Authors (including presenting author) :
CHOW KKY(1), CHAN TCW(1), YAU CWS(2), TAM SKF(2), POON MWY(1)
Affiliation :
(1) Physiotherapy Department, Hong Kong Buddhist Hospital (2) Department of Medicine, Hong Kong Buddhist Hospital
Introduction :
Symptom management on palliative care(PC) patients is deemed to be more challenging as they approach end-of-life. Common symptoms such as pain and breathlessness pose severe burden on patients, which greatly affect patient’s quality-of-life and increase caregiver’s stress. Transcutaneous electrical acupoint stimulation(TEAS) is an emerging therapeutic approach for managing cancer-related symptoms. It possesses relative advantages over traditional acupuncture and needle-based electrostimulation in terms of patient’s acceptance due to its non-invasive nature. Physiotherapy Department of Hong Kong Buddhist Hospital(HKBH) has reviewed PC service in May 2024 and introduced TEAS as a routine intervention for symptom management in PC ward.
Objectives :
To evaluate the effect of TEAS on symptoms burden amongst PC patients.
Methodology :
A retrospective analysis has been adopted. Patients who were hospitalized in HKBH PC ward and received TEAS from June to December 2024 were recruited. TEAS was applied on four acupoints: Hegu(LI4), Neiguan(PC6), Zushanli(ST36) and Sanyinqiao(SP6) bilaterally using 2”x2” square electrodes for 30 minutes. Parameters were set as pulse width of 200μs, modulated pulse frequency of 2-100Hz with 2s ramp time, and current intensity of 5-15mA on upper limbs and 10-25mA on lower limbs to achieve a strong but comfortable sensation. Patient’s symptoms were measured using Edmonton Symptom Assessment System(ESAS) at three occasions: 1)before treatment, 2)immediately after treatment, 3)24-hours after treatment.
Result & Outcome :
A total of 46 terminally-ill patients aged between 40 to 88 years-old were reviewed. Symptoms identified included pain(76%), breathlessness(22%), fatigue(35%) and nausea(22%). The average performance status was 40% in Palliative Performance Scale(PPS). No adverse event such as electrical burn was reported. Significant reduction in all symptoms were found immediately after TEAS, in which ESAS(pain) reduced from 5.6 to 4.0(p<0.001), ESAS(breathlessness) reduced from 5.2 to 3.8(p=0.039), ESAS(fatigue) reduced from 6.5 to 5.4(p=0.004) and ESAS(nausea) reduced from 4.9 to 2.7(p=0.003). Significant improvement in pain, breathlessness and nausea was maintained 24 hours after TEAS with a reduction in ESAS scores on pain, breathlessness and nausea of 1.0, 1.1 and 1.6 respectively. Our preliminary findings demonstrated that TEAS was a safe and effective intervention for relieving symptom burdens on palliative care patients. TEAS enriches the array of treatment options accessible by patients and caregivers even when patient returned. Further study is warranted to investigate the long-term cumulative effect of TEAS in treating refractory symptoms on PC patients.
