The effect of slow-stroke back massage on chemotherapy-related fatigue in women with breast cancer: An assessor blinded, parallel group, randomized control trial

Non-pharmacological treatment options for fatigue: A systematic review of RCTs in adults

OBJECTIVE

Fatigue is a significant contributor to the burden experienced by patients with chronic disorders. The development of standardized treatments is challenging due to the lack of consensus concerning the etiology of fatigue. The aim of this systematic review is to provide an overview of non-pharmacological interventions for fatigue. The efficacy and differences in fatigue treatment across conditions will be explored.

METHODS

A systematic literature search was conducted using the databases PubMed, Web of Science, PsycInfo and CINAHL. Trials were eligible when (1) adult patients (≥ 18 years old) with disorders causing fatigue were included, (2) non-pharmacological interventions performed, (3) treatment was compared to standard care, placebo or active control group, (4) fatigue was the only primary outcome assessed with a multidimensional tool, and (5) a randomized controlled trial (RCT) design was applied.

RESULTS

7592 papers were screened. 91 RCTs were eligible, with data reported in 95 papers. Specific fatigue interventions were present for a broad range of conditions. Findings demonstrated promising evidence for physical activity, CBT, online programs and multidimensional modules. Additional types of interventions were effective, but evidence was limited due to risk of bias and small sample sizes. Due to high heterogeneity concerning methodology, a meta-analysis was not possible.

CONCLUSION

Several non-pharmacological treatment options for fatigue are promising. No clear evidence was found that fatigue should be treated differently depending on the underlying condition. However, further research is necessary with a focus on a transdiagnostic approach to fatigue, high study quality and long-term follow-ups.

The therapeutic effect of two different massages on the sleep quality of orthopedic surgery patients: A randomized controlled study

OBJECTIVE

Poor sleep quality due to pain, anxiety, and other surgical complications is a common challenge in postoperative patients. The present study aims to investigate the effect of postoperative slow-stroke back and hot stone massage therapy on the sleep quality of orthopedic surgery patients.

METHODS

This randomized and controlled clinical trial was conducted on 99 patients in the postoperative period of orthopedic surgery. The participants were randomly distributed into three groups (slow-stroke back massage, hot stone massage, and routine care). On the first or second day after the surgery, one group received a slow-stroke back massage, and another received a hot stone massage in the morning and afternoon for 10-15 minutes. Demographic surveys and the Richard-Campbell Sleep Questionnaire (RCSQ) were used for data collection. Chi-square, Kruskal-Wallis, and Wilcoxon tests were used for analysis, and the desired significance level was considered < 0.05.

RESULTS

There was a significant improvement in sleep quality scores of patients in the slow-stroke back or hot stone massage groups compared with the routine care group (p < 0.001) and also before intervention (p < 0.001).

CONCLUSION

The results suggest that slow-stroke back and hot stone massages can improve sleep quality in patients with orthopedic surgery in the postoperative period.

The effect of hand massage on fatigue in women with cancer receiving brachytherapy: randomized clinical trial

PURPOSE

This randomized controlled study was conducted to analyze the effect of hand massage on the fatigue level of the women receiving brachytherapy.

METHODS

It was determined that 12 patients were included in each group (control and hand massage group), so 24 women with gynecologic cancer were included in the study. The application was performed on each hand for 5 min, a total of 10 min in hand massage group. Hand massage was applied before each brachytherapy (at the first, second, and third sessions, a total of three times) every other day for 1 week in the hand massage group. No intervention was performed to the control group during the study. The data were collected using the Patient Information Form and Brief Fatigue Inventory (BFI).

RESULTS

At the end of the brachytherapy, the fatigue severity score and impact of fatigue on activities of daily living scores of the group that applied hand massage were determined to be lower than the control group (p < 0.05).

CONCLUSION

It was determined that hand massage effectively controlled fatigue and the impact of fatigue on activities of daily living. Hand massage is a safe and economical method that can be performed by certified nurses.

TRIAL REGISTRATION

This clinical trial is registered at ClinicalTrials.gov (NCT06056713-09/21/2023).

The skin-brain connection and pleasant touch as supportive care for psychocutaneous disorders

Psychodermatology is a subdiscipline of dermatology at the intersection of dermatology, psychiatry, and psychology. In dermatology clinical practice, patients may present with skin disease that affects their mental health, or skin disorders induced or worsened by psychological/psychiatric problems so there is a need for specialised education of dermatologists, as well as multidisciplinary teams, to achieve better management of these patients. Understanding the interaction between the central nervous system and the skin underlying psychocutaneous disorders could help identify alternative therapies that may improve patient well-being. The concept of pleasurable touch has received increasing attention following the discovery of C-tactile (CT) fibres. While afferent C-fibre stimulation is usually associated with pain, temperature, or itch, CT-fibres are stimulated optimally by a stimulus not in the nociceptor range but by a gentle, low-force stroking. As this affective touch may counteract unpleasurable sensations, such as pain and itch, and elicit positive feelings, the potential benefits of gentle touch and massage are interesting for dermatological, especially psychocutaneous, disorders. Here we provide an overview of the skin-brain connection to help understand the benefits of touch and massage, as illustrated with studies on atopic dermatitis and burns, as an adjunct to dermatological treatment for improving patient well-being and optimising treatment outcomes.

Massage therapy significantly improves cancer-related fatigue in cancer patients: a meta-analysis of randomized controlled trials

PURPOSE

This study was designed to investigate the effectiveness and safety of massage therapy in cancer-related fatigue (CRF) and to provide a reference for the future management of CRF.

METHODS

Eight databases (PubMed, Embase, Cochrane Library, CINAHL, Sinomed, Chinese Scientific Journal database (VIP), Wanfang, and China National Knowledge Infrastructure (CNKI)) were systematically reviewed from inception to May 2022 for randomized controlled trials. Two reviewers critically and independently assessed the risk of bias using Cochrane Collaboration criteria and extracted correlated data using the designed form. The meta-analysis was performed using RevMan 5.3 to calculate the pooled effect sizes and 95% confidence intervals (CIs). Sensitivity analysis was performed to find the source of the heterogeneity. Publication bias was assessed via funnel plot analysis and the Egger test.

RESULT

A total of 11 qualified studies that included 789 patients (massage therapy group: 389; control group: 400) were included in the meta-analysis. Massage therapy had a marked effect on fatigue in cancer patients [standardized mean difference (SMD) =  - 1.69, 95% CI (- 2.46, - 0.93), P < 0.01], especially in breast cancer [SMD =  - 1.62, 95% CI (- 2.18, - 1.05), P < 0.01]. Reflexology [SMD =  - 2.71, 95% CI (- 4.65, - 0.77), P < 0.01] and Chinese massage [SMD =  - 1.14, 95% CI (- 1.95, - 0.33), P < 0.01] can have a more significant effect on fatigue. Massage time is 20 to 40 min [SMD =  - 2.39, 95% CI (- 4.13, - 0.66), P < 0.01], twice a week [SMD =  - 3.46, 95% CI (- 5.47, - 1.45), P < 0.01] for 3-5 weeks [SMD =  - 2.36, 95% CI (- 3.53, - 1.19), P < 0.01], which is more effective in relieving fatigue in cancer patients. Five studies described the occurrence of adverse events and only two studies had adverse events.

CONCLUSION

Massage therapy can be effective in relieving fatigue in cancer patients. Current evidence suggests that reflexology is the most effective approach to relieve fatigue, particularly in the breast cancer patients. The optimal intervention frequency and cycle for massage therapy is twice a week for 3-5 weeks, and the optimal duration is 20-40 min.