Effect of acupressure on nausea and vomiting during pregnancy

Penny Robertshawe

Aim Of Study

The purpose of this study was to determine the effects of acupressure acupressure
or shiatsu

Alternative-medicine practice in which pressure is applied to points on the body aligned along 12 main meridians (pathways), usually for a short time, to improve the flow of vital force (qi).
on nausea and vomiting Nausea and Vomiting Definition

Nausea is the sensation of being about to vomit. Vomiting, or emesis, is the expelling of undigested food through the mouth.
in pregnant women.


Seventy-five pregnant women who were in their 5th to 20th week of gestation GESTATION, med. jur. The time during which a female, who has conceived, carries the embryo or foetus in her uterus. By the common consent of mankind, the term of gestation is considered to be ten lunar months, or forty weeks, equal to nine calendar months and a week. took part in this study. All of these women had experienced at least one episode of nausea either with or without vomiting in the 24 hours prior to study commencement. None of the women were taking vitamin B
vitamin B
1. Vitamin B complex.

2. A member of the vitamin B complex, especially thiamine.

vitamin B, vitamin B complex

a group of water-soluble substances described separately.
6 or medication for nausea and vomiting. None of the women were diagnosed with hyperemesis gravidarum Hyperemesis Gravidarum Definition

Hyperemesis gravidarum means excessive vomiting during pregnancy.

In pregnant women, nausea and vomiting (morning sickness) are common, affecting up to 80% of pregnancies.
(a condition characterised by severe and protracted pro·tract
tr.v. pro·tract·ed, pro·tract·ing, pro·tracts
1. To draw out or lengthen in time; prolong: disputants who needlessly protracted the negotiations.

vomiting). There were no statistical differences between the women for severity, length and frequency of nausea and vomiting episodes.

The women were randomly divided into three groups: 26 in the treatment group, 25 in the control group and 24 in the placebo group. None of the women were made aware of which group they had been allocated to. All the women in this study were asked to keep a diary of nausea and vomiting episodes for the nine day duration of the intervention.

Those in the treatment group had acupressure wristbands applied to the P6 acupressure point. The wristband was 2.5 cm thick with a cloth covered semi-sphere shaped button that was placed over the P6 point on the inner wrist. The women in this group applied pressure to the P6 point digitally. To ensure the instructions were correctly carried out, written materials explaining the procedure were also provided.

Women in the placebo group wore the same acupressure wristbands as the treatment group, but with the button on the upper wrist in the opposite position to the P6 point. Written instructions were provided to this group as well to ensure that the wristbands were correctly worn. The control group did not wear wristbands.

The study's length was nine days. On days 1-3 no wristbands were worn by any group. During days 4-6 the acupressure bands were used by the treatment and placebo groups. These bands were taken off at night before going to sleep and put back on before getting out of bed in the morning. If the bands needed to be removed at any time over the-day, they had to be replaced within 15 minutes and this had to be recorded in the diary. On days 7-9 the wristbands were not worn at all.


Visual analogue scales (VAS
vas (vas) pl. va´ sa [L.] vessel.va´sal

vas aber´rans
1. a blind tubule sometimes connected with the epididymis; a vestigial mesonephric tubule.

) formed part of the women's daily diary notes. The VAS consisted of a 10 cm horizontal line (Descriptive Geometry & Drawing) a constructive line, either drawn or imagined, which passes through the point of sight, and is the chief line in the projection upon which all verticals are fixed, and upon which all vanishing points are found.

See also: Horizontal
with 0 cm representing 'no symptoms' and 10 cm indicating 'worst possible symptoms'.


There was a highly significant reduction in the frequency of nausea symptoms between days 1-3 and days 4-6 in the treatment group. The placebo group also showed a significant reduction in frequency of nausea symptoms in these two time periods. The control group showed no significant difference between days 1-3 and 4-6.

There was a significant reduction in the severity of nausea for both the treatment and the placebo groups between days 1-3 and days 4-6. The control group showed no difference in nausea severity for the same periods.

There was a significant reduction in the intensity of discomfort for both the treatment and the placebo groups between days 1-3 and days 4-6, although the reduction was greater in the treatment group. The control group showed no difference in nausea severity for the same periods. During days 7-9, there were no significant differences between any of the groups for frequency or severity of nausea episodes or for intensity of discomfort.


The researchers concluded that:

   acupressure wristbands may have both a therapeutic and a placebo
   effect on reducing symptoms of nausea and ensuring relief for the

Limitations Of The Study

The researchers noted that women who came to the centre in which the study took place tended to have their regular medical examinations at similar appointment times. Thus the possibility that the women might communicate with each other was created. In an effort to reduce any negative effects that this may cause, the women who were allocated to the same group were given appointments on the same day. _

Gurkan OZ, Arsian H. Effect of acupressure on nausea and vomiting during pregnancy. Complementary Therapies in Clinical Practice 2008;14:46-52.

 COPYRIGHT  Australian Traditional-Medicine Society reproduced with permission


Massage vs guided relaxation on wellbeing and stress in older patients

Penny Robertshawe

Sharpe, P, Williams, H, Granner M, Hussey J. A randomised Adj. 1. randomised - set up or distributed in a deliberately random way

irregular - contrary to rule or accepted order or general practice; "irregular hiring practices"
study of the effects of massage therapy Massage Therapy Definition

Massage therapy is the scientific manipulation of the soft tissues of the body for the purpose of normalizing those tissues and consists of manual techniques that include applying fixed or movable pressure, holding, and/or
compared to guided relaxation on well-being and stress perception among older adults. Complementary Ther Med 2007;15:157-163.

Why Was This Study Conducted?

This study was conducted to compare the effects of massage therapy with guided relaxation on general wellbeing and stress perception in older adults.

What Were The Parameters Of This Study?

Forty-nine adults aged 60 years and over took part in this study. Of these, 25 were randomly selected for the massage treatment group and 24 for the guided relaxation group. All participants were randomised and were given approval by their physicians to take part. None received massage therapy in the three months prior to the study.

The participants in the treatment group received massage therapy twice a week on either Monday/Wednesday or Tuesday/Thursday for four weeks for a total of eight sessions. The 50 minute massage sessions consisted of neuromuscular
neuromuscular /neu·ro·mus·cu·lar/ (-mus´ku-ler) pertaining to nerves and muscles, or to the relationship between them.

, myofascial and Swedish massage Swed·ish massage
A system of therapeutic massage and exercise for the muscles and joints, developed in Sweden in the 19th century.
techniques. The treatments were standardised by written guidelines.

Participants in the guided relaxation group were read 50 minute scripts while in the supine position. The relaxation scripts were developed with reference to relaxation techniques available in published materials. The same gentle background music was played for both study groups.

How Were The Measurements Taken?

Face to face interviews that involved completing two measurement scales were used to assess the wellbeing and stress perception in each participant. These interviews were conducted prior to the commencement of the study and within three days after its completion.

The 18 item General Wellbeing Schedule (GWB GWB George W Bush (US president)
GWB Gesetz Gegen Wettbewerbsbeschränkungen (act against restraints of competition, Germany)
GWB Geochemist's Workbench (scientific software)
) was used to measure depression, anxiety, positive wellbeing, self-control, vitality and general health. Each item consists of a six point response with the higher scores indicating greater wellbeing or less distress.

The Perceived Stress Scale (PSS See EPSS. ) was used to measure the degree to which experienced situations were perceived as stressful during the past month. It consisted of 14 scaled items that span five points each. The higher scores indicate greater extents of perceived stress.

In addition to the two measurement scales, a post treatment question about 'the perceived quality of interaction with the therapist' was assessed on a 4 point scale. This question was designed to monitor any differences between the two groups in how the human interaction with the therapist was perceived.

What Were The Results?

At the pre-test interviews, results from the GWB did not differ between the two groups. After treatment, participants in the massage group showed significantly improved results in the categories of anxiety, depression, positive wellbeing, vitality and general health. Participants in the guided relaxation group showed no significant differences in any of these categories post study. Results for the self-control category did not improve for either group.

There were no significant differences between the two treatment groups in the PSS measurements prior to treatment. Post treatment, participants in the massage group showed significant improvement in stress perception as opposed to the guided relaxation group who showed no significant improvement.

Neither age nor sex indicated any significant predictors. Interaction with the therapist was rated either as good or excellent in both groups and no significant differences were found between groups.

What Did The Researchers Conclude?

The researchers concluded that this study 'provides support for the hypothesis that the positive effects from massage techniques are not due entirely to a general relaxation response relaxation response,
n the physiologic counterbalance to the fight-or-flight response, in which a deep state of mental and physiological rest may be elicited.
or to potential stress reduction effects of positive human interaction'.

What Were The Limitations Of This Study?

This study was limited by the fact that it did not measure the long term effects of the massage treatments and nor did it measure effects at shorter intervals such as at the end of each treatment week. The question remains as to how frequently a person needs to receive massage treatment to reap the benefits outlined in this study.


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