], and in one study [22], a Bluetoothoperated kneepad was developed.…”