Moderate Pressure is Essential for Massage Therapy Effects

The effects of massage therapy and white noise application on premature infants' sleep

AIM

Sleep is vital to premature infants' physical, social and emotional development. The significance of sleep duration, efficiency, and function in premature infants regarding growth development, behavior and neurological development has been increasing.

MATERIALS AND METHODS

This study was conducted in a randomized controlled experimental design with three groups. Premature infants at 28-37 weeks of gestation who were admitted to the Neonatal Intensive Care Unit of Şanlıurfa Mehmet Akif İnan Training and Research Hospital Haliliye Annex Building were the research population. The sample of the present study consisted of 120 premature infants in the massage therapy group (40), white noise group (40), and control group (40).

RESULTS

The sleep duration and sleep efficiency of the premature infants in the massage group increased compared to before the application, whereas the number of awakenings and WASO values decreased. The sleep duration of premature infants in the massaged group increased by some five hours. In the white noise group, the sleep duration increased by about two hours than the pre-treatment, and there was an increase in sleep efficiency. White noise application provided a significant decrease in the number of awakenings and WASO values in premature infants.

CONCLUSION

In this experimental study, which was designed with three groups, it was revealed that massage and white noise application in premature infants were significant non-pharmacological methods to increase sleep duration and sleep efficiency. It was concluded that massage therapy and white noise application is one of the considerable interventions regarding sleep duration, efficiency and functions in premature infants who left the intrauterine period early.

Energy metabolism and behavioral parameters in female mice subjected to obesity and offspring deprivation stress

This study aimed to evaluate the behavioral and energy metabolism parameters in female mice subjected to obesity and offspring deprivation (OD) stress. Eighty female Swiss mice, 40 days old, were weighed and divided into two groups: Control group (control diet, n = 40) and Obese group (high-fat diet, n = 40), for induction of the animal model of obesity, the protocol was based on the consumption of a high-fat diet and lasted 8 weeks. Subsequently, the females were subjected to pregnancy, after the birth of the offspring, were divided again into the following groups (n = 20): Control non-deprived (ND), Control + OD, Obese ND, and Obese + OD, for induction of the stress protocol by OD. After the offspring were 21 days old, weaning was performed and the dams were subjected to behavioral tests. The animals were humanely sacrificed, the brain was removed, and brain structures were isolated to assess energy metabolism. Both obesity and OD led to anhedonia in the dams. It was shown that the structures most affected by obesity and OD are the hypothalamus and hippocampus, as evidenced by the mitochondrial dysfunction found in these structures. When analyzing the groups separately, it was observed that OD led to more pronounced mitochondrial damage; however, the association of obesity with OD, as well as obesity alone, also generated damage. Thus, it is concluded that obesity and OD lead to anhedonia in animals and to mitochondrial dysfunction in the hypothalamus and hippocampus, which may lead to losses in feeding control and cognition of the dams.

ROLE OF MANUAL THERAPY AND MASSAGE IN THE TREATMENT OF FIBROMYALGIA: TESTING THE HYPOTHESIS

Fibromyalgia syndrome (FMS) is a chronic rheumatic disease in which pain is predominant and accompanied by fatigue, anxiety, depression, sleep disturbance and cognitive dysfunction. Although there are numerous pharmacological and non-pharmacological therapeutic alternatives, symptom control is frequently problematic. Manual therapy covers manipulating soft tissue and various joints using the hands. It is organized by mapping of soft tissue structures with rhythmically applied pressure to improve physical function, facilitate daily activities, promote rehabilitation procedures and decrease pain.  Massage is generally accepted as an essential component of manual therapy. Stretching and mobilizations are also part of manual therapy. Although numerous beneficial effects of manual therapy and massage on the musculoskeletal system and pain have been proven, the data in FMS patients studies are inconclusive. We hypothesize that manual therapy and massage are beneficial therapeutic options for the control of symptoms of FMS patients. Furthermore, these strategies can be employed in conjunction with well-established and high-evidence therapeutic procedures. Future research should focus on establishing standardized protocols for manual therapy and massage, which is one of the major limitations. To ensure a high level of evidence, research studies with large sample sizes, long follow-up periods and methodologically complete are needed.

Widespread Pressure Delivered by a Weighted Blanket Reduces Chronic Pain: A Randomized Controlled Trial

Pleasant sensation is an underexplored avenue for modulation of chronic pain. Deeper pressure is perceived as pleasant and calming, and can improve sleep. Although pressure can reduce acute pain, its effect on chronic pain is poorly characterized. The current remote, double-blind, randomized controlled trial tested the hypothesis that wearing a heavy weighted blanket - providing widespread pressure to the body - relative to a light weighted blanket would reduce ratings of chronic pain, mediated by improvements in anxiety and sleep. Ninety-four adults with chronic pain were randomized to wear a 15-lb. (heavy) or 5-lb. (light) weighted blanket during a brief trial and overnight for one week. Measures of anxiety and chronic pain were collected pre- and post-intervention, and ratings of pain intensity, anxiety, and sleep were collected daily. After controlling for expectations and trait anxiety, the heavy weighted blanket produced significantly greater reductions in broad perceptions of chronic pain than the light weighted blanket (Cohen's f = .19, CI [-1.97, -.91]). This effect was stronger in individuals with high trait anxiety (P = .02). However, weighted blankets did not alter pain intensity ratings. Pain reductions were not mediated by anxiety or sleep. Given that the heavy weighted blanket was associated with greater modulation of affective versus sensory aspects of chronic pain, we propose that the observed reductions are due to interoceptive and social/affective effects of deeper pressure. Overall, we demonstrate that widespread pressure from a weighted blanket can reduce the severity of chronic pain, offering an accessible, home-based tool for chronic pain. The study purpose, targeted condition, study design, and primary and secondary outcomes were pre-registered in ClinicalTrials.gov (NCT04447885: "Weighted Blankets and Chronic Pain"). Perspective: This randomized-controlled trial showed that a 15-lb weighted blanket produced significantly greater reductions in broad perceptions of chronic pain relative to a 5-lb weighted blanket, particularly in highly anxious individuals. These findings are relevant to patients and providers seeking home-based, nondrug therapies for chronic pain relief.

The effect of haptic stimulation simulating heartbeats on the regulation of physiological responses and prosocial behavior under stress: The influence of interoceptive accuracy

Research has discovered the modulatory effect of peripheral stimulation simulating altered bodily signals on emotion. Whether such an effect varies depending on one's interoceptive accuracy (IAc) remains unclear. Therefore, we provided haptic stimulation simulating participants' slowed-down heartbeats or no stimulation while they engaged in socially stressful tasks to examine whether participants reacted differently depending on their IAc. Results showed that haptic stimulation exhibited the opposite effect on participants with different levels of IAc for both heart rate and heart rate variability (HRV). When receiving the stimulation, participants with higher IAc showed less increased heart rate and more elevated HF than participants with lower IAc. In contrast, in the absence of stimulation, an opposite pattern of response depending on participants' IAc was observed. The modulatory effect of stimuli and IAc on prosocial behavior was not significant. Individual differences in IAc were shown to affect how one perceives/responds to altered bodily signals.

Effects, Side Effects and Contraindications of Relaxation Massage during Pregnancy: A Systematic Review of Randomized Controlled Trials

Healthcare professionals and expecting mothers frequently voice concerns that massages during pregnancy might cause complications or premature labor. This PRISMA review outlines current results on effects, side effects and contraindications of relaxation massage during pregnancy. Inclusion criteria: all randomized controlled trials (RCT) comparing relaxation massage during pregnancy with standard care or standard care plus another intervention (i.e., progressive muscle relaxation). Restrictions were full text availability and English language. Results: 12 RCT were included. Trials had good methodological quality but unknown risk of bias. All women were at least 12 weeks gestation at the start of the study. The main benefits of massage during pregnancy were: reduced stress, back and leg pain, depression and anxiety; increased immune response; increased serotonin and dopamine levels; higher fetal birth weight and reduced risk of preterm delivery. Only 2 RCT reported potential side effects of massage, which were minor and transient. Seven RCT excluded women with difficult pregnancies or preexisting complications, five studies did not report preexisting conditions. Those obstetric or postnatal complications that occurred were most likely unrelated to massage treatments. In healthy pregnant women without complications, relaxation massage has positive effects throughout pregnancy. Precautions for massage during pregnancy (i.e., to prevent pulmonary embolism) are discussed.

Tuina plus acupuncture for post-stroke depression: A protocol for systematic review and meta-analysis

BACKGROUND

Post-stroke depression (PSD) is the most common mental health issue, affecting approximately 33% of stroke survivors. Tuina and acupuncture treatments are often combined to treat PSD; however, there has been no meta-analysis on their synergistic effect. Therefore, we aimed to perform a systematic review and meta-analysis to estimate the effectiveness of Tuina and acupuncture in PSD treatment.

METHODS

The following electronic databases will be searched: PubMed, the Cochrane Library, Embase, Web of Science, Medline, CNKI, Chinese Biomedical Literature Database, VIP, and Wan Fang databases. We will consider articles published between database initiation and April 2021. Clinical randomized controlled trials related to Tuina combined with acupuncture for post-stroke depression will be included in the study. Language is limited to Chinese and English. Research selection, data extraction, and research quality assessment were independently completed by 2 researchers. Data were synthesized using a fixed effect model or random effect model, depending on the heterogeneity test. The Hamilton depression rating scale (HDRS) and effective rate were the primary outcomes. The post-stroke depression rating scale (PSDRS), patient health questionnaire-9 (PHQ-9), and the incidence of adverse events will also be assessed as secondary outcomes. RevMan V.5.4 statistical software will be used for meta-analysis. If it is not appropriate for a meta-analysis, a descriptive analysis will be conducted. Data synthesis uses the risk ratio and the standardized or weighted average difference of continuous data to represent the results.

RESULTS

This study provides a high-quality synthesis to assess the effectiveness and safety of Tuina for post-stroke depression.

CONCLUSION

This systematic review will provide evidence to determine whether Tuina plus acupuncture is an effective and safe intervention for patients with post-stroke depression.

ETHICS AND DISSEMINATION

The protocol of the systematic review does not require ethical approval because it does not involve humans. This article will be published in peer-reviewed journals and presented at relevant conferences.

SYSTEMATIC REVIEW REGISTRATION

INPLASY202140098.

A sensory intervention to improve sleep behaviours and sensory processing behaviours of children with sensory processing disorders

Purpose

This paper aims to investigate if a sensory intervention of moderate pressure touch of children with sensory processing disorder (SPD) affects sleep behaviours and sensory processing behaviours.

Design/methodology/approach

A total of 50 children, aged 5–11 years with both SPD and sleep difficulties in Israel, were randomly divided into an experimental and a control group, nonblinded. Participants in the experimental group received three weeks of nightly massage by their parents, with a baseline week on both ends. Parents filled out questionnaires reporting on sensory and sleep behaviours and filled out a nightly sleep log. Parents determined outcome goals using goal attainment scoring. The assessment tools used were the short sensory profile and the child sleep habits questionnaire (Dunn, 1999; Owens et al., 2000).

Findings

Significant improvement was found in the total and subgroup scores of sleep participation measures including sleep onset, sleep anxiety, parasomnias, sleep duration, daytime sleepiness, as well as the total sleep score (F (1,48) = 24.71, p < 0.001).

Originality/value

Results of this study suggest that consistent application of moderate pressure touch as advised or trained by an occupational therapist may be used in clinical practice to improve sleep participation in children with SPD.

Prevalence and perceptions of infant massage in India: study from Maharashtra and Madhya Pradesh states

Background

Knowledge of the prevailing infant care practices and their effects is important to inform practice and public programs. Infant massage is a traditional practice in India but remains less studied. This study was conducted to study the prevalence and perceptions of infant massage practices in two states of India.

Methods

A total of 1497 caretakers of children under 18 months of age were interviewed in a cross-sectional study at immunisation units of medical schools in Maharashtra (MH) and Madhya Pradesh (MP) states and through home visits in villages in MH during March through August 2018.

Results

Infant massage was a prevalent practice (93.8% [95%CI: 92.4,94.9]) in both study states – 97.9%[95%CI:96.9,98.8] in MH and 85.3%[95%CI: 81.9,88.3] in MP – and the prevalence did not vary between male (94.5%) and female (93.5%) infants (p = 0.44). Massage was mostly initiated in the first week of life (82%); it is widely viewed as a traditional practice. It was common to massage the baby once daily (77%), before bathing (77%), and after feeding (57%). Massage was mostly conducted using oils (97%). In MH, preferred oils were a sesame oil-based proprietary traditional medicine oil (36%) and coconut oil (18%) while olive (29%) and mustard (20%) oils were most popular in MP. Commonly reported application techniques included gentle massage with minimal pressure, pressing (30%) and manually stretching certain joints (60%). Commonly reported perceived benefits of infant massage included increased bone strength, better sleep and growth, while no harm was perceived (95%).

Conclusion

Infant oil massage is a highly prevalent traditional practice in MH and MP. Clear guidance on the use of massage, choice of oil, and techniques for application is required to optimize benefits and minimize risks of this popular traditional practice.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12887-020-02416-y.

Pressure Point Thresholds and ME/CFS Comorbidity as Indicators of Patient's Response to Manual Physiotherapy in Fibromyalgia

Current pharmacological treatments of Fibromyalgia (FM) are merely symptom palliative, as clinical trials have so far failed to provide overall benefits without associated harms. Polypharmacy often leads to patient’s health deterioration and chronic drug use to an eventual lack of patient’s response. Emerging evidence supports that physiotherapy treatments based on mechanical triggers improve FM symptoms and therefore could be used for therapeutic purposes by themselves or in combination with current pharmacological treatments, as part of integrative medicine programs. However, a paucity of studies rigorously and systematically evaluating this possibility exists. This study uses scores from validated standardized questionnaires, algometer pressure point threshold (PPT) readings and responses from a custom self-developed questionnaire to determine the impact of a pressure-controlled custom manual protocol on FM hyperalgesia/allodynia, fatigue and patient’s quality of life. The results show that patient’s baseline sensitivity to pain inversely correlates with treatment response in FM. Moreover, post-stratification analysis unexpectedly reveals that patients presenting comorbid ME/CFS do not seem to respond to the applied therapy as those presenting FM only. Therefore, pre-treatment PPTs and ME/CFS comorbidity may serve as indicators to predict patient’s response to physiotherapy programs based on mechanical triggers. Further exploration of these findings is granted. In addition, the study of gene expression profiles in the blood collection generated by this study should help unveil the molecular mechanisms behind patient’s differential response to manual therapy.

Pleasant Deep Pressure: Expanding the Social Touch Hypothesis

Neuroscientific research on pleasant touch has focused on the C-tactile pathway for gentle stroking and has successfully explained how these sensory fibers transmit information about affective social touch to the brain and induce sensations of pleasantness. The C-tactile social/affective touch hypothesis even proposes that C-tactile fibers form a privileged pathway underlying social touch. However, deep pressure is a type of touch commonly considered pleasant and calming, occurring in hugs, cuddling, and massage. In this paper we introduce a paradigm for studying pleasant deep pressure and propose that it constitutes another important form of social touch. We describe development of the oscillating compression sleeve (OCS) as one approach to administering deep pressure and demonstrate that this touch is perceived as pleasant and calming. Further, we show that deep pressure can be imaged with functional magnetic resonance imaging (MRI) using the air-pressure-driven OCS and that deep pressure activates brain regions highly similar to those that respond to C-tactile stroking, as well as regions not activated by stroking. We propose that deep pressure constitutes another social touch pathway of evolutionary importance signaling the close proximity of conspecifics.

Effects of Manual Therapy on Fatigue, Pain, and Psychological Aspects in Women with Fibromyalgia

Fibromyalgia is a condition characterised by chronic widespread muscle pain and fatigue, sleep disturbances, cognitive disorders, and mood disturbance. The purpose of this study was to determine the effectiveness of a manual therapy technique performed with moderate digital pressure in women with fibromyalgia (n = 24). In this randomised, controlled trial, the participants were randomly assigned to the experimental group or placebo group. The experimental group was assisted with manual therapy sessions based on connective tissue massage, whereas the placebo group was “treated” with ultrasound sessions performed without conductive gel and with the machine turned off as the placebo. Fatigue severity scale (FSS), visual analogical scale (VAS), Pittsburgh sleep quality index (PSQI), and profile of mood states (POMS-29) were completed before and after the intervention. In the experimental group (manual therapy), significant results were obtained on a VAS scale, referring to the neck pain in patients with fibromyalgia (p < 0.001). Correlations showed a relationship between fatigue and sleep variables (R = 0.411; p = 0.046) and pain variables with the POMS anger-hostility subscale (R = 0.436; p = 0.033). Although the size of the sample could be a limitation, the study concluded that the application of manual therapy in fibromyalgia patients performed with moderate pressure for 15 min on the posterior cervical musculature decreased the perception of pain, muscle fatigue, and the state of tension-anxiety.

The immediate effect of IASTM vs. Vibration vs. Light Hand Massage on knee angle repositioning accuracy and hamstrings flexibility: A pilot study

INTRODUCTION

The effectiveness of novel soft-tissue interventions relative to traditional ones requires further exploration. The purpose of this pilot study was to evaluate the immediate effect of Instrument Assisted Soft Tissue Mobilization (IASTM) compared to Vibration Massage or Light Hand Massage on hamstrings' flexibility and knee proprioception.

METHODS

16 healthy non-injured male participants (mean age 23.7 years, height 1.80 cms and body mass 77.7 kg) were randomly assigned to the following interventions: (a) 5min IASTM, (b) 5min Vibration Massage and (c) 8min Light Hand-Massage, sequentially delivered to all participants with an in-between 1-week time interval. A single application of each intervention was given over the hamstrings of their dominant leg (repeated measures under 3 different experimental conditions). An active knee angle reproduction proprioception test and the back-saver sit and reach flexibility test were performed before and immediately after each intervention. Reliability of outcomes was also assessed.

RESULTS

Reliability for flexibility (ICC_3,1 = 0.97-0.99/SEM = 0.83-1.52 cm) and proprioception (ICC_3,1 = 0.83-0.88/SEM = 1.63-2.02°) was very good. For flexibility, statistically significant immediate improvement (p < 0.001) was noted in all 3 groups (1.61-3.23 cm), with no between-group differences. For proprioception, improvement in the IASTM (2.12°), Vibration Massage (0.32°) and Light Hand-Massage (1.17°) conditions was not statistically significant; no between-group differences were also evident.

CONCLUSIONS

Our findings indicate that muscle flexibility was positively influenced immediately after a single intervention of IASTM, Vibration Massage or Light Hand Massage. Proprioception changes were not statistically significant either within or between groups. Further evaluation of those interventions in a larger population with hamstrings pathology is required.

Body-Centered Interventions for Psychopathological Conditions: A Review

World-wide, billions of dollars are spent each year on body-centered interventions to alleviate both physical and psychological pathologies. Given the high demand and increasing popularity of body-centered interventions, there is need for a systematic organization of empirical evidence associated with body-centered therapies. This article reviews the psychological effects of body-centered interventions on emotional well-being, including both self and other-administered (receptive) therapies. Theory behind body-centered interventions rely upon the bidirectional communication pathway between the brain and body. We investigated the bidirectional communication pathway between the brain and body by evaluating evidence across multiple body-centered therapies. The research reviewed includes studies that investigate effects of massage therapy, reflexology, acupuncture, functional relaxation, emotional freedom technique, Rolfing, yoga, tai-chi, and dance/movement therapy on psychological conditions across the lifespan. Results demonstrated that overall, massage therapy, tai-chi, dance/movement therapy, functional relaxation, reflexology, acupuncture and emotional freedom technique seem to alleviate stress, depression, anxiety, bipolar disorder and facilitate pain reduction. Of these, the most robust evidence available was for massage therapy, indicating it is an effective intervention for numerous age groups and populations. Rolfing and reflexology had the least amount of support, with few studies available that had small sample sizes. Although these conclusions are limited by scarcity of high-quality empirical data and contradictory findings, available evidence indicates that body-centered interventions can be effective in reducing psychopathology and supports the proposed mechanism of the bidirectional pathway between the brain and body: the body holds the potential to influence the mind. Integrating body-centered therapies in both clinical settings and as self-care could lead to better outcomes. Lastly, we propose the first taxonomy of body-centered interventions and empirical evidence of their effectiveness for clinicians and researchers.

Randomised controlled trial on the impact of kinesthetic stimulation on early somatic growth of preterm infants in Kangaroo position

AIM

Evaluation of early growth in preterm infants receiving kinesthetic stimulation with massage in Kangaroo position or in incubator.

METHODS

A cohort of 66 infants between 30 and 33 weeks of gestational age (GA), born at a university hospital in 2013 in Bogota, were randomised when eligible to intervention. We measured weight gain (g/kg/day) at five days and 15 days postrandomisation and weight at 40 weeks, according to chronological age at randomisation.

RESULTS

Daily weight gain was significantly higher (p = 0.02) with kinesthetic stimulation in Kangaroo position with a growth at five days of 11.0 g/kg/day (95% CI 5.7;16.3) and at 15 days of 12.1 g/kg/day (95% CI 10.4;13.7) versus 2.1 g/kg/day (95% CI -3.1;7.4) at five days and 9.4 g/kg/day (95% CI 7.7;11.1) at 15 days in incubator. Weight at 40 weeks was higher (p = 0.05) in Kangaroo position group (2.904 g) than in incubator group (2.722 g) (95% CI 2.784;3.007). Daily weight gain according to chronological age at randomisation was higher when kinesthetic stimulation initiates before five days of life in Kangaroo position with 1.53 g/kg/day (95% CI 5.9;9.0) versus -11.9 g/kg/day (95% CI -19.0;-4.8) in incubator.

CONCLUSION

Early kinesthetic stimulation in Kangaroo position reduces the initial weight loss in infants between 30-33 weeks born without major health problems.

Pediatric Massage Therapy Research: A Narrative Review

This narrative review on pediatric massage literature from the last decade suggests that massage therapy has positive effects on several pediatric conditions. These include preterm infant growth, psychological problems including aggression, gastrointestinal problems including constipation and diarrhea, painful conditions including burns and sickle cell, muscle tone disorders including cerebral palsy and Down syndrome, and chronic illnesses including diabetes, asthma cancer, and HIV. Potential underlying mechanisms for the massage therapy effects include increased vagal activity and decreased stress hormones. Limitations of the literature include the need for more randomized controlled trials, longitudinal studies, and underlying mechanism studies.

Gentle remedies: Restoring faith in the first step of nonpharmacological infant mental health care for the prevention and treatment of "disruptive behavior"

Parents and healthcare providers are reported to be "desperate" for solutions for dealing with temper tantrums and other extreme "disruptive behaviors." Reports state that at least 10,000 and as many as 20,000 infants under the age of two in 2014 were prescribed drugs such as risperidone, quetiapine, and other antipsychotic medications, suggesting that parents may have lost faith in their inner abilities to create an environment for their infant. Dr. Maria Montessori, concluded from her work that the nervous troubles of many "difficult" children can be traced to one of the most "harmful forms of repressive action" an adult can take, that of "interference" with or interrupting a child's self-chosen activity. This paper explores alternatives to adult interruption that begins with shushing crying infants and may extend to demanding medications with the intention of stopping behaviors. It discusses a tiered infant mental health care system in which conservative care, the first tier or step can be restored with nonpharmacological gentle remedies. Gentle remedies are neither better than nor are they a replacement for pharmaceutical drugs, the fourth and last step of the tiered system due to their known short term and potential long-term risks. The gentle remedies first step approach begins with parents engaging in environment and lifestyle management. Examples of other gentle remedies discussed for use in helping infants to discharge stress and frustration include lullabies, hot water bottles, infant massage education, oatmeal baths and other herbal simples, and Bach Flower Remedies.

Therapeutic massage to enhance family caregivers' well-being in a rehabilitation hospital

BACKGROUND AND PURPOSE

A massage therapy program was implemented to address the psychological well-being of family caregivers to patients in a rehabilitation hospital. The impact of massage "dosage" on caregiver stress and psychological well-being was examined in this study. Participants' perspectives on the program were also explored.

MATERIALS AND METHODS

Thirty-eight family caregivers were randomized to receive either one massage per week or three massages per week for two weeks. Caregivers reported psychological symptoms and stress pre- and post-program. Program acceptability was assessed via responses on an exit survey.

RESULTS

Overall, 79% of massages were received (89% among program completers). Post-program symptom scores were lower than baseline scores for both groups (F (1, 31) = 8.74 - 24.50, P < 0.01). Exit surveys indicated high program acceptability and perceived benefits.

CONCLUSION

Findings suggest that massage services would be welcomed, utilized, and beneficial for improving the psychological well-being of family caregivers in a rehabilitation hospital.

Interpersonal touch interventions for patients in intensive care: A design-oriented realist review

AIM

To develop a theoretical framework to inform the design of interpersonal touch interventions intended to reduce stress in adult intensive care unit patients.

DESIGN

Realist review with an intervention design-oriented approach.

METHODS

We searched CINAHL, MEDLINE, EMBASE, CENTRAL, Web of Science and grey literature sources without date restrictions. Subject experts suggested additional articles. Evidence synthesis drew on diverse sources of literature and was conducted iteratively with theory testing. We consulted stakeholders to focus the review. We performed systematic searches to corroborate our developing theoretical framework.

RESULTS

We present a theoretical framework based around six intervention construction principles. Theory testing provided some evidence in favour of treatment repetition, dynamic over static touch and lightening sedation. A lack of empirical evidence was identified for construction principles relating to intensity and positive/negative evaluation of emotional experience, moderate pressure touch for sedated patients and intervention delivery by relatives versus healthcare practitioners.

Massage Therapy in Management of Occupational Stress in Emergency Medical Services Staffs: a Randomized Controlled Trial

BACKGROUND

Results of various studies indicate that emergency medical service (EMS) staff suffer from occupational stress that adversely affects their quality of life and their care quality.

PURPOSE

This study aimed at determining the effect of massage on occupational stress experienced by emergency medical service staff.

SETTING

Prehospital emergency medical services stations of a city in the southwest of Iran.

PARTICIPANTS

A total of 58 members of staff of the emergency medical services, working in prehospital emergency medical services stations.

RESEARCH DESIGN

In this randomized controlled trial, a total of 58 EMS staff were selected from prehospital EMS stations, according to inclusion and exclusion criteria, and then assigned in two groups (29 in massage and 29 in control group) randomly by the minimization method. The intervention group received Swedish massage, twice a week for four weeks in the morning after the end of the work shift. Each massage session lasted 20-25 minutes. Subjects in the control group received no intervention. The level of occupational stress of the two groups was measured under the same conditions before and after the intervention by using the expanded nurses' occupational stress scale (ENSS). Data were analyzed with the SPSS16 software by using the chi-squared test, paired and independent-sample t tests, one-way ANCOVA. P value < .05 was considered as the level of significance.

RESULTS

The mean and SD of total occupational stress scores in the control group was 114.41±30.11 in pretest and reach to 112.58± 30.62 in posttest stage. Also the mean and SD of total occupational stress scores in the intervention group was 130.20±26.45 in pretest and reach to 110.41±21.75 in posttest stage. A one-way ANCOVA showed that there is a significant effect of massage on EMS staff's occupational stress level after controlling for pretest score (p = .001).

CONCLUSIONS

The training and the application of massage therapy can serve as an effective method in reducing occupational stress in emergency medical centers.

Unraveling the Molecular Determinants of Manual Therapy: An Approach to Integrative Therapeutics for the Treatment of Fibromyalgia and Chronic Fatigue Syndrome/Myalgic Encephalomyelitis

Application of protocols without parameter standardization and appropriate controls has led manual therapy (MT) and other physiotherapy-based approaches to controversial outcomes. Thus, there is an urgency to carefully define standard protocols that elevate physiotherapy treatments to rigorous scientific demands. One way in which this can be achieved is by studying gene expression and physiological changes that associate to particular, parameter-controlled, treatments in animal models, and translating this knowledge to properly designed, objective, quantitatively-monitored clinical trials (CTs). Here, we propose a molecular physiotherapy approach (MPTA) requiring multidisciplinary teams, to uncover the scientific reasons behind the numerous reports that historically attribute health benefits to MT-treatments. The review focuses on the identification of MT-induced physiological and molecular responses that could be used for the treatment of fibromyalgia (FM) and chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME). The systemic effects associated to mechanical-load responses are considered of particular relevance, as they suggest that defined, low-pain anatomic areas can be selected for MT treatment and yet yield overall benefits, an aspect that might result in it being essential to treat FM. Additionally, MT can provide muscle conditioning to sedentary patients without demanding strenuous physical effort, which is particularly detrimental for CFS/ME patients, placing MT as a real option for integrative medicine programs to improve FM and CFS/ME.

Efectos del masaje terapéutico sobre la ansiedad y el estrés en población pediátrica

Introducción. El masaje es una estrategia terapéutica estudiada por diferentes profesionales de la salud y de la cual la literatura reporta efectos que redundan en el bienestar físico y emocional del niño.Objetivo. Describir el estado del arte en relación con los efectos que genera la aplicación de masaje terapéutico sobre la ansiedad y el estrés en población pediátrica a partir de la evidencia disponible.Materiales y métodos. Revisión sistematizada que incluyó artículos de naturaleza experimental, en su mayoría ensayos clínicos aleatorizados evaluados mediante la escala PEDro. Las bases de datos consultadas fueron EBSCO, Embase, ScienceDirect, PubMed, BVS y PEDro.Resultados. En total, se seleccionaron 7 artículos, incluyendo 4 ensayos clínicos aleatorizados y 3 cuasi experimentales.Conclusiones. La literatura reporta efectos beneficiosos del masaje terapéutico aplicado en población pediátrica; entre ellos, disminución de los niveles de cortisol, mejor adaptación de respuestas fisiológicas frente a estresores, ganancia de peso y mejor organización comportamental y del sueño. Dichos efectos se potencializan al aplicar presión moderada, en comparación con técnicas de masaje realizadas con presión ligera.

The effects of unilateral Swedish massage on the neural activities measured by quantitative electroencephalography (EEG)

Purpose

It is generally accepted that massage can provide a lot of benefits to human health, especially for the brain functions. Little is known about the effect of unilateral massage on the brain activities. Nowadays, Swedish massage is a modern massage technique that is popular in both treatment and research fields. The purpose of this paper is to investigate the effect of unilateral Swedish massage on brain activities with electroencephalography (EEG) recording.

Design/methodology/approach

In total, 18 healthy adult participants (5 men, 13 women) aged between 22 and 36 years were massaged over one side of arm, forearm, hand, neck and face. Then the same procedures were repeated to another side of the body. EEG was recorded before (baseline) and during each massage condition. The absolute power of four common brain waves consisting of δ (0.5-4 Hz), θ (4-8 Hz), α (8-13 Hz), and β activities (13-30 Hz) from the quantitative EEG analysis between baseline and each massage condition were used to compare with the paired t-test.

Findings

The study found the reduction of δ and θ powers over bilateral frontal, fronto-central, and central areas. The increments of α power over the similar brain areas were also observed. These findings indicated the generalized effect of unilateral Swedish massage for inducing relaxation. Moreover, the significant reduction of β power was also found over right central area when left-arm massage was applied. This finding revealed the initial inhibitory effect of Swedish massage over right somatosensory cortex that received sensory stimulation through massage from left side of the body.

Originality/value

Unilateral Swedish massage induced the inhibitory effect at the contralateral somatosensory cortex and then produced the generalized effect which is compatible with relaxation.

Rhythmical massage improves autonomic nervous system function: a single-blind randomised controlled trial

BACKGROUND

Rhythmical massage therapy (RMT) is a massage technique used in anthroposophic medicine.

OBJECTIVE

The authors aimed to investigate the physiological action of RMT on the cardiovascular system by analysing heart rate variability (HRV).

DESIGN, SETTING, PARTICIPANTS AND INTERVENTION

This study was a randomised, controlled and single-blinded trial, involving 44 healthy women (mean age: (26.20 ± 4.71) years). The subjects were randomised to one of three arms: RMT with aromatic oil (RA), RMT without aromatic oil (RM) or standardised sham massage (SM). In the study the subjects were exposed to a standardised stress situation followed by one of the study techniques and Holter electrocardiograms (ECGs) were recorded for 24 h.

MAIN OUTCOME MEASURES

HRV parameters were calculated from linear (time and frequency domain) and nonlinear dynamics (symbolic dynamics, Poincare plot analysis) of the 24-h Holter ECG records.

RESULTS

Short- and long-term effects of massage on autonomic regulation differed significantly among the three groups. Immediately after an RMT session, stimulation of HRV was found in the groups RA and RM. The use of an aromatic oil produced greater short-term measurable changes in HRV compared with rhythmic massage alone, but after 24 h the effect was no longer distinguishable from the RM group. The lowest stimulation of HRV parameters was measured in the SM group.

CONCLUSION

RMT causes specific and marked stimulation of the autonomic nervous system. Use of a medicinal aromatic oil had only a temporary effect on HRV, indicating that the RM causes the most relevant long-term effect. The effect is relatively specific, as the physiological effects seen in the group of subjects who received only SM were considerably less pronounced.

TRIAL REGISTRATION

Registration trial DRKS00004164 on DRKS.

The Effects of Massage Therapy on Pain and Anxiety after Surgery: A Systematic Review and Meta-Analysis

Pain management is critical for patients after surgery, but current pain management methods are not always adequate. Massage therapy may be a therapeutic complementary therapy for pain. Many researchers have investigated the effects of massage therapy on post-operative pain, but there have been no systematic reviews and meta-analysis of its efficacy for post-operative patients. Our objective was to assess the effects of massage therapy on pain management among post-operative patients by conducting a systematic review and meta-analysis. The databases searched included MEDLINE, CINAHL, and the Cochrane Library's CENTRAL. To assess the effects of massage therapy on post-operative pain and anxiety, we performed a meta-analysis and calculated standardized mean difference with 95% CIs (Confidential Intervals) as a summary effect. Ten randomized controlled trials were selected (total sample size = 1,157). Meta-analysis was conducted using subgroup analysis. The effect of single dosage massage therapy on post-operative pain showed significant improvement (-0.49; 95% confidence intervals -0.64, -0.34; p < .00001) and low heterogeneity (p = .39, I² = 4%), sternal incisions showed significant improvement in pain (-0.68; -0.91, -0.46; p< .00001) and low heterogeneity (p = .76, I² = 0%). The anxiety subgroups showed substantial heterogeneity. The findings of this study revealed that massage therapy may alleviate post-operative pain, although there are limits on generalization of these findings due to low methodological quality in the reviewed studies.

Interventions to improve sensory and motor outcomes for young children with central hypotonia: A systematic review

OBJECTIVE

To evaluate evidence supporting physical and occupational therapy interventions used to improve sensory and motor outcomes for children 0-6 years with central hypotonia.

METHODS

Four electronic databases were searched from 1996 to March 2017. Level of evidence and study conduct was evaluated using American Academy of Cerebral Palsy and Developmental Medicine criteria. Traffic lighting classification identified interventions that were green (proven effective), yellow (possibly effective) or red (proven ineffective or contraindicated).

RESULTS

Thirty-seven articles were included. Nine studies measured orthotic interventions while four distinct studies published over nine articles measured treadmill interventions. Remaining studies measured impact of compression garments, massage, motor and sensori-motor interventions, positioning and mobility interventions.

CONCLUSIONS

Green light evidence supports treadmill training (to promote ambulation and gait characteristics) and massage (to positively affect muscle tone, motor development and use of vision) for infants with Down syndrome. These interventions are considered Yellow (possibly effective) for other populations. Green light evidence supports impact of orthoses on foot alignment for ambulatory children with hypotonia, while impact on gait characteristics is Yellow light and motor development may be negatively impacted (Red light) in pre-ambulatory children. All other interventions rated Yellow (possibly effective) and therapists should monitor using sensitive outcome measures.

Prevalence, patterns, and predictors of massage practitioner utilization: Results of a US nationally representative survey

BACKGROUND

The use of massage therapy is common, especially in patients with musculoskeletal pain. The purpose of this study was to examine the prevalence, utilization, socio-demographic and health-related predictors of massage practitioner consultations in the US population.

METHODS

Cross-sectional data from the 2012 National Health Interview Survey for adults (n = 34,525).

RESULTS

Prevalence of massage practitioner utilization were 12.8% (lifetime) and 6.8% (last 12 months). Compared to non-users, those who used massage in the last year were more likely: female, at least high school educated, annual income ≥ US$ 15,000, diagnosed with spinal pain or arthritis, report moderate physical activity level as compared to low level, and consume alcohol as compared to being abstinent. Massage was mainly used for general wellness or disease prevention (56.3%), but also for specific, typically musculoskeletal, health problems (41.9%) for which 85.2% reported massage helped to some or a great deal. Most (59.1%) did not disclose massage use to their health care provider, despite 69.4% reporting massage therapy combined with medical treatment would be helpful.

CONCLUSIONS

Approximately 7% (15.4 million) of US adults used massage therapy in the past year, mainly for general disease prevention, wellness or musculoskeletal pain. The majority of respondents reported positive outcomes of massage on specific health problems and overall well-being. Massage utilization was rarely covered by health insurance. Despite the majority of massage users considered massage therapy combined with medical care helpful, most did not disclose massage therapy use to their health care provider.

The effect of a short course of moderate pressure sunflower oil massage on the weight gain velocity and length of NICU stay in preterm infants

OBJECTIVE

The aim of this study was to evaluate the efficacy of five-day course of sunflower oil massage with moderate pressure on the weight gain and length of NICU stay in preterm infants.

METHODS

Forty-four healthy preterm infants with a corrected gestational age of 30-36 weeks at the time of the study, were randomly assigned to the study group receiving body massage with sunflower oil and the control group receiving only routine NICU care. The massage was performed three times per day, each session including three consecutive five-minute stages, for five days. The primary outcome was to evaluate the efficacy of a short course of moderate pressure sunflower oil massage on the weight gain velocity. The secondary outcome was to compare the length of NICU stay between the two groups.

RESULTS

During the study period, the increase in the average daily and fifth-day weight gain was significant in the intervention group. The length of NICU stay was shorter in the intervention group significantly.

CONCLUSION

Our findings suggest that even a short course of body massage with sunflower oil for only five days increases preterm infants' weight gain and decreases their duration of NICU stay significantly.

The effects of enteral feeding improvement massage on premature infants: A randomised controlled trial

AIMS AND OBJECTIVES

To prove the effects of an enteral feeding improvement massage for premature infants with regard to their feeding, growing and superior mesentery artery blood flow aspect by a randomised controlled trial.

BACKGROUND

Premature infants have feeding-related problems related to eating and absorbing nutrition due to their immature gastrointestinal function. Studies regarding the effectiveness of premature infants' enteral feeding improvement by tactile stimulation massage are rare.

DESIGN

The study group was composed of 55 patients. Of the 55 patients, 26 were randomised into an experimental group and 29 were randomised into a control group.

METHODS

They were all born <34 weeks of gestational age between 1 July 2011 and 30 March 2012. Premature infants in the experimental group received enteral feeding improvement massage twice a day for 14 days, and infants in the control group received a sham exercise. The collected data were analysed by spss 19.0, through t test, chi-square test (Fisher's exact) and ANCOVA.

RESULTS

(i) The experimental group had reached the day of full enteral feeding significantly faster. (ii) The experimental group had a higher superior mesentery artery peak velocity (V_max ) and lower RI (resistant index). (iii) The experimental group of the feeding-intolerant subgroup had a higher superior mesentery artery V_max and V_min . (iv) The experimental group had a heavier weight and larger head circumference after 14 days.

CONCLUSIONS

This study demonstrates that enteral feeding improvement massage can be helpful for achieving earlier full enteral feeding, more increased superior mesentery artery, and faster growing. In particular, it can be a therapeutic, independent and evidence-based nursing intervention for feeding-intolerant premature infants.

RELEVANCE TO CLINICAL PRACTICE

Neonatal nurses in neonatal intensive care unit can apply enteral feeding improvement massage massage for feeding-intolerant infants.

Clinical Validation of Pain Management Manipulative Therapy for Knee Osteoarthritis With the Squeeze-Hold Technique: A Case Series

OBJECTIVE

The purpose of this case series was to describe the short-term and long-term clinical effects of a manual technique for treating osteoarthritis (OA) knee pain.

METHODS

This study measured of the immediate effect and long-term effect by using a case series of different groups of subjects. Knee OA and activity restriction in patients were evaluated by using the Kellgren-Lawrence (K/L) Grading Scale and the Japanese Knee Osteoarthritis Measure (JKOM) index. In the intervention, lower limb muscles were squeezed by hand for 20 seconds. Each squeeze was performed for both lower limbs. Passive range-of-motion (ROM) exercise was performed on the knee joint. In one set of cases, immediate effects were measured after a one-time treatment with pretreatment and posttreatment outcome measures. Eleven people with knee OA participated in the study. On a visual analogue scale (VAS) for pain, muscle stiffness, and muscular hemodynamics for estimation of muscle blood flow were recorded before and after the squeeze-hold treatment. In another set of cases, the treatment was given to all patients once a week for 6 months, and long-term effects were measured. Data on 5 subjects with knee OA were collected for 6 months after initial treatment. The VAS for pain and JKOM were recorded every month for 6 months.

RESULTS

For immediate effects, the VAS was 69 ± 21 mm before treatment and 26 ± 22 mm after treatment. Muscle stiffness was 8.8 ± 3.6 (absolute number) before treatment and 3.5 ± 2.1 after treatment. Tissue (muscle) oxygen saturation was 60.1 ± 5.7% before treatment and 65.3 ± 4.8% after treatment. Total hemoglobin was 24.3 ± 3.3 (absolute number) before treatment and 25 ± 2.3 after treatment. A tendency for reduction in OA knee pain and muscle stiffness was observed, and a tendency for increase was observed in the blood flow in the muscle. For long-term effects in all 5 participants (any K/L grade, any JKOM score), OA knee pain and JKOM score improved gradually through 6 months.

CONCLUSIONS

The participants in this case series showed improvement in pain and function. These findings indicate the feasibility of a larger study on the squeeze-hold intervention for OA knee pain.

Effects of manual lymph drainage for abdomen on the brain activity of subjects with psychological stress

[Purpose] The present study investigated the effects of manual lymph drainage for abdomen on electroencephalography in subjects with psychological stress. [Subjects and Methods] Twenty-eight subjects were randomly allocated to undergo a 20-min session of either manual lymph drainage or abdominal massage on a bed. [Results] Analysis of electroencephalograms from the manual lymph drainage group showed a significant increase in relaxation, manifested as an increase in average absolute, relative alpha activity and a decrease in relative gamma activity. [Conclusion] Our results suggest that the application of manual lymph drainage from the abdomen provides acute neural effects that increase relaxation in subjects with psychological stress.

Impact of Massage Therapy on Fatigue, Pain, and Spasticity in People with Multiple Sclerosis: a Pilot Study

BACKGROUND

Multiple sclerosis (MS) is a chronic, immune-mediated, inflammatory disease that leads to fatigue, pain, and spasticity, as well as other sensorimotor and cognitive changes. Often traditional medical approaches are ineffective in alleviating these disruptive symptoms. Although about one-third of surveyed individuals report they use massage therapy (MT) as an adjunct to medical treatment, there is little empirical evidence that MT is effective for symptom management in people with MS.

PURPOSE

To measure the effects of MT on fatigue, pain, spasticity, perception of health, and quality of life in people with MS.

SETTING

Not-for-profit long-term care facility.

PARTICIPANTS

Twenty-four of 28 enrolled individuals with MS (average age = 47.38, SD = 13.05; 22 female) completed all MT sessions and outcome assessments.

RESEARCH DESIGN

Nonrandomized, pre-post pilot study.

INTERVENTION

Standardized MT routine one time a week for six weeks.

MAIN OUTCOME MEASURES

Modified Fatigue Index Scale (MFIS), MOS Pain Effects Scale (MOS Pain), and Modified Ashworth Scale (MAS). Secondary outcome measures: Mental Health Inventory (MHI) and Health Status Questionnaire (HSQ).

RESULTS

There was a significant improvement in MFIS (p < .01), MOS Pain (p < .01), MHI (p < .01), and HSQ (p < .01), all with a large effect size (ES) (Cohen's d = -0.76, 1.25, 0.93, -1.01, respectively). There was a significant correlation between change scores on the MFIS and the MOS Pain (r = 0.532, p < .01), MHI (r = -0.647, p < .01), and subscales of the HSQ (ranging from r = -0.519, to -0.619, p < .01).

CONCLUSIONS

MT as delivered in this study is a safe and beneficial intervention for management of fatigue and pain in people with MS. Decreasing fatigue and pain appears to correlate with improvement in quality of life, which is meaningful for people with MS who have a chronic disease resulting in long-term health care needs.

Enhance placebo, avoid nocebo: How contextual factors affect physiotherapy outcomes

INTRODUCTION

Placebo and nocebo represent complex and distinct psychoneurobiological phenomena in which behavioural and neurophysiological modifications occur together with the application of a treatment. Despite a better understanding of this topic in the medical field, little is known about their role in physiotherapy.

PURPOSE

The aim of this review is: a) to elucidate the neurobiology behind placebo and nocebo effects, b) to describe the role of the contextual factors as modulators of the clinical outcomes in rehabilitation and c) to provide clinical and research guidelines on their uses.

IMPLICATIONS

The physiotherapist's features, the patient's features, the patient-physiotherapist relationship, the characteristics of the treatment and the overall healthcare setting are all contextual factors influencing clinical outcomes. Since every physiotherapy treatment determines a specific and a contextual effect, physiotherapists should manage the contextual factors as a boosting element of any manual therapy to improve placebo effects and avoid detrimental nocebo effects.

Effect of classic massage in quality of life of university students

Abstract Introduction : Due to often excessive academic activities, some university students are affected by stress, anxiety and depression, which can negatively influence quality of life. The classical massage was tested as a strategy for improving quality of life, since it presents psychogenic effects that contribute to this. Objective : To evaluate the effects of classical massage on quality of life, in stress, anxiety, depression and cardiorespiratory variables of university students. Methods : The sample consisted of an intervention group and a control group. While the intervention group (n = 10) received ten massage sessions, twice a week, for 30 minutes in the region of the cervical and thoracic spine, the control group (n = 12) received no intervention. For evaluating psychological variables, the Quality of Life Scale, the Lipp Inventory of Stress Symptoms for Adults, and the Hospital Anxiety and Depression Scale were used. To assess cardiorespiratory variables, blood pressure, heart and respiratory rate were measured. Results : There was a significant improvement in quality of life and significant decrease in cardiorespiratory variables. Conclusion : The classic massage can be a strategy for the improvement of quality of life in university students who present symptoms of stress, anxiety, elevation of blood pressure, heart and respiratory rate.

Massage-like stroking boosts the immune system in mice

Recent clinical evidence suggests that the therapeutic effect of massage involves the immune system and that this can be exploited as an adjunct therapy together with standard drug-based approaches. In this study, we investigated the mechanisms behind these effects exploring the immunomodulatory function of stroking as a surrogate of massage-like therapy in mice. C57/BL6 mice were stroked daily for 8 days either with a soft brush or directly with a gloved hand and then analysed for differences in their immune repertoire compared to control non-stroked mice. Our results show that hand- but not brush-stroked mice demonstrated a significant increase in thymic and splenic T cell number (p < 0.05; p < 0.01). These effects were not associated with significant changes in CD4/CD8 lineage commitment or activation profile. The boosting effects on T cell repertoire of massage-like therapy were associated with a decreased noradrenergic innervation of lymphoid organs and counteracted the immunosuppressive effect of hydrocortisone in vivo. Together our results in mice support the hypothesis that massage-like therapies might be of therapeutic value in the treatment of immunodeficiencies and related disorders and suggest a reduction of the inhibitory noradrenergic tone in lymphoid organs as one of the possible explanations for their immunomodulatory function.

A unifying neuro-fasciagenic model of somatic dysfunction - Underlying mechanisms and treatment - Part II

This paper offers an extensive review of the main fascia-mediated mechanisms underlying various therapeutic processes of clinical relevance for manual therapy. The concept of somatic dysfunction is revisited in light of the several fascial influences that may come into play during and after manual treatment. A change in perspective is thus proposed: from a nociceptive model that for decades has viewed somatic dysfunction as a neurologically-mediated phenomenon, to a unifying neuro-fascial model that integrates neural influences into a multifactorial and multidimensional interpretation of manual therapeutic effects as being partially, if not entirely, mediated by the fascia. By taking into consideration a wide spectrum of fascia-related factors - from cell-based mechanisms to cognitive and behavioural influences - a model emerges suggesting, amongst other results, a multidisciplinary-approach to the intervention of somatic dysfunction. Finally, it is proposed that a sixth osteopathic 'meta-model' - the connective tissue-fascial model - be added to the existing five models in osteopathic philosophy as the main interface between all body systems, thus providing a structural and functional framework for the body's homoeostatic potential and its inherent abilities to heal.

Massage therapy research review

Moderate pressure massage has contributed to many positive effects including increased weight gain in preterm infants, reduced pain in different syndromes including fibromyalgia and rheumatoid arthritis, enhanced attentiveness, reduced depression and enhanced immune function (increased natural killer cells and natural killer cell activity).Surprisingly, these recent studies have not been reviewed, highlighting the need for the current review. When moderate and light pressure massage have been compared in laboratory studies, moderate pressure massage reduced depression, anxiety and heart rate, and it altered EEG patterns, as in a relaxation response. Moderate pressure massage has also led to increased vagal activity and decreased cortisol levels. Functional magnetic resonance imaging data have suggested that moderate pressure massage was represented in several brain regions including the amygdala, the hypothalamus and the anterior cingulate cortex, all areas involved in stress and emotion regulation. Further research is needed to identify underlying neurophysiological and biochemical mechanisms associated with moderate pressure massage.

Effect of vimala massage on physiological jaundice in infants: a randomized controlled trial

INTRODUCTION

Considering the prevalence of Jaundice in newborn infants and the risk of developing acute Bilirubin encephalopathy, in early weeks after birth. the importance of Infancy, as well as positive effects of giving massage on physical and behavioral growth and evolution of infants, the current study has been aimed to investigate the effects of Vimala massage on neonatal physiological Jaundice.

METHODS

This is a single blind clinical trial study, 43 healthy term infants, with 1(st) day Bilirubin levels of less than 5mg/dl, carried out in Tabriz Al-Zahra hospital. Newborns were selected through convenience sampling and then randomly assigned to intervention and control groups. Control group received routine care, while newborns of intervention group received four days of Vimala massage starting from the first day of their birth. Main variables of study include transcutaneous Bilirubin and frequency of defecation. Collected data were analyzed by SPSS Ver.13 through Chi-square and Mann-Whitney tests.

RESULTS

There were no statistical significant differences between two groups for skin bilirubin, however the number of defecations in the intervention group exceeded than of control group, and was statistically significant.

CONCLUSION

The RESULTS show that Vimala massage within four days has no effect on increasing process of bilirubin, yet can affect the incidence rate of physiological Jaundice and care of infants by increasing defecation frequency.

Effect of a brief seated massage on nursing student attitudes toward touch for comfort care

BACKGROUND

While massage has been removed from nursing curricula, studies have reported massage as safe and effective for stress reduction, relaxation, pain relief, fatigue, and quality of life.

OBJECTIVE

To compare the efficacy of two intensities of touch administered during two seated massages on the attitudes of nursing students toward touch for their self-care and patient care.

PARTICIPANTS

Nursing students who volunteered gave institutional review board-approved written informed consent to undergo massage by a licensed massage therapist.

SETTINGS/LOCATION

A private room adjacent to the nursing lab in a school of nursing.

INTERVENTION

Brief seated massages of differing intensities. Each participant received low-intensity and high-intensity touch in a two-block, randomized order, within-subjects design. Linear mixed models nested within subject and random intercept analyses were used to test hypotheses in this two-treatment, two-sequence, two-period crossover design.

OUTCOME MEASURES

Health questionnaires/visual analogue scales pertaining to physical/affective/and attitudinal status were completed before and after each massage.

RESULTS

Twenty-nine participants (93% female, 83% single) completed the study. Before massage, the optimal intensity of touch anticipated for self-comfort was 6.6 (0=no pressure;10=most intense pressure imaginable). The mean touch intensities were 6.7 for high-intensity massage and 0.5 for low-intensity (p<0.001). The overall percentage differences (feeling better or worse) following massage were as follows: low intensity, 37.5% better; high intensity, 62.7% better (p<0.001). Significantly more improvement was reported for energy, pain, stress, and feeling physically uptight after high-intensity compared with low-intensity (p<0.03). Participants were more likely to both receive touch for self-care and provide touch for patient care after experiencing high- versus low-intensity massage (p<0.01).

CONCLUSIONS

High-intensity seated massage was more efficacious than low-intensity massage and positively influenced nursing student attitudes toward the inclusion of massage in self-care/patient care. The role of touch for self-care/patient care in the nursing curricula merits reconsideration.

Interactions during feeding with mothers and their infants with symptoms of gastroesophageal reflux

OBJECTIVES

To examine whether maternal-child interaction during feedings was suboptimal in dyads in which the infant had gastroesophageal reflux disease (GERD) and to compare massage therapy to a nonmassage therapy sham treatment in improving the mother-child interaction in these dyads.

DESIGN

In this randomized, controlled pilot study, infants received massage therapy (n=18) or a nonmassage touch/holding sham treatment (n=18). Mothers, data collectors, and the investigator who scored the feeding observations were blinded to group assignment.

SETTINGS/LOCATION

Dyads were recruited from pediatric care providers in the Denver metropolitan area and online advertisements at the University of Colorado. Treatments were given in the home of the dyad.

PARTICIPANTS

Healthy infants, born at 38-42 weeks gestational age, were 5-10 weeks of age at enrollment; had a score of at least 16 on the Infant Gastroesophageal Reflux Questionnaire-Revised; and were diagnosed with GERD by their pediatric provider. Mothers were English speaking and at least 18 years of age.

INTERVENTIONS

Treatments were given for 30 minutes twice weekly for 6 weeks. A certified infant massage therapist administered massage, and a registered nurse or physical therapist experienced with infants administered the control treatment.

OUTCOME MEASURES

Maternal and infant scores on the Nursing Child Assessment of Feeding Scale (NCAFS).

RESULTS

NCAFS scores were significantly lower than national norms. Small to moderately sized effects showing improvement in the massage group relative to the nonmassage group were seen for Sensitivity to Cues, Social-Emotional Growth Fostering, Cognitive Growth Fostering, and Clarity of Cues (Cohen d) and ranged from 0.24 to 0.56.

CONCLUSIONS

Mothers and infants with GERD experience significantly worse interactions than those without GERD. Massage given twice weekly by a professional trended toward improved interaction during feeding. Daily maternal administration of massage may have a positive effect on the relationship.

Preterm infant weight gain is increased by massage therapy and exercise via different underlying mechanisms

OBJECTIVE

To compare the effects of massage therapy (moderate pressure stroking) and exercise (flexion and extension of limbs) on preterm infants' weight gain and to explore potential underlying mechanisms for those effects.

METHODS

Weight gain and parasympathetic nervous system activity were assessed in 30 preterm infants randomly assigned to a massage therapy group or to an exercise group. Infants received 10min of moderate pressure massage or passive flexion and extension of the limbs 3 times per day for 5days, and EKGs were collected during the first session to assess vagal activity.

RESULTS

Both massage and exercise led to increased weight gain. However, while exercise was associated with increased calorie consumption, massage was related to increased vagal activity.

CONCLUSION

Taken together, these findings suggest that massage and exercise lead to increased preterm infant weight gain via different underlying mechanisms.

Massage therapy restores peripheral vascular function after exertion

OBJECTIVE

To determine if lower extremity exercise-induced muscle injury reduces vascular endothelial function of the upper extremity and if massage therapy (MT) improves peripheral vascular function after exertion-induced muscle injury.

DESIGN

Randomized, blinded trial with evaluations at 90 minutes, 24 hours, 48 hours, and 72 hours.

SETTING

Clinical research center.

PARTICIPANTS

Sedentary young adults (N=36) were randomly assigned to 1 of 3 groups: (1) exertion-induced muscle injury and MT (n=15; mean age ± SE, 26.6 ± 0.3); (2) exertion-induced muscle injury only (n=10; mean age ± SE, 23.6 ± 0.4), and (3) MT only (n=11; mean age ± SE, 25.5 ± 0.4).

INTERVENTION

Participants were assigned to exertion-induced muscle injury only (a single bout of bilateral, eccentric leg press exercise), MT only (30-min lower extremity massage using Swedish technique), or exertion-induced muscle injury and MT.

MAIN OUTCOME MEASURES

Brachial artery flow-mediated dilation (FMD) was determined by ultrasound at each time point. Nitroglycerin (NTG)-induced dilation was also assessed (0.4 mg).

RESULTS

Brachial FMD increased from baseline in the exertion-induced muscle injury and MT group and the MT only group (7.38%±.18% to 9.02%±.28%, P<.05 and 7.77%±.25% to 10.2%±.22%, P<.05, respectively) at 90 minutes and remained elevated until 72 hours. In the exertion-induced muscle injury only group, FMD was reduced from baseline at 24 and 48 hours (7.78%±.14% to 6.75%±.11%, P<.05 and 6.53%±.11%, P<.05, respectively) and returned to baseline after 72 hours. Dilations of NTG were similar over time.

CONCLUSIONS

Our results suggest that MT attenuates impairment of upper extremity endothelial function resulting from lower extremity exertion-induced muscle injury in sedentary young adults.

Benefits of massage therapy for infants with symptoms of gastroesophageal reflux disease

OBJECTIVES

This randomized controlled pilot trial was conducted to evaluate the clinical efficacy of massage therapy (MT) for relief of symptoms of gastroesophageal reflux disease (GERD). The hypothesis was that, when compared to infants who received nonmassage therapy, infants who received MT would display fewer GERD symptoms, greater weight gain, greater amount of sleep, lower cortisol levels before and after treatment, and lower daily (area under the curve [AUC]) cortisol secretion.

METHODS

Participants were 36 infants born at term, 4-10 weeks of age at enrollment, healthy except for a diagnosis of GERD by their pediatrician, and with a score of at least 16 on the Infant Gastroesophageal Reflux Questionnaire-Revised (I-GERQ-R). Infants were randomized to receive either MT or a nonmassage sham treatment in their homes for 30 min twice a week for 6 weeks. Data collectors and parents were blind to study condition.

RESULTS

GERD symptoms decreased in both groups and weight increased. Pretreatment salivary cortisol levels decreased significantly over time in the massage group while increasing in the nonmassage group. Daily cortisol level also decreased in the massage group and increased in the nonmassage group, but the difference was not significant.

CONCLUSIONS

MT administered by a professional therapist did not affect symptoms of GERD differently than a sham treatment but did decrease infant stress as measured by cortisol. Research focusing on stress reduction in infants with GERD and multimodal treatments addressing GERD symptoms may yield the most effective treatment.