Non-pharmacological Techniques Research Articles

Non-invasive temporal interference brain stimulation reduces preference on morphine-induced conditioned place preference in rats

Long-term use of opioid drugs such as morphine can induce addiction in the central nervous system through dysregulation of the reward system of the brain. Deep brain stimulation (DBS) is a non-pharmacological technique capable of attenuating behavioral responses associated with opioid drug consumption and possesses the capability to selectively activate and target localized brain regions with a high spatial resolution. However, long-term implantation of electrodes in brain tissue may limit the effectiveness of DBS due to changes in impedance, position, and shape of the tip of the stimulation electrode and the risk of infection of nerve tissue around the implanted electrode. The main objective of the current study is to evaluate the effect of temporal interference (TI) brain stimulation on addictive behaviors of morphine-induced conditioned place preference (CPP) in rats. TI stimulation is a non-invasive technique used transcranially to modulate neural activity within targeted brain regions. It involves applying two high-frequency currents with slightly different frequencies, resulting in interference and targeted stimulation of different brain areas with the desired spatial resolution. The results indicated that TI stimulation with the amplitude of I1=I2=0.5\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$${\ ext{I}}_{1}{ = }{\ ext{I}}_{2}{ = 0.5}$$\\end{document} mA, carrier frequency of 2 kHz, frequency difference of 25 Hz, ON–OFF stimulation frequency of 0.25 Hz, and total duration of 10 min in three consecutive days resulted in a significant reduction of morphine preference in the morphine-stimulation group in comparison with the morphine group (p < 0.001). These findings highlight the potential of TI stimulation as a modulatory intervention in mitigating the addictive properties of morphine and provide valuable insights into the therapeutic implications of this stimulation paradigm for treatment of opioid drugs in human subjects.

Research status and frontiers of renal denervation for hypertension: a bibliometric analysis from 2004 to 2023

BackgroundRenal Denervation (RDN) is a novel non-pharmacological technique to treat hypertension. This technique lowers blood pressure by blocking the sympathetic nerve fibers around the renal artery, then causing a decrease in system sympathetic nerve excitability. This study aimed to visualize and analyze research hotspots and development trends in the field of RDN for hypertension through bibliometric analysis.MethodsIn total, 1479 studies were retrieved on the Web of Science Core Collection (WoSCC) database from 2004 to 2023. Using CiteSpace (6.2.R4) and VOSviewer (1.6.18), visualization maps were generated by relevant literature in the field of RDN for hypertension to demonstrate the research status and frontiers.ResultsThe number of publications was found to be generally increasing. Europe and the United States were the first countries to carry out research on different techniques and related RDN clinical trials. The efficacy and safety of RDN have been repeatedly verified and gained increasing attention. The study involves multiple disciplines, including the cardiovascular system, peripheral vascular disease, and physiological pathology, among others. Research hotspots focus on elucidating the mechanism of RDN in the treatment of hypertension and the advantages of RDN in appliance therapy. Additionally, the research frontiers include improvement of RDN instruments and techniques, as well as exploration of the therapeutic effects of RDN in diseases with increased sympathetic nerve activity.ConclusionThe research hotspots and frontiers reflect the status and development trend of RDN in hypertension. In the future, it is necessary to strengthen international collaboration and cooperation, conduct long-term clinical studies with a large sample size, and continuously improve RDN technology and devices. These measures will provide new options for more patients with hypertension, thereby improving their quality of life.

Systematic Review and Clinical Insights: The Role of the Ketogenic Diet in Managing Glioblastoma in Cancer Neuroscience

Recent scientific research has shown that the ketogenic diet may have potential benefits in a variety of medical fields, which has led to the diet receiving a substantial amount of attention. Clinical and experimental research on brain tumors has shown that the ketogenic diet has a satisfactory safety profile. This safety profile has been established in a variety of applications, including the management of obesity and the treatment of drug-resistant epileptic cases. However, in human studies, the impact of ketogenic therapy on the growth of tumors and the life expectancy of patients has not provided results that are well characterized. Consequently, our purpose is to improve the comprehension of these features by succinctly presenting the developments and conclusions that have been gained from the most recent study that pertains to this non-pharmacological technique. According to the findings of our study, patients with brain tumors who stick to a ketogenic diet are more likely to experience improved survival rates. However, it is required to conduct additional research on humans in order to more accurately define the anti-tumor efficiency of this diet as well as the underlying processes that support the therapeutic effects of this dieting regimen.

An Integrated Review of Hepatorenal Syndrome

The purpose of this review was to go over and condense the intricate details that have been updated over time about the diagnosis, etiopathology, definition, and available treatments for hepatorenal syndrome. When individuals have decompensated liver disease, acute kidney injury might have multiple causes, including hormone replacement therapy (HRS). Type 1 and type 2 are the two clinical subtypes of hepatorenal syndrome. Lack of proteinuria, hematuria, or aberrant renal ultrasonography, as well as declining kidney function, are the basis for the diagnosis. Liver transplantation is the best treatment for cases of HRS, but because of the high death rate, very few people get one. In light of the improved understanding of the condition, more hepatorenal syndrome therapeutic options, including pharmacological and non-pharmacological techniques, are also explored.

Nursing Care for Mrs. W with Dyspepsia Diagnosis

Dyspepsia is a clinical condition that can cause limb pain, such as flatulence, fullness, nausea, and vomiting. Dyspepsia is one of the non-communicable diseases and not only occurs in Indonesia but also in other parts of the world. This study aims to provide an overview of the implementation of Nursing Care in patients with dyspepsia diagnoses in the Old Jimbaran Room, Sumber Kasih Hospital, Cirebon City. The method used is a case study approach. The subject in this case study was one patient with a medical diagnosis of dyspepsia in the inpatient room. The results of the study showed that the management of nursing care in patients with a medical diagnosis of dyspepsia in fulfilling basic needs with dyspeptic nursing problems carried out the intervention of deep breath relaxation techniques with a frequency of 15 times with a time of approximately 10--15 minutes, the intervention was carried out when the patient felt pain, the results of the patient's pain level were reduced from pain scale 6 (moderate) to pain scale 3 (mild). From the results of nursing care that has been made and interventions that have been carried out, it can be concluded that deep breath relaxation techniques are effective in reducing the pain scale from 6 (moderate) to a pain scale of 3 (mild). These non-pharmacological techniques can be used as a companion to pharmacological therapy.

Penerapan Pengaruh Terapi Murottal Surat Ar Rahman terhadap Status Hemodinamik pada Pasien Rawat Inap di Ruang ICU (Intensive Care Unit) RSUD Dr. Soehadi Prijonegoro Sragen

Intensive Care Unit (ICU) is a special room for patients who are critically ill to receive special medical and nursing services in a hospital. This is associated with several conditions and situations, for example heart disease and other conditions that affect the heart can cause hemodynamic instability. An unstable hemodynamic condition carries a high risk of potential complications that can cause death. Non-pharmacological therapy to reduce hemodynamic status is by using Murottal Surah Ar-Rahman therapy. To find out the results of applying the effect of Murottal Surah Ar Rahman therapy on hemodynamic status in inpatients in the ICU (Intensive Care Unit) RSUD dr. Soehadi Prijonegoro Sragen. The design used was qualitative with descriptive methods using pre-test and post-test case studies, the application of therapy was carried out 3 days for 16 minutes on 2 respondents. Based on the results of the implementation, there was a decrease in hemodynamic status after Murottal Surat Ar Rahman Therapy was carried out. Murottal Surat Ar Rahman therapy can be used as a non-pharmacological technique or independent intervention in patients with inpatient hemodynamic status

Risk reduction: using the properties of sedation to mitigate the risks of stress-induced medical emergencies - a case series.

Dental anxiety and phobia are widespread in the population, with various non-pharmacological and pharmacological techniques available to manage it, including conscious sedation. Medically complex, anxious patients may be at a higher risk of a stress-induced medical emergency during dental treatment. This article lays out the forms of sedation that may be used to help mitigate this risk, the detailed risk assessment required and how conscious sedation may be used as a prophylactic tool to prevent medical emergencies in these patients. Referring clinicians must know what options are available to enable this cohort of patients to access care.

Influence of Guided Imagination on Pain Intensity in Fracture Patients at Bumiayu Regional Hospital

SA survey by the Indonesian Ministry of Health found that 25% of fracture sufferers died, 45% experienced physical disabilities, 15% experienced psychological stress due to anxiety and even depression and 10% recovered well. Both open and closed fractures will affect nerve fibers which can cause pain and discomfort. Efforts that can be made to reduce pain in fracture patients are with one of the non-pharmacological techniques, namely guided imagination. The aim of this research is to determine the effect of guided imagination on reducing pain intensity in fracture patients at Bumiayu Hospital 2024. The type of research is Quasi Experiment research with a One Group Pre-test Post-test design. The population in this study were all fracture patients at Bumiayu Regional Hospital in the period 4 March - 2 April 2024, totaling 52 people and the sample was taken using a purposive sampling method, namely 35 people. Data collection used a numerical scale research instrument sheet or The Pain Numerical Rating Scale (PNRS). The data analysis used is univariate and bivariate analysis. The results of this study show that statistical analysis showed that the difference in average pain intensity in fracture patients before guided imagination was 6.83 and after guided imagination was 3.46 with a probability value of (p=0.000), so Ho was rejected and Ha was accepted, meaning that guided imagination had an effect on reducing the intensity. pain in fracture patients. In conclusion, there is an effect of providing guided imagery on pain intensity in fracture patients at Bumiayu Regional Hospital in 2024.

Nursing Care for Mr. S, Diagnosed with Pulmonary Tuberculosis (TB) in the Emergency Department (ED) of Gunung Jati Hospital in Cirebon City

Tuberculosis or TB is a disease caused by infection of the Mycobacterium tuberculosis bacteria in the lungs. This condition is sometimes referred to as pulmonary TB. Tuberculosis bacteria that invade the lungs cause respiratory problems, such as chronic cough and shortness of breath. TB patients usually also experience other symptoms, such as night sweats and fever. This study aims to provide an overview of the implementation of Nursing Care in patients with a medical diagnosis of Pulmonary Tuberculosis (TB) in the emergency room of Gunung Jati Hospital, Cirebon City. The method used is a case study approach. The subject in this case study was one patient diagnosed with Pulmonary Tuberculosis (TB) in the emergency room. The results showed nursing care management in patients diagnosed with Pulmonary Tuberculosis (TB). The nursing problem is Ineffective Airway Cleansing, which is carried out by interventions, namely effective cough techniques; interventions are carried out when the patient has difficulty removing sputum, the results obtained at the time of assessment, the patient complains of shortness of breath, coughing and difficulty removing sputum. Before performing effective cough techniques, respiration was 28x/minute, and after performing effective cough techniques, respiration decreased to 25x/minute. This study implies non-pharmacological techniques, such as effective coughing techniques, can be essential in managing patients with pulmonary tuberculosis alongside pharmacological therapy. This study provides a valuable contribution to improving the understanding and practice of nursing care in Tuberculosis cases in the hospital environment, especially in the emergency room of Gunung Jati Hospital, Cirebon City.

Nursing Care for Mr. W Diagnosed with Hemorrhoids in the Kemuning Ward of Waled Hospital in Cirebon Regency

Hemorrhoids are dilated blood vessels in the anus that originate from the hemorrhoidal plexus, which will cause discomfort resulting in swelling commonly called hemorrhoids or hemorrhoids. The purpose of this study was to describe the identification of nursing care in patients with a medical diagnosis of hemorrhoids in the Kemuning room of Waled Hospital, Cirebon Regency. This research method is a qualitative descriptive research conducted at Waled Hospital. Data was collected through observation, interviews, and medical record documentation studies. The main focus of the research is on the nursing problems that arise, such as acute pain, and the interventions provided, such as relaxation techniques. The results showed that relaxation techniques are one of the effective interventions in reducing acute pain in patients with hemorrhoids. Before the intervention, patients often experience pain with a scale level of 5, which is shown by grimacing expressions. However, after doing relaxation therapy, the patient's pain scale decreased to 3, and the patient's expression seemed calmer. This study implies that non-pharmacological techniques such as relaxation can be a practical companion to pharmacological therapy in pain management in hemorrhoidal patients. Emphasis on holistic and individualized nursing care is essential in improving the quality of care for patients with this medical condition.

A software-based observational coding approach for evaluating paediatric dental pain, anxiety, and fear.

Dental practitioners desire non-pharmacological methods to alleviate anxiety, fear, and pain in children receiving dental care; high-quality evidence, however, is required to evaluate methods' efficacy. This study aimed to develop and validate an observation-based coding approach (paediatric dental pain, anxiety, and fear coding approach [PAFCA]) to evaluate non-pharmacological behavior management techniques for anxiety, fear, and pain. Objective (video-based) and subjective (self-reported) anxiety, fear, and pain data were collected from a pilot clinical trial evaluating animal-assisted therapy (AAT) in paediatric dentistry, in which 37 children aged 7-14 were assigned to AAT or control before dental treatment (restorations or extractions). A coding approach utilizing a codebook, a gold standard calibration video, and a user training guide was developed. Trained examiners coded the gold standard video for inter-rater agreement, and masked, calibrated examiners analyzed videos using the Noldus Observer XT software. A novel, software-based coding approach was developed, with moderately high inter-rater agreement. Using PAFCA, we found children reporting higher levels of pain, fear, and anxiety exhibited treatment-interfering behaviors, including crying/moaning, attempts to dislodge instruments, and more upper and lower body movements. PAFCA shows promise as a reliable tool for assessing anxiety, pain, and fear in behavioral research for paediatric dentistry.

Narative Review The Effect of Endorphin Massage and Counter Pressure During Labor On Endorphin Hormone Release

Background: Labor pain is a subjective experience associated with uterine contractions, stretching of the cervix, and descent of the fetal head. According to the World Health Organization (WHO), every year, 210 million pregnancies occur in the world, and 20 million women experience pain due to childbirth. Of the 2700 mothers giving birth, 30% experienced severe pain, 20% of labor was accompanied by very severe pain, and 15% experienced mild pain. Non-pharmacological therapy continues to be developed in the world of obstetrics, which aims to provide comfort during the birthing process. Endorphin massage and counter pressure are non-pharmacological therapies that can stimulate the release of endorphins and reduce pain and anxiety during childbirth. Objective: This study aims to determine the effect of endorphin massage and counter pressure during labor on the release of endorphin hormones and their benefits. Methods: This research method was a literature review study. Journal searches were carried out by applying online databases such as PubMed, Garuda Portal, ScienceDirect, and Google Scholar. Articles were selected based on inclusion and exclusion criteria. Results: The analysis was carried out on 32 research articles. It was found that endorphin massage and counter pressure are non-pharmacological techniques to overcome and reduce labor pain and anxiety through the help of endorphin hormones which are useful for a smooth delivery process. Conclusion: The influence of endorphin massage and counter pressure during labor on the release of endorphin hormones, which are useful for reducing labor pain, reducing anxiety, increasing comfort, and speeding up the labor process.

Use of Dexmedetomidine versus Nitroglycerine to Provide Hypotensive Anesthesia in ENT Surgeries (Functional Endoscopic Sinus Surgery)

Abstract Background controlled (deliberate/induced) hypotension is a technique by which the arterial blood pressure is lowered in a controllable manner to reduce surgical blood loss and improve the operative field visibility. There are pharmacological and nonpharmacological techniques for inducing hypotension. The nonpharmacological methods for deliberate hypotension include positioning and positive pressure ventilation to control venous return. Aim of the Work to evaluate the efficacy of dexmedetomidine (DEX) as a hypotensive agent in comparison to nitroglycerin (NTG) in FESS regarding the bloodless field, reduction of mean arterial blood pressure, decrease inhalational anesthetic requirements (MAC), decrease perioperative opioid requirements, increase the time to first postoperative analgesic request and recovery profile and increase hemodynamics stability. Patients and Methods we conducted this study on 20 patients who were planned to perform functional endoscopic sinus surgery and were randomly distributed into 2 equal groups: 10 patients received dexamedotomidine and equal number of patients received nitroglycerine. Serial measurements of mean arterial blood pressure and heart rate were obtained and records between both groups were compared. Results There were statistically significant differences between both groups regarding heart rate as mean values of heart rate were lower among dexamedotomidine group. There were no statistically significant differences between both groups regarding mean arterial blood pressure values at different time points during the operation. Regarding the period after stopping infusion, mean values of heart rate and blood pressure were lower among dexamedotomidine group than nitroglycerine group after 5 minutes and after 10 minutes and the differences had statistically significant differences. Regarding postoperative period, both groups were comparable regarding heart rate and blood pressure immediately postoperative. Conclusion From the results of this study, we could conclude that both Dexmedetomidine and Nitroglycerin can be effectively used in induced hypotensive anesthesia for ENT surgery as FESS. Both groups were comparable with intra operative MAP with no statistically significant differences. This study also show that Dexmedetomidine has added advantages as better haemodynamic stability than Nitroglycerin (No rebound HTN, no tachycardia). Has sedative and analgesic effect, reduce requirement of anesthetic agents and perioperative analgesia. Postoperative recovery score (Time to reach modified Aldert score more than nine significantly higher. Postoperative complication as nausea and vomiting is less.

New non-drug technologies for lymphedema associated with breast cancer: a review

INTRODUCTION. Breast Cancer-Related Lymphedema (BCRL) is the most common complication after radical treatment of breast cancer (BC). Currently, there are no molecular therapeutic targets whose pharmacologic action could prevent edema, making it necessary to study the efficacy of non-pharmacologic techniques. AIM. To study the effectiveness of non-medication technologies in BCRL to develop recommendations for practical application based on the analysis of systematic reviews and meta-analyses of randomized controlled trials (RCTs). MATERIALS AND METHODS. The search was conducted in the Physiotherapy Evidence-Based Database (PEDro, 2002–2024) using the keywords: “lymphedema”, “upper limbs”, “breast cancer”. A total of 203 sources were selected as of March 2024. RESULTS AND DISCUSSION. Numerous studies have found that the use of early postoperative physical exercise with a gradual expansion of the load in patients at risk of developing BCRL is a safe and effective method of rehabilitation. The effectiveness of early preventive use of manual lymphatic drainage (MLD) in 4 RCTs was studied in a Cochrane review. However, the clinical effectiveness of early prophylactic use of MLD to prevent BCRL remains insufficiently proven. In contrast, prophylactic use of compression sleeves has been shown to reduce and delay the onset of arm lymphedema in women at high risk of developing BCRL during the first year after breast cancer surgery. Studies have also confirmed the effectiveness of an early Prospective Surveillance Model using bioimpedance spectroscopy for early detection and immediate treatment of BCRL. It has been proven that in order to reduce the volume of a limb with BCRL, it is necessary to prescribe an intensive phase of complex decongestive therapy (CDT) for at least 3 weeks. Studies have also proven the effectiveness of using a standard or improved intermittent pneumatic compression device in the rehabilitation phases, including at home. CONCLUSION. To reduce the risk of development and progression of BCRL, modern exercise therapy techniques should be used to increase physical activity in order to control body weight, and educational techniques for self-massage and self-application of compression bandages should be actively used. The “golden” standard for conservative treatment of BCRL remains CDT, which is based on MLD. At the same time, the wider use and development of new methods of hardware lymphatic drainage that imitate MLD, which is a highly resourceful and costly method of treatment for BCRL, is justified. To confirm the clinical effectiveness of improved hardware pneumocompression, additional RCTs assessing long-term treatment results are required.

Electric polarization catheter for systemic cardiac output

The electrical activity plays a vital role in the physiological functions of live organisms, electrical stimulation has been identified as a promising nonpharmacological technique that can modulate the behavior of cellular network, restore and monitoring critical functions and accelerate tissue healing in vitro and in vivo. The red blood cell (RBC) membrane contains proteins and glycoproteins embedded in a fluid lipid bilayer that confers viscoelastic behavior. Sialylated glycoproteins of the RBC membrane are responsible for a negatively charged surface which creates a repulsive electric zeta potential (ζ)between cells. These charges help prevent the interaction between RBCs and the other cells and especially between each other. The zeta potential is a physical property which is exhibited by all particles in suspension. In this context we present for the first time the invention concerns the field of measurement of physiological parameters for determining cardiac output (CO), plus specifically refers to a new apparatus for determination of cardiac output based on determination of the electrical charges induced on the membrane of the RBC (electrical polarization of red blood cells).

Dementia in-patient units in psychiatric hospitals: research priority setting

Aims and method Dementia in-patient units (DIU) are mental health wards that care for people living with dementia (PLWD) whose symptoms are causing severe distress or potential risk. DIUs look after some of the most vulnerable and unwell people in society, yet they are environments that are underresearched: a recent systematic review revealed only 36 articles worldwide relating to DIUs. To better understand research priorities in DIUs, we undertook a two-round online Delphi survey of PLWD with experience of DIUs, their carers and professionals who work in DIUs. Results Ten research priorities were described and ranked. The top three were how to use non-pharmacological techniques to manage non-cognitive symptoms of dementia, supporting families and better understanding of how to discharge PLWD safely and healthily. Clinical implications This is the first Delphi consensus to describe DIU research priorities. This paper will help researchers focus on the areas that matter most to people who use DIUs.

PENGARUH BRAIN EXERCISE TERHADAP KEMAMPUAN KOGNITIF PADA LANSIA DI WILAYAH KERJA PUSKESMAS BANGGAE 1 KABUPATEN MAJENE

Abstrack The final stage of human development is old age, where many changes occur, including significant physical, cognitive, psychological, and social changes experienced by elderly people over 60 years old. Brain exercise is a non-pharmacological technique to improve cognitive function. Brain exercise is a method to improve cognitive function in the elderly so that it can affect better cognitive function. The aim of this study was to determine the effect of brain exercise on cognitive abilities in the elderly. The type of research used in this research is quasi-experimental, using a pre- and post-test approach without control. The number of samples from 31 respondents was selected by sampling technique, namely accidental sampling. Data analysis using univariate and bivariate results of the Wilcoxon Test found that the p-value was 0.007 (p &lt;0.05). The conclusion is that there is a significant effect of brain exercise on cognitive abilities in the elderly in the working area of the Banggae 1 Health Center, Majene Regency. Keywords: Elderly, Cognitive Function, Brain Exercise

The use of laser photobiomodulation as pre-anesthetic tissue management technique in reducing injection pain in children

BackgroundOne of the main goals for pediatric dentists is to offer a painless anesthesia experience. Laser photobiomodulation is among the suggested strategies to decrease injection pain. So, this study aimed to assess the impact of laser photobiomodulation on local anesthesia (LA) injection pain in children and its effect on the efficacy of LA during pulpotomy and SSC procedures.MethodsThe research was carried out as a randomized controlled clinical trial with two parallel group design. It involved 64 cooperative healthy children, age range from 5 to 7 years, each having at least one maxillary molar indicated for pulpotomy. Children were randomly allocated to one of the two groups based on the pre-anesthetic tissue management technique used: test group received laser photobiomodulation, while control group received topical anesthetic gel. Pain during injection, pulpotomy, and SSC procedures was assessed using physiological measures (Heart Rate (HR)), subjective evaluation (modified Face-Pain‐Scale (FPS), and objective analysis (Sound‐Eye‐Motor scale (SEM)).ResultsA total of 64 children with mean age 6.23 ± 0.78 participated in this research. The mean HR scores were significantly lower in the laser PBM group during buccal and palatal infiltration injections. The SEM mean scores were significantly lower in the laser PBM group during both injections. For the FPS scale, the number of children who recorded satisfaction during injection was significantly higher in laser PBM group. There was no statistically significant difference in mean HR as well as in SEM and FPS scores between the two groups during pulpotomy and SSC procedures. Comparisons between the two study groups were performed using independent samples t- and Mann-Whitney U tests. Significance was set at p value < 0.05.ConclusionLaser photobiomodulation is a promising non-pharmacological pre-anesthetic tissue management technique in children that offered less painful injection compared to topical anesthetic gel without compromising the effectiveness of LA.Trial RegistrationClinicalTrials.gov Identifier: NCT05861154. Registered on 16/5/2023.Graphical

Non-pharmacological methods and techniques used in the therapy of children diagnosed with adhd. Study of literature

Attention deficit and hyperactivity disorder (ADHD) is seen as a long-lasting and chal-lenging condition that affects various areas of life, such as academic and career success, relationships, and daily activities. Both the mind and the muscles jump from one task to another, failing to complete the activity, and thus difficulties arise in carrying out activities such as writing, tying shoelaces, riding a bicycle and more. Banal activities we would say, but essential for a normal lifestyle. Medical recovery has a signifiant contribution in relieving symptoms and treating many pathologies, in both physical and mental relaxation. Moreover, it has been shown countless times that physical activity reduces stress, mainly based on muscle relaxation and improving cognitive and motor function through the development of neural functions. More and more children are diagnosed with this disorder, but, not enough attention is paid to these cases, which is one of the reasons why we chose to address this topic. The paper aims to analyze studies carried out in recent years in different countries on motor impairments and other complications that can present children with ADHD, but also the way that balneophysiokinetotherapy has a positive effect in their therapy, being an essential form of therapy, alongside the psychological or medicinal one. The studies analyzed confirm the benefits of physical exercise for children diagnosed with ADHD, showing visible effects on both the motor skills of the children and their lev-els of agitation and attention deficit. Although movement therapy is widely used in this condition, there are no protocols standardizing the type, duration, and intensity of exer-cise programs used. Occupational therapy, massage, and yoga have been noted for their beneficial effects on patients diagnosed with ADHD. Keywords: ADHD, hyperactivity, therapy

(044) AN INNOVATIVE AND NON-INVASIVE METHOD OF REDUCING PAIN UTILIZING VIBRATION DURING IUD INSERTION: PATIENT REACTIONS AND ONE PROVIDER’S APPROACH

Abstract Introduction Pain is commonly experienced during Intrauterine device (IUD) insertion and a possible barrier to this form of contraception. Pharmacological methods and non-pharmacological techniques are available to reduce pain during this procedure, but the efficacy varies on a case-by-case basis and data is conflicting regarding doses. Additional techniques are needed to increase the likelihood of a more patient centered approach to address pain experienced during IUD placement. Objective The purpose of the current project is to describe exploratory use of vibration and propose it as an innovative pain management technique during IUD insertion. Methods Recognizing that the umbilicus and the distal third of the vagina are embryologically connected, the current clinician hypothesized that external vibration applied to the umbilicus by a patient during IUD placement may reduce pain. Starting in 2017 external umbilical vibration was added to a previously established list of pain reduction options available during IUD placement at one clinical practice. Patients were consulted prior to IUD insertion and the list of multiple options discussed as part of regular practice. Patients and the provider determined the methods of pain reduction that best fit the individual patient’s needs based on their previous experiences, apprehension, and other concerns related to the procedure. Clinician observation and recall of response and reactions following the use of vibration will be shared. Results A detailed description of the umbilical vibration technique will be provided. Provider recall and summary of anonymous patient responses will be discussed, as well as the possible implications for gynecological care. Verbal and non-verbal responses from patients who elected to use umbilical vibration, or a combination of umbilical vibration and other techniques, to reduce pain have been overwhelmingly positive. No negative experiences with this non-invasive technique have occurred. Conclusions Umbilical vibration may serve as an effective, low-cost option to reduce pain during IUD placement. Providers considering this technique should be comfortable discussing vibration and open to this type of patient centered care. Umbilical vibration as a pain reduction technique for IUD insertion could be utilized in a trauma informed practice. A more in-depth study to further explore the intricacies of this technique is in preparation. Disclosure No.