Acustimulation

Acustimulation

PEP Topic 
Fatigue
Description 

Acustimulations is electrostimulation of acupressure points (most commonly, the P6 point) by transcutaneous, electrical stimulation through a wristband device. A wristband device currently available is the Reliefband®, a class II device approved by the U.S. Food and Drug Administration for the treatment of chemotherapy-induced nausea and vomiting (CINV). The device delivers slow, weak, electrical impulses to the P6 point via two metallic electrodes. Patients can adjust the electrical output to deliver 10–35 mAmps per pulse. Reliefband® (for the indication of CINV) requires a prescription. Acustimulation has been evaluated in CINV and fatigue.

Effectiveness Not Established

Research Evidence Summaries

Gadsby, J. G., Franks, A., Jarvis, P., & Dewhurst, F. (1997). Acupuncture-like transcutaneous electrical nerve stimulation within palliative care: a pilot study. Complementary Therapies in Medicine, 5, 13–18.

doi: 10.1016/S0965-2299(97)80084-2
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Intervention Characteristics/Basic Study Process:

Acupuncture-like transelectrical nerve stimulation (AL-TENS) with low-frequency, high-intensity stimulation using acupuncture points for emesis and analgesia was delivered by a nurse practitioner in five consecutive daily treatments. The study was divided into three groups:  AL-TENS, standard care, and standard care plus placebo.

Sample Characteristics:

  • The study included 15 adults with multiple cancer diagnoses admitted for symptom control for pain or nausea and vomiting.
  • Complete data were collected for 13 participants.
  • Age ranged from 38 to 74 years.
  • Of the participants, 14 were female, all were Caucasian, and three were in the end-of-life phase of care.

Setting:

  • Hospice
  • United Kingdom

Study Design:

The study was a pilot study and a double-blind, randomized, controlled trial.

Measurement Instruments/Methods:

  • European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) fatigue subscale at baseline and day six (posttreatment)
  • Pain
  • Nausea and vomiting
  • Quality of life (QOL)

Results:

  • High baseline levels of electrical resistance were observed.
  • Fatigue decreased compared to the controls.

Conclusions:

No significant differences were observed, but the study was underpowered and groups were not equivalent in symptoms at baseline.

Limitations:

  • The very small sample led to a lack of power and inability to control covariates.
  • Groups were not equivalent in baseline symptoms.
  • The power estimates for QOL seemed inaccurate.
  • No information was provided related to patient tolerance of treatment or adverse events.

Nursing Implications:

Nurses should be trained in the use of AL-TENS and identification of acupuncture points. Future trials focused on fatigue are recommended.


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