Acupuncture for anxiety in respiratory disorders

Abstract

Anxiety is a key component of respiratory disorders, which can exacerbate symptoms as well as impact upon treatment outcomes. This PhD offers an original contribution to knowledge by demonstrating the clinical effects of acupuncture on anxiety related to two chronic respiratory disorders, (hyperventilation syndrome (HVS) and chronic obstructive pulmonary disease (COPD)). This thesis contains findings from two novel trials that have examined the use of body acupuncture and ear acupuncture for the treatment of anxiety associated with respiratory disorders. These studies are linked through one research question: does acupuncture, offered as an adjunctive treatment to physiotherapy, reduce anxiety in patients with common chronic respiratory disorders? Previous research examining acupuncture for the treatment of anxiety has focused on the treatment of generalised anxiety disorder, or anxiety related to exposure to anxiety provoking situations. The research included within this thesis has examined the use of acupuncture in a population of individuals with respiratory disorders to assess the feasibility of using acupuncture for anxiety in this population, and to enhance our understanding of its efficacy and clinical benefits.

No previous respiratory acupuncture studies have been identified that were designed with anxiety as a primary outcome. Study 1 is a three-arm single-blind randomised controlled trial (RCT) of acupuncture for HVS. In this trial acupuncture was used as an adjunct to standard physiotherapy (in the form of breathing retraining (BR)). Study 2 was a trial to examine the feasibility of using ear acupuncture as an adjunct to physiotherapy (in the form of pulmonary rehabilitation for COPD). Hypotheses were tested using anxiety data from the Hospital Anxiety and Depression Scale. The findings from both studies suggest that it is feasible to use acupuncture as an adjunct to physiotherapy in these patient groups. Within each trial, there were no statistically significant differences in anxiety between groups at outcome. However, following the interventions, there were clinically relevant reductions in anxiety in the acupuncture groups within both studies. In study 1 the reduction in mean anxiety scores in the acupuncture group took them to below the cut-off for clinically relevant anxiety. There were also statistically significant between-group differences in breathlessness associated with HVS.

These findings indicate that both body acupuncture and ear acupuncture are feasible in patients with chronic respiratory disorders, when delivered as an adjunct to physiotherapy. They also suggest that acupuncture may have clinically significant benefits for anxiety associated with respiratory disorders, as well as for symptoms such as breathlessness. This knowledge will provide practitioners with some supportive evidence for the use of acupuncture within their clinical practice.

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Identifiers

ORCID for Anne Bruton: orcid.org/0000-0002-4550-2536

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