Auricular Acupressure in Prehabilitation

University of Chicago40 enrolled

Overview

Complementary medicine is recognized for its ability to enhance appetite, increase energy, reduce anxiety, decrease pain, and improve sleep, among many other benefits. Acupuncture is among the most frequent types of complementary medicine practiced in the US, and Medicare currently includes back pain as a reimbursable indication for this therapy. Acupuncture-related therapies may enhance efforts at prehabilitation in candidates for major lung resection.

The plan is to use a small number of points for auricular acupressure that are selected to improve overall health, both physical and mental. Auricular acupuncture for management of pain using 5 points, informally referred to as "battlefield acupuncture" has demonstrated significant improvement in acute and chronic pain management. Auricular acupressure using a similarly small number of points has demonstrated improvement in chemotherapy-related disturbed sleep, fatigue, and appetite, postpartum depression and fatigue, and chemotherapy related fatigue and depression. It appears that auricular acupressure may be suitable for enhancing prehabilitation interventions for preoperative patients. Patients will be selected from among individuals being considered for major lung surgery (wedge resection, segmentectomy, lobectomy, bilobectomy, or pneumonectomy; open or minimally invasive) who are expected to pursue a period of prehabilitation of 2 or more weeks prior to surgery.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

SUPPORTIVE_CARE

Masking

SINGLE

Enrollment

Conditions

Frailty

Interventions

Auricular AcupressureOTHER

Seeds will be placed during the clinic visit by the acupuncturist or the research associate according to the group the patient was assigned to. The care partner will observe the placement. A photograph of the seed placement will be taken and given to the care partner and to the patient after the relevant points are labeled by number or letter. The method of pressing is demonstrated for 1 one of the seeds, the care partner practices pressing on 2 other seeds, and the patient practices pressing on the remaining 2 seeds. Pressing consists of applying pressure, gradually increasing the pressure until the patient expresses discomfort, and maintaining that pressure until 2 minutes have passed. After pressing has been performed for each seed, the seeds are removed in clinic prior to clinic discharge.

Eligibility

Sex: ALLMin age: 50 Years

Medical Language ↔ Plain English

Inclusion Criteria * Being considered for major lung surgery * Surgery is not scheduled for at least 2 weeks * Age ≥ 50 years * Able to understand English at a 4th grade level * No known contraindications to prehabilitation (strength, endurance, balance exercises) * Able to provide informed consent for participation * Has an adult care partner who will be available and capable of placing seeds * Has access to smart phone for communication and image sharing * Underwent frailty screening (given any score) * Able to perform spirometry testing in clinic Exclusion Criteria: * Allergy to Vaccaria seeds * Medical condition affecting either ear preventing use of auricular acupressure such as eczema, frostbite, sunburn

Outcomes

Primary Outcomes

Number of patients enrolled

The patient will complete a form after each seed pressing confirming the pressing and the time.

Time frame: 2 weeks

Secondary Outcomes

Ease of participation in the study.