title: Effects of acupressure on anxiety: a systematic review and meta-analysis.
abstract: OBJECTIVE
  To evaluate the evidence from randomised controlled trials (RCTs) and quantify the effects of acupressure on anxiety among adults.
  
  
  METHODS
  RCTs published between January 1997 and February 2014, comparing acupressure with sham control, were identified from the databases Science Citation Index/Social Sciences Citation Index, Scopus, PubMed and PsycINFO. Meta-analysis of eligible studies was performed and the magnitude of the overall effect size was calculated for the anxiety outcome. Revised STRICTA (the Standards for Reporting Interventions in Clinical Trials of Acupuncture) criteria were used to appraise the acupressure procedures, and the Cochrane risk of bias tool was used to assess the methodological quality of the studies.
  
  
  RESULTS
  Of 39 potentially relevant studies, seven RCTs met the inclusion criteria for review while five studies met the criteria for meta-analysis. All studies reported the positive effect of acupressure on relieving anxiety from the anticipation of surgery or treatment. EX-HN3 (Yintang), HT7 (Shenmen) were the commonest points selected and two studies used bilateral points. The acupressure procedure was generally well reported and studies had a low risk of bias. The combined results of the five trials showed a greater overall reduction in anxiety in the acupressure group than in the sham controls (standardised mean differences (SMD)=-1.11; 95% CI -1.61 to -0.61; p<0.0001 heterogeneity: I(2)=75%; χ(2)=16.17; p=0.003; r=0.485).
  
  
  CONCLUSIONS
  Acupressure seems to be effective in providing immediate relief of pretreatment anxiety among adults, and has a medium effect size. However, conflicting results were found for the improvements on physiological indicators. More rigorous reporting, including allocation concealment procedure, is needed to strengthen the results.
authors.affiliation: Faculty of Education, The University of Hong Kong, Hong Kong, Hong Kong.
authors.forename: Doreen W H
authors.initials: DW
authors.lastname: Au
authors.affiliation: Neuropsychiatric Rehabilitation Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong.
authors.forename: Hector W H
authors.initials: HW
authors.lastname: Tsang
authors.affiliation: Neuropsychiatric Rehabilitation Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong.
authors.forename: Paul P M
authors.initials: PP
authors.lastname: Ling
authors.affiliation: Neuropsychiatric Rehabilitation Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong.
authors.forename: Christie H T
authors.initials: CH
authors.lastname: Leung
authors.affiliation: Neuropsychiatric Rehabilitation Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong.
authors.forename: P K
authors.initials: PK
authors.lastname: Ip
authors.affiliation: Faculty of Education, The University of Hong Kong, Hong Kong, Hong Kong.
authors.forename: W M
authors.initials: WM
authors.lastname: Cheung
mesh_terms: D019050:Acupressure; D000328:Adult; D001007:Anxiety; D006801:Humans
keywords: ACUPRESSURE; PSYCHIATRY; SYSTEMATIC REVIEWS