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Randomized Controlled Trial
. 2014 May 21;9(5):e97553.
doi: 10.1371/journal.pone.0097553. eCollection 2014.

The effect of daily self-measurement of pressure pain sensitivity followed by acupressure on depression and quality of life versus treatment as usual in ischemic heart disease: a randomized clinical trial

Natasha Bergmann  1 , Søren Ballegaard  2 , Per Bech  3 , Ake Hjalmarson  4 , Jesper Krogh  1 , Finn Gyntelberg  5 , Jens Faber  6
Affiliations
Randomized Controlled Trial

The effect of daily self-measurement of pressure pain sensitivity followed by acupressure on depression and quality of life versus treatment as usual in ischemic heart disease: a randomized clinical trial

Natasha Bergmann et al. PLoS One. .

Abstract

Background: Depressive symptoms and reduced quality of life (QOL) are parts of the chronic stress syndrome and predictive of adverse outcome in patients with ischemic heart disease (IHD). Chronic stress is associated with increased sensitivity for pain, which can be measured by algometry as Pressure Pain Sensitivity (PPS) on the sternum.

Aim: To evaluate if stress focus by self-measurement of PPS, followed by stress reducing actions including acupressure, can decrease depressive symptoms and increase psychological well-being in people with stable IHD.

Design: Observer blinded randomized clinical trial over 3 months of either intervention or treatment as usual (TAU).

Statistical analysis: Intention to treat.

Methods: Two hundred and thirteen participants with IHD were included: 106 to active treatment and 107 to TAU. Drop-out: 20 and 12, respectively. The active intervention included self-measurement of PPS twice daily followed by acupressure as mandatory action, aiming at a reduction in PPS. Primary endpoint: change in depressive symptoms as measured by Major depression inventory (MDI). Other endpoints: changes in PPS, Well-being (WHO-5) and mental and physical QOL (SF-36).

Results: At 3 months PPS decreased 28%, to 58, in active and 11%, to 72, in TAU, p<0.001. MDI decreased 22%, to 6.5, in active group vs. 12%, to 8.3 in TAU, p = 0.040. WHO-5 increased to 71.0 and 64.8, active group and TAU, p = 0.015. SF-36 mental score sum increased to 55.3 and 53.3, active and TAU, p = 0.08.

Conclusions: PPS measurements followed by acupressure reduce PPS, depressive symptoms and increase QOL in patients with stable IHD.

Trial registration: ClinicalTrials.gov NCT01513824.

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Conflict of interest statement

Competing Interests: Søren Ballegaard invented the instrument used to measure PPS (Ullmeter, patent numbers: PA 2004-00349; PA 2004-00550) and is a shareholder of the firm that owns the PPS instrument (Ullcare A/S). In order to avoid bias, he was not involved in patient contact, collection of data or statistical analysis and was prohibited admittance to the research site during the entire period of the study. His authorship does not alter the authors’ adherence to PLOS ONE policies on sharing data and materials. The other authors have no competing interests to declare and no relation to Ullcare A/S including employment, consultancy, patents, products in development or marketed products.

Figures

Figure 1
Figure 1. Consort.
See this image and copyright information in PMC

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