Zick, S.M., Sen, A., Wyatt, G.K., Murphy, S.L., Arnedt, J.T., & Harris, R.E. (2016). Investigation of 2 types of self-administered acupressure for persistent cancer-related fatigue in breast cancer survivors: A randomized clinical trial. JAMA Oncology, 2, 1470–1476. 

To identify improvement in fatigue, sleep, and quality of life in breast cancer survivors using self-administered acupressure

Self-administered relaxing acupressure or stimulating acupressure performed once daily for three minutes for six weeks. Assessments were conducted at baseline, three weeks (to assess technique), six weeks (end of intervention), and 10 weeks (washout).

• N = 288   
• AGE = Not stated
• FEMALES: 100%
• CURRENT TREATMENT: Not applicable
• KEY DISEASE CHARACTERISTICS: Stage 0-III breast cancer
• OTHER KEY SAMPLE CHARACTERISTICS: Patients who had reported fatigue, completed chemotherapy or radiation 12 months prior, and were cancer-free

• SITE: Single-site   
• SETTING TYPE: Home    
• LOCATION: Michigan

• PHASE OF CARE: Late effects and survivorship
• APPLICATIONS: Elder care, palliative care 

• Phase III, randomized, single-blind trial
• Computer-generated randomization 1:1:1 (relaxing acupressure, stimulating acupressure, usual care)

• Brief Fatigue Inventory (BFI)
• Pittsburgh Sleep Quality Index (PSQI)
• Long-Term Quality of Life Instrument (LTQL)

• At six weeks, improvement in BFI for both relaxing and stimulating acupressure over usual care was observed (p < 0.001). No difference between the relaxing and stimulating groups existed. At 10 weeks, improvement in BFI for both relaxing and stimulating acupressure over usual care was reported (p < 0.001), and no difference between the acupressure groups existed. Both acupressure groups achieved normal fatigue levels versus usual care at weeks 6 and 10 (p < 0.001).
• An improvement in PSQI score in the relaxing acupressure group was observed compared to the stimulating group and usual care group at week 6, and no difference between groups existed at week 10. 
• An improvement in quality of life scores at weeks 6 and 10 in the relaxing acupressure group was reported.

Self-administered relaxing and stimulating acupressure may improve fatigue in breast cancer survivors who have completed treatment at least 12 months ago. Relaxing acupressure may also improve sleep and quality of life in this patient group.

• Key sample group differences that could influence results
• Intervention expensive, impractical, or training needs
• Limited to breast cancer survivors who were one year post treatment in one state
• Lack of diversity in population studied
• Staff need to be trained in acupressure to train patients.

Self-administered relaxing and stimulating acupressure may be beneficial in the reduction of fatigue in breast cancer survivors who have completed treatment at least 12 months ago. Additional studies could be conducted with those currently receiving treatment and with patients with other cancers.