The Journal of Alternative and Complementary Medicine Vol. 24, No. 6 pp. 532-540 2018
Acupoint Massage for Managing Cognitive Alterations in Older Adults: A Systematic Review and Meta-Analysis
Fang Liu, Cuiling Shen, Liqun Yao,, Zhuangmiao Li
School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, China
Abstract
Background:
Cognitive disorders pose a major problem in the aging population across the globe. Acupoint massage has been used to improve cognitive functions in older adults. In this study, the authors performed a meta-analysis to evaluate the usefulness of acupoint massage in preventing cognitive declines in older adults.
Design: The authors searched for randomized controlled trials (RCTs) reporting on the effectiveness of acupoint massage on cognition in older adults in the following literature databases: PubMed, MEDLINE, Embase, CINAHL, ScienceDirect, Foreign Medical Journal Service, Cochrane Library, VIP Information, Chinese National Knowledge Infrastructure, WANFANG, and Chinese Biomedical. Two reviewers independently extracted the data related to the study and participants' characteristics and the cognitive impairment outcomes. Only RCTs meeting the inclusion criteria were used in the present meta-analysis .
Results:
Eight RCTs with 657 participants in total (age =60 years) were included. It is actually 8 for synthetic and 6 in the meta-analysis. The authors calculated the pooled estimates of the random effects of changes in the Mini-Mental State Examination to compare the groups with and without acupoint massage. The merged mean difference (MD) was 1.94 (95% confidence interval, C.I., [1.41–2.47], p<0.00001) after 3 months of acupoint massage treatment and 3.04 (95% C.I. [2.43–3.64], p<0.00001) after 6 months of treatment. They also calculated the merged MD of the Wechsler Memory Scale-Revised Chinese version after 6 months of acupoint massage. Visual Reproduction was 2.95 (95% C.I. [1.30–4.60], p=0.0005), Associate Learning was 1.89 (95% C.I. [1.41–2.37], p<0.00001), Logical Memory was 2.85 (95% C.I. [2.06–3.63], p<0.00001), and Digit Span was 3.16 (95% C.I. [2.59–3.73], p<0.00001). The Cochrane Handbook for Systematic Reviews of Interventions was used to rate the quality of the studies, which was moderate overall.
Conclusion:
The findings suggested that acupoint massage is an effective intervention for maintaining cognitive functions in older adults.
https://www.liebertpub.com/doi/abs/10.1089/acm.2017.0142Excerpts:
“Several practices of Traditional Chinese Medicine (TCM) have gained popularity worldwide, including acupuncture, acupoint massage, moxibustion, and qigong. Among these, acupuncture and massage therapies are the most widely accepted in the medical profession.9–11 Acupoint massage is a relatively simple, inexpensive, and noninvasive intervention used to treat many diseases in China for many years. Acupoint stimulation indicates a family of procedures involving the stimulation of anatomical point on the body, using a variety of techniques,12 such as electroacupuncture, manual acupuncture, and acupressure (pressing on the acupoint usually with fingertip). Acupoint massage is based on meridians and acupoints, and it prevents and cures diseases by stimulating acupoints.13,14 While the descriptions of massage have changed from the ancient to the modern practice, the overall essence of it is the application of human hands or another object to the superficial skin of a recipient for the purpose of rendering remedial or palliative aid—remains unchanged.15 It has a functional mechanism similar to acupuncture. However, acupoints massage is simple and easier to manipulate with high safety and high patient acceptance, and can effectively avoid the damage and pain caused by acupuncture. Based on the TCM theory, cognition is closely related to meridians and acupoints as well as qi and blood circulation. In clinical practice, acupoint massage can unblock meridians and collaterals, smooth qi and blood circulation, and regulate functions of Zang-fu organs through meridian conduction.14,16,17"
“The present meta-analysis demonstrated that acupoint massage is an effective intervention for maintaining cognitive functions in older adults.”
“Acupoint massage has been used since ancient times, with acupoint massage textbooks dating as far back as the Huangdi Neijing, an ancient fundamental source for Chinese medicine. Notably, acupoint massage is reminiscent of acupuncture in that it also uses the meridian system and is effective in managing similar health problems. Acupoint massage prevents and/or cures diseases by applying pressure on acupuncture points (acupoints) using the fingers on the skin surface. The TCM has suggested that meridian acupoint massage has a curative effect against headaches, dizziness, shoulder and back pain, stiffness of the neck, and stomachaches, among others. Meridian therapy is suggested to relieve the patients' symptoms by point massage,17,28–30 and its effects and mechanisms have been previously reported.31–37 For instance, TCM was proved effective in the treatment of cardiovascular diseases and hypertension.5,38 In a single-blinded placebo-controlled randomized trial, the effects of acupressure on the cognitive impairments associated with traumatic brain injury were assessed using event-related potentials,39 which reflect the brain's response to a specific sensory, cognitive, or motor event.40 The pressure on acupoints is believed to reduce the muscular tonus and promote blood circulation.41 According to the TCM theory, acupoint massage can unblock meridians and collaterals, promote the circulation of blood and qi, and regulate the functions of the Zang-fu organs through meridian conduction.
“Positive effects of acupuncture on cognitive functions following stroke have been reported in a recent meta-analysis.42 Acupoint massage and acupuncture share similar functional mechanisms. Compared with acupuncture, acupoint massage has the advantages of being an easier and safer process, with higher patient acceptance. Moreover, acupoint massage does not result in the damage and pain often associated with acupuncture. Furthermore, acupoint massage can be taught to anyone, and self-massages are possible.
“Therefore, acupoint massage offers great potential uses in preventing cognitive disorders in older adults, which may have a positive impact on the global public health.”
“Furthermore, the selected RCTs did not include a blind condition to exclude the psychologic effects of acupoint massage.”
“Comparing the effects of acupoint massage with nonacupoint massage interventions in older adults remains challenging.”
