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Hemodialysis patients have a high prevalence of pain, mainly musculoskeletal and intra dialytic pain. A high prevalence of pain was also observed in the upper and lower limbs and the trunk. In addition, severe functional interference of pain in the ability to walk was associated with pain in the upper Limb. These results indicate that pain in hemodialysis patients is limiting and disabling (Dos Santos et al., 2021).
Acupressure increases relaxation, relieves pain, and reduces anxiety and depression, especially in the elderly. It is relatively inexpensive, safe, non-invasive, and easy to use and is performed by hands, elbows. by applying pressure to specific areas of the body so muscle spasms are relieved, blood circulation and vital energy are improved (Bastani et al.,2022).
Strong non-painful TENS within or close to the site of pain produces clinically important reductions in the intensity of pain during or immediately after treatment. With no reports of serious adverse events. TENS as an adjunct to core treatment or immediate short-term relief of pain, irrespective of diagnosis. Patients should be advised to tailor TENS Treatment according to their individual needs (Johnson et al., 2022).
Sixty patients will be randomly assigned into two equal groups (n=30):
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Acupressure | Experimental | The acupressure points will be determined, patients are informed that they will feel soft vibrations and pain during acupressure application. Patients are advised that it is sufficient for them to feel the vibrations of the acupressure device slightly. It be felt first symmetrically right knee, right leg, left knee, left leg Patients will receive acupressure 24 sessions three times a week for eight weeks. After application the patient will be asked about the severity of pain half an hour after administration (Çevik & Taşcı, 2020). |
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| Transcutaneous electrical nerve stimulation | Active Comparator | • Placement electrodes applied on the painful area lower leg. Settings:
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Acupressure | Other | Acupressure is effective on anxiety and depression management. acupressure therapy at K1, ST36, and SP6 acupoints significantly reduced anxiety & depression in patients with ESRD. |
| Measure | Description | Time Frame |
|---|---|---|
| Pain pressure algometry: | Pain pressure algometry: Device to measure the intensity of painful stimuli objectively | Pain pressure algometry:will be measured at baseline, and it will be measured again after eight weeks |
| The Brief Pain Inventory (BPI): | The Brief Pain Inventory (BPI): Is a multidimensional pain assessment tool used to evaluate pain severity and pain interference. The BPI has been translated and validity estimated across multiple languages and patient populations for clinical and research settings. | The Brief Pain Inventory (BPI): will be measured at baseline, and it will be measured again after eight weeks |
| Short form -36 questionnaire (KDQoL SF-36): | Short form -36 questionnaire (KDQoL SF-36): Is generic measure of health that has also been used widely in trials in hemodialysis patients for the objective measure quality of life | Short form -36 questionnaire (KDQoL SF-36):will be measured at baseline, and it will be measured again after eight weeks |
| Measure | Description | Time Frame |
|---|---|---|
| The incremental shuttle walking test (ISWT): | The incremental shuttle walking test (ISWT):Is an important marker of aerobic capacity in patients on renal dialysis | The incremental shuttle walking test (ISWT):will be measured at baseline, and it will be measured again after eight weeks |
| Patient health questionnaire PHQ-9: |
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Inclusion Criteria:
• Sixty patients with renal failure stage 5 undergoing hemodialysis sessions at least six months ago up to 2 years.
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Hany Obaya, assistant professor | giza, Egypt, 12511 | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Cairo University | Cairo | 11432 | Egypt |
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| ID | Term |
|---|---|
| D019050 | Acupressure |
| D004561 | Transcutaneous Electric Nerve Stimulation |
| ID | Term |
|---|---|
| D064746 | Therapy, Soft Tissue |
| D026201 | Musculoskeletal Manipulations |
| D000529 | Complementary Therapies |
| D013812 | Therapeutics |
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| Transcutaneous electrical nerve stimulation | Device | TENS lead to meaningful reduction of pain in patients suffering from difficult to treat phantom limb pain. This treatment has a high success rate and is associated with high satisfaction rates and no reported adverse events. The suggested duration of treatment is at least 30 minutes and may be extended up to 45 minutes. TENS delivers pulsed electric currents across the intact surface of the skin to stimulate peripheral nerves and the spinal cord, resulting in segmental and extra segmental analgesia. TENS delivers pulsed electric currents across the intact surface of the skin to stimulate peripheral nerves and the spinal cord, resulting in segmental and extrasegmental analgesia. (Vathakul et al., 2022). |
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Patient health questionnaire PHQ-9: Is a nine-item questionnaire designed to screen depression in primary care and other medical settings |
| Patient health questionnaire PHQ-9:will be measured at baseline, and it will be measured again after eight weeks |
| D026741 | Physical Therapy Modalities |
| D012046 | Rehabilitation |
| D004599 | Electric Stimulation Therapy |
| D000698 | Analgesia |
| D000760 | Anesthesia and Analgesia |