Effect of Transcutaneous Acupoint Electrical Stimulation on Post-Hemorrhoidectomy-Associated Pain, Anxiety, and Heart Rate Variability: A Randomized-Controlled Study

2017 ◽  
Vol 27 (4) ◽  
pp. 450-466 ◽  
Author(s):  
Mei-Ling Yeh ◽  
Yu-Chu Chung ◽  
Lun-Chia Hsu ◽  
Shuo-Hui Hung

Hemorrhoidectomy is the current best treatment for severe hemorrhoids, but it causes significant postoperative pain and anxiety, which is associated with heart rate variability (HRV). Transcutaneous acupoint electrical stimulation (TAES) was assumed to alleviate pain and anxiety, and modify the autonomic nervous system. This study aimed to examine the effects of TAES intervention on postoperative pain, anxiety, and HRV in patients who received a hemorrhoidectomy. A randomized-controlled trial with five repeated measures was conducted. The TAES group ( n = 39) received four 20-min sessions of electrical stimulation at chengshan (BL57) and erbai (EX-UE2) after hemorrhoidectomy, whereas the control group ( n = 41) did not. Data were collected using Visual Analogue Scale (VAS), State Anxiety Inventory (STAI), and HRV physiological signal monitor. TAES resulted in a significant group difference in pain scores, anxiety levels, and some HRV parameters. The findings indicate that TAES can help reduce pain and anxiety associated with hemorrhoidectomy. TAES is a noninvasive, simple, and convenient modality for post-hemorrhoidectomy-associated pain control and anxiety reduction.

2020 ◽  
pp. 003151252097083
Author(s):  
Rainer Schneider

Two recent publications demonstrated that specifically designed essential odor inhalers can enhance performance through (a) better selective attention and scanning speed and (b) physiological changes of increased heart rate variability and blood oxygenation. In this study, we compared two natural odor inhalers with a popular energy drink (Red Bull®) with regard to their ability to improve vigilance on a computerized attention test. We employed a four-armed, randomized controlled experimental design and used a modified version of the CompACT-Vi test module to investigate whether deep inhalations of essential oil scents improved vigilance. Both inhalers markedly improved the number of correctly identified targets and participants’ reaction time when compared to a control condition and consumption of Red Bull® (0.9 < d < 1.3). Additionally, the number of correctly solved mathematical sums during the second half of the vigilance test was substantially higher (d = 1.3) with the use of inhalers than for the control and Red Bull participants. Inhaler use was also associated with relatively increased heart rate variability (d = 1.0) as a mechanism of adapting to the experimental demands. Thus, short and deep inhalations of essential oil scents delivered directly to the nose improved vigilance, while a popular energy drink failed to show an effect beyond that of a control group receiving no stimulant.


Author(s):  
Ilana Levy ◽  
Samuel Attias ◽  
Lior Cohen ◽  
Nadav Stoppelmann ◽  
Dan Steinberger ◽  
...  

Abstract Background Postoperative pain is common in patients hospitalized in surgical departments, yet it is currently not sufficiently controlled by analgesics. Acupuncture, a complementary medical practice, has been evaluated for its benefits in postoperative pain with heterogeneous results. We tested the feasibility of a controlled study comparing the postoperative analgesic effect of acupuncture together with standard-of-care to standard-of-care only. Methods In this pilot non-randomized controlled study conducted at a tertiary medical center in Israel, patients received either acupuncture with standard-of-care pain treatment (acupuncture group) or standard-of-care treatment only (control group) following surgery. Visual Analogue Scale (VAS) ratings for pain level at rest and in motion were evaluated both at recruitment and two hours after treatment. Acupuncture-related side effects were reported as well. Results We recruited 425 patients; 336 were assigned to the acupuncture group and 89 to the control group. The acupuncture group exhibited a decrease of at least 40% in average level of pain both at rest (1.8±2.4, p<0.0001) and in motion (2.1±2.8, p<0.0001) following acupuncture, whereas the control group exhibited no significant decrease (p=0.92 at rest, p=0.98 in motion). Acupuncture's analgesic effect was even more prominent in reducing moderate to severe pain at baseline (VAS ≥4), with a decrease of 49% and 45% of pain level at rest and in motion respectively (p<0.001), compared with no significant amelioration in the control group (p=0.20 at rest, p=0.12 in motion). No major side effects were reported. Conclusion Integrating acupuncture with standard care may improve pain control in the postoperative setting.


Author(s):  
Toshiki Kutsuna ◽  
Hitoshi Sugawara ◽  
Hideaki Kurita ◽  
Satomi Kusaka ◽  
Tetsuya Takahashi

Background: Low-intensity resistance training (RT) combined with neuromuscular electrical stimulation (NMES) is one method of exercise to improve the deterioration of physical function. However, it is unclear whether low-intensity RT combined with NMES (RT + NMES) can be safely implemented. Objective: This study aimed to examine the influence of low-intensity RT + NMES on autonomic activity and cardiovascular responses in healthy adults. Methods: This study was an open-label, randomized controlled cross-over trial. The exercise intensity of isometric knee extension RT was set to 40% of the maximum voluntary contraction (peak torque). NMES was adjusted to a biphasic asymmetrical waveform with the frequency maintained at 50 Hz and a phase duration of 300 [Formula: see text]s. The difference in the change in autonomic activity and cardiovascular responses was compared by assessing heart rate variability, blood pressure, and heart rate during RT and [Formula: see text]. Results: Twenty healthy male college students (mean age [Formula: see text] years) participated in this study. The ratio of low- and high-frequency components of heart rate variability, systolic blood pressure, and heart rate increased during exercise in the RT and [Formula: see text] sessions ([Formula: see text]). There were no significant differences in autonomic activity and cardiovascular responses throughout the sessions during RT and [Formula: see text]. Conclusion: In conclusion, our results demonstrated that low-intensity [Formula: see text] was safe and did not induce excessive autonomic and cardiovascular responses in healthy adults.


2021 ◽  
Vol 79 (8) ◽  
pp. 724-731
Author(s):  
Thais Regina Belli ◽  
Luciane Aparecida Pascucci Sande de Souza ◽  
Silméia Garcia Zanati Bazan ◽  
Rodrigo Bazan ◽  
Gustavo José Luvizutto

ABSTRACT Background: It has been shown that the autonomic nervous system can be modulated by physical exercise after stroke, but there is a lack of evidence showing rehabilitation can be effective in increasing heart rate variability (HRV). Objective: To investigate the effectiveness and safety of rehabilitation programs in modulating HRV after stroke. Methods: The search strategy was based in the PICOT (patients: stroke; interventions: rehabilitation; comparisons: any control group; outcomes: HRV; time: acute, subacute and chronic phases of stroke). We searched MEDLINE, CENTRAL, CINAHL, LILACS, and SCIELO databases without language restrictions, and included randomized controlled trials (RCTs), quasi-randomized controlled trials (quasi-RCTs), and non-randomized controlled trials (non-RCTs). Two authors independently assessed the risk of bias and we used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology to rate the certainty of the evidence for each included study. Results: Four studies (two RCTs with low certainty of the evidence and two non-RCTs with very low certainty of the evidence) were included. Three of them showed significant cardiac autonomic modulation during and after stroke rehabilitation: LF/HF ratio (low frequency/high frequency) is higher during early mobilization; better cardiac autonomic balance was observed after body-mind interaction in stroke patients; and resting SDNN (standard deviation of normal R-R intervals) was significantly lower among stroke patients indicating less adaptive cardiac autonomic control during different activities. Conclusions: There are no definitive conclusions about the main cardiac autonomic repercussions observed in post-stroke patients undergoing rehabilitation, although all interventions are safe for patients after stroke.


2019 ◽  
Vol 22 (1) ◽  
pp. 34-44
Author(s):  
Wan-Ling Chang ◽  
Jiunn-Tay Lee ◽  
Chi-Rong Li ◽  
Amy H. T. Davis ◽  
Chia-Chen Yang ◽  
...  

Background: Autonomic dysfunction, cognitive impairment, and psychological distress are associated with poorer prognosis in patients with acute ischemic stroke (AIS). Heart rate variability (HRV) biofeedback (BF) improves autonomic dysfunction, cognitive impairment, and psychological distress in other patient populations, but its effect in patients with AIS is still unclear. Objective: This study investigated the effects of an HRVBF intervention on autonomic function, cognitive impairment, and psychological distress in patients with AIS. Method: In this randomized, controlled, single-blind trial, patients with AIS were randomly assigned to the experimental or control group. The experimental group received four HRVBF training sessions. The control group received usual care. Repeated measures of HRV, mini-mental status examination (MMSE), and Hospital Anxiety and Depression Scales (HADS) were collected prior to and at 1 and 3 months postintervention. Results: A total of 35 patients completed the study (19 experimental, 16 control). HRV and HADS significantly improved in the experimental group ( p < .001) but not in the control group. Likewise, only the experimental group showed significant improvements in HRV, MMSE, and HADS over time ( p < .05). Conclusion: HRVBF is a promising intervention for improving autonomic function, cognitive impairment, and psychological distress in patients with AIS. More studies of HRVBF interventions are needed to further optimize the effects of HRVBF on autonomic, cognitive, and psychological function in patients with AIS.


2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Anders Galaasen Bakken ◽  
Andreas Eklund ◽  
David M. Hallman ◽  
Iben Axén

Abstract Background Persistent or recurrent neck pain is, together with other chronic conditions, suggested to be associated with disturbances of the Autonomic Nervous System. Acute effects on the Autonomic Nervous System, commonly measured using Heart Rate Variability, have been observed with manual therapy. This study aimed to investigate the effect on Heart Rate Variability in (1) a combination of home stretching exercises and spinal manipulative therapy versus (2) home stretching exercises alone over 2 weeks in participants with persistent or recurrent neck pain. Methods A randomized controlled clinical trial was carried out in five multidisciplinary primary care clinics in Stockholm from January 2019 to April 2020. The study sample consisted of 131 participants with a history of persistent or recurrent neck. All participants performed home stretching exercises daily for 2 weeks and were scheduled for four treatments during this period, with the intervention group receiving spinal manipulative therapy in addition to the home exercises. Heart Rate Variability at rest was measured at baseline, after 1 week, and after 2 weeks, with RMSSD (Root mean square of successive RR interval differences) as the primary outcome. Both groups were blinded to the other group intervention. Thus, they were aware of the purpose of the trial but not the details of the “other” intervention. The researchers collecting data were blinded to treatment allocation, as was the statistician performing data analyses. The clinicians provided treatment for participants in both groups and could not be blinded. A linear mixed-effects model with continuous variables and person-specific random intercept was used to investigate the group-time interaction using an intention to treat analysis. Results Sixty-six participants were randomized to the intervention group and sixty-five to the control group. For RMSSD, a B coefficient of 0.4 (p value: 0.9) was found, indicating a non-significant difference in the regression slope for each time point with the control group as reference. No statistically significant differences were found between groups for any of the Heart Rate Variability indices. Conclusion Adding four treatments of spinal manipulation therapy to a 2-week program of daily stretching exercises gave no significant change in Heart Rate Variability. Trial Registration: The trial was registered 03/07/2018 at ClinicalTrials.gov, registration number: NCT03576846. (https://pubmed.ncbi.nlm.nih.gov/31606042/)


2020 ◽  
Author(s):  
Jing Li ◽  
Dong Wei ◽  
Lingyun Ouyang ◽  
Shuyi Liu ◽  
Shuyi Liu ◽  
...  

BACKGROUND Exercise has been recommended as a cornerstone for diabetes management. Supervised exercise is more effective than unsupervised exercise, but is less convenient and inaccessible for most subjects. Exercise under remote monitoring by fitness app and heart rate band may be useful to improve exercise efficiency. OBJECTIVE To determine the feasibility and effectiveness of exercise on type 2 diabetes under remote monitoring using fitness app and heart rate monitor compared with traditional exercise. METHODS This is a prospective, multi-center, randomized controlled trial (RCT). Type 2 diabetic patients without severe complications or comorbidities were recruited. Both groups were asked to follow the same exercise prescription. The app group was given heart rate band plus remote monitoring by app, while the control group was given traditional exercise guidance. Cardiopulmonary endurance, indices of body composition, and other parameters were assessed before and after intervention. The study had an average follow-up of 3 months. RESULTS 101 patients were enrolled and 85 completed the study. With the exception of age and history of hypertension, two groups were similar in most clinical measures. Self-reported total exercise time in control group was longer than app-recorded time in app group (214 vs 193 min/week). However, compared with control group, app group had a larger increase in cardiopulmonary endurance (-2.0 vs 1.0 beats/min, p=0.023) and a larger decrease in body-fat percentage (-1.8 vs-0.8%, p=0.013). There was no difference in HbA1c between two groups, yet four subjects in app group stopped taking hypoglycemic drugs and nine lowered drug dosage, compared with one and two in the control group. There were no serious adverse reactions in both groups. CONCLUSIONS This was the first pragmatic RCT in China that tested the feasibility and preliminary efficacy of the effect of exercise under remote monitoring using app and heart rate band. This study suggested that exercise remotely supervised by app and heart rate band were more effective than unsupervised exercise in patients with type 2 diabetes. CLINICALTRIAL Chinese Clinical Trial Registry number, ChiCTR1800015963


Biosensors ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 77
Author(s):  
Petr Bahenský ◽  
Gregory J. Grosicki

We evaluated the efficacy of heart rate variability (HRV)-guided training in adolescent athletes during a 2-week, high altitude (≈1900 m) training camp. Sixteen middle- and long-distance runners (4 female/12 male, 16.9 ± 1.0 years, 65.44 ± 4.03 mL·kg−1·min−1) were divided into 2 matched groups, both of which received the same training plan, but one of which acquired postwaking HRV values that were used to tailor the training prescription. During the camp, seven athletes in the HRV-guided group combined for a total of 32 training adjustments, whereas there were only 3 runners combined for 14 total training adjustments in the control group. A significant group by time interaction (p < 0.001) for VO2max was driven by VO2max improvements in the HRV group (+2.8 mL·kg−1·min−1, +4.27%; pBonf = 0.002) that were not observed in the control condition (+0.8 mL·kg−1·min−1, +1.26%; pBonf = 0.643). After returning from the camp, all athletes in the HRV group set a personal best, and six out of eight achieved their best positions in the National Championship, whereas only 75% of athletes in the control group set a personal best and five out of eight achieved their best positions in the National Championship. These data provide evidence in support of HRV-guided training as a way to optimize training prescriptions in adolescent athletes.


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