| Chronic obstructive pulmonary disease (COPD) as a specific diagnostic label refers to emphysema and/or chronic bronchitis. Dyspnea and fatigue are major symptoms in COPD patients and are important causes of disability. Unfortunately, at this time, there are no successful treatments for relief of dyspnea and fatigue. Acupressure is a 5,000-year-old therapy, in which gentle pressure is applied with fingers at specific acupoints. The purpose of this study was to ascertain the value of self-administered acupressure as an adjunct to a pulmonary rehabilitation program (PRP). A single-blind pretest-posttest, cross-over design was used with each subject randomly assigned to one of two groups. Subjects were 31 new patients beginning a 12-week PRP at two private hospitals. Acupressure consisted of self-applied finger pressure on each side of the body at seven acupoints. For sham acupressure, used as a placebo, seven non-acupoints were used. The techniques of acupressure and sham acupressure were taught using demonstration, verbal explanation, and an investigator-designed instruction booklet at the first pulmonary rehabilitaion session of each 6-week period. Each subject practiced acupressure daily at home. Once per week, the investigator assessed compliance and accuracy of the subject's performance and gave reinforcement and encouragement. Outcome measures include data from a Dyspnea visual Analog Scale, a Modified Borg Scale for dyspnea, the Bronchitis-Emphysema Symptom Checklist, the Human Activity Profile, the Wright Peak Flow Meter, and a 6-minute walking distance test. An extension of a paired t-test to include covariables was used to analyze the subscale and final scores. This was accomplished by regressing the difference between scores after real acupressure and sham acupressure on the covariables. The results for the 31 subjects in this study suggest that acupressure appears to be useful to COPD patients as an adjunct to a PRP in reducing dyspnea. The results also suggest that some American patients can learn and will accept self-administered acupressure as part of their self-care. More research is needed to understand how sex (male or female) affects the symptoms, response to treatment, and quality of life of COPD patients. |
