# Acupressure for Managing Osteoarthritis: A Systematic Review and Meta-Analysis
## 3 Results
### Outcome Assessment  
#### 3.4.1 Primary Outcomes  
Pain  
_Acupressure vs. sham acupressure_  
Three RCTs [38; 39; 40] compared acupressure with sham acupressure, where one trial [38] reported that acupressure has positive effect in reducing pain and two trials [39; 40] reported otherwise. The meta-analysis showed that acupressure has equivalent effect on reducing pain (\(n=174\), MD \(-1.93\), CI 95%: \(-4.38\) to \(0.51\), \(p=0.12\), \(\Gamma^{2}=87\%\), Figure 3A), as compared to sham acupressure. _Acupressure vs. no intervention_  
Of the four RCTs [38; 39; 40; 41] comparing acupressure with no intervention, three trials [38; 39; 40] reported that acupressure has positive effect in reducing pain and one trial [41] reported otherwise. The meta-analysis showed that acupressure has equivalent effect on reducing pain (\(n=218\), MD \(-2.37\), CI 95%: \(-5.13\) to \(0.40\), \(p=0.09\), \(\Gamma^{2}=92\%\), Figure 3B), as compared to no intervention. _Acupressure plus conventional intervention vs. conventional intervention_  
Two RCTs [43; 44], comparing acupressure complementing conventional intervention with conventional intervention, reported that acupressure has superior effect in reducing pain. The pooled results also showed similar results (\(n=291\), MD \(-3.72\), 95% CI: \(-4.84\) to \(-2.61\), \(p<0.00001\), \(\Gamma^{2}=88\%\), Figure 3C), where acupressure as complementary intervention has superior effect in reducing pain compared to conventional intervention alone. _Acupressure only vs. conventional intervention_  
One RCT [44] evaluated the effectiveness of acupressure alone in comparison with conventional intervention and showed superior effect in reducing pain (\(n=90\), MD 5.44, 95% CI: 5.06 to 5.82, \(p<0.00001\)). _Acupressure only vs. health education_  
One RCT [42] evaluated the effectiveness of acupressure alone in comparison with health education and showed favorable effect in reducing pain (\(n=35\), MD 0.54, 95% CI: 0.07 to 1.01, \(p=0.03\)). Stiffness  
_Acupressure vs. sham acupressure_  
Two RCTs [38; 39] compared acupressure with sham acupressure and reported equivalent effect in relieving stiffness for both groups. The meta-analysis showed that acupressure has failed to show superior effects in relieving stiffness (\(n\) = 92, MD \(-\)0.26, CI 95%: \(-\)0.86 to 0.33, \(p\) = 0.38, I\({}^{2}\) = 0%, Figure 3D), as compared to sham acupressure. _Acupressure vs. no intervention_  
Three RCTs [38; 39; 40; 41], comparing acupressure with no intervention, also reported equivalent effect in relieving stiffness for both groups. The meta-analysis presented similar result where acupressure failed to show superior effects in relieving stiffness (\(n\) = 135, MD \(-\)0.23, CI 95%: \(-\)1.31 to 0.85, \(p\) = 0.68, I\({}^{2}\) = 75%, Figure 3E), as compared to no intervention. _Acupressure only vs. health education_  
The only RCT [42] that compared acupressure with health education also failed to show beneficial effects of acupressure in relieving stiffness (\(n\) = 35, MD: \(-\)0.04, 95% CI: \(-\)0.32 to 0.24, \(p\) = 0.78). Physical Function  
_Acupressure vs. sham acupressure_  
Three RCTs [38; 39; 40] compared acupressure with sham acupressure, where one trial [38] reported that acupressure has positive effect in improving physical function and two trials [39; 40] reported otherwise. The meta-analysis showed that acupressure has equivalent effects on improving physical function (\(n\) = 174, MD \(-\)4.02, CI 95%: \(-\)9.02 to 0.98, \(p\) = 0.12, I\({}^{2}\) = 71%, Figure 3F), as compared to sham acupressure. _Acupressure vs. no intervention_  
Of the four RCTs [38; 39; 40; 41] comparing acupressure with no intervention, two trials [38; 40] reported that acupressure has positive effect in improving physical function and two trials [39; 41] reported otherwise. The meta-analysis showed that acupressure has superior effects (\(n\) = 218, MD \(-\)6.30, CI 95%: \(-\)11.69 to \(-\)0.92, \(p\) = 0.02, I\({}^{2}\) = 77%, Figure 3G), as compared to no intervention.