Among patients with end-stage renal disease who were undergoing chronic hemodialysis, the application of 20 minutes of acupressure three times a week for four weeks resulted in a significant reduction in fatigue, as compared to both a placebo and control group, according to recent research.

The study, “Effect of acupressure on fatigue in patients on hemodialysis,” involved 96 patients undergoing chronic hemodialysis. Criteria to participate in the study included a diagnosis of end-stage renal disease, undergoing hemodialysis for at least three months and a primary complaint of fatigue with a score of five or more on the Fatigue Severity Scale.

Participants were randomly assigned to either the acupressure group, the placebo group or the control group, with 32 subjects in each group. Before and after the four-week intervention began, the subjects filled out the Piper Fatigue Scale, which assesses the behavioral, emotional, sensory and cognitive dimensions of mental fatigue.

For the intervention, patients assigned to both the acupressure group and the placebo group received three 20-minute sessions per week for four weeks. These sessions took place during the first two hours of hemodialysis.

According to the researchers, the acupressure was applied on the major acupoints K1, GB 34, ST 36, SP 6, BL 23 and HT7. The placebo intervention was applied one centimeter away from each of these six points. Subjects in the control group continued to receive standard care with no intervention sessions.

Results of the research revealed a significant decrease in total fatigue score and also the score of fatigue on the emotional, cognitive and behavioral dimensions of the Piper Fatigue Scale in the acupressure group as compared to both the placebo and control groups. There was no significant difference on these fatigue scores between the placebo and control group.

As for the mean score of fatigue in the sensory dimension of the Piper Fatigue Scale, it was significantly lower in the acupressure group as compared to the placebo group. Also, this score was significantly lower in the placebo group as compared to the control group.

“The results of acupressure medicine on severity of fatigue in hemodialysis patients showed that the study group experienced less fatigue severity compared to the placebo and control groups,” state the study’s authors. “Although a similar improvement was observed in the placebo group … the improvement was more in the study group.”


Authors: Fakhri Sabouhi, Leila Kalani, Mahboubeh Valiani, Mojgan Mortazavi and Mahboobeh Bemanian.

Sources: Isfahan University of Medical Sciences and Islamic Azad University Najafabad Branch, Isfahan, Iran. Originally published in the November-December 2013 issue of the Iranian Journal of Nursing and Midwifery Research, 18(6), 429-434.