The aim of this qualitative study was to explore the experiences and meaning of touch between parents and children with autism before and after attending a Touch Therapy Programme. The sample comprised 12 parents (1 father and 11 mothers) of children (1 female and 11 male) with autism. Parents were interviewed before and immediately after the 8-week programme. Pre-programme results suggested that children were controlling the experience of touch. Parents felt 'hurt' in response to the 'aloof nature of autism, and natural parenting instincts (e.g. spontaneous cuddles) were restricted. Post-programme results suggested that children appeared to tolerate touch. Parents reported that routine tasks (e.g. dressing) were accomplished more easily and that children appeared generally more relaxed. Parents reported feeling 'closer' to their children and felt that the touch therapy had opened a communication channel between themselves and their children.

Cold intolerance is an inability to tolerate cold temperatures and is accompanied by symptoms including headache, shoulder discomfort, dizziness and palpitations. The current study was performed to examine whether reflexology therapy affected cold intolerance in human subjects and whether the treatment was systemically effective. Ten female volunteer examinees with subjective feelings of cold were examined. After a 5-minute foot bath, 10 minutes of reflexology therapy was performed on their left foot. Skin temperature and blood flow were estimated before and after treatment, together with an interview concerning their feelings of cold and daily habits. In addition, how the recovery rate was affected by the application of a chilled-water load was also estimated. Along with significant increases in skin temperature and blood flow compared with pre-treatment at the bilateral points of KI-1, LR-3, and BL-60, a faster recovery after the application of the chilled-water load was also seen in the lower limbs on both sides. From these results, we conclude that reflexology has systemic effects and is an alternative method for treating cold intolerance.

Cold intolerance is an inability to tolerate cold temperatures and is accompanied by symptoms including headache, shoulder discomfort, dizziness and palpitations. The current study was performed to examine whether reflexology therapy affected cold intolerance in human subjects and whether the treatment was systemically effective. Ten female volunteer examinees with subjective feelings of cold were examined. After a 5-minute foot bath, 10 minutes of reflexology therapy was performed on their left foot. Skin temperature and blood flow were estimated before and after treatment, together with an interview concerning their feelings of cold and daily habits. In addition, how the recovery rate was affected by the application of a chilled-water load was also estimated. Along with significant increases in skin temperature and blood flow compared with pre-treatment at the bilateral points of KI-1, LR-3, and BL-60, a faster recovery after the application of the chilled-water load was also seen in the lower limbs on both sides. From these results, we conclude that reflexology has systemic effects and is an alternative method for treating cold intolerance.

Research suggests that patients with cancer, particularly in the palliative care setting, are increasingly using aromatherapy and massage. There is good evidence that these therapies may be helpful for anxiety reduction for short periods, but few studies have looked at the longer term effects. This study was designed to compare the effects of four-week courses of aromatherapy massage and massage alone on physical and psychological symptoms in patients with advanced cancer. Forty-two patients were randomly allocated to receive weekly massages with lavender essential oil and an inert carrier oil (aromatherapy group), an inert carrier oil only (massage group) or no intervention. Outcome measures included a Visual Analogue Scale (VAS) of pain intensity, the Verran and Snyder-Halpern (VSH) sleep scale, the Hospital Anxiety and Depression (HAD) scale and the Rotterdam Symptom Checklist (RSCL). We were unable to demonstrate any significant long-term benefits of aromatherapy or massage in terms of improving pain control, anxiety or quality of life. However, sleep scores improved significantly in both the massage and the combined massage (aromatherapy and massage) groups. There were also statistically significant reductions in depression scores in the massage group. In this study of patients with advanced cancer, the addition of lavender essential oil did not appear to increase the beneficial effects of massage. Our results do suggest, however, that patients with high levels of psychological distress respond best to these therapies.

This study aimed to evaluate the effectiveness of the court-type traditional Thai massage (CTTM) to treat patients with chronic tension-type headaches (CTTHs) comparing with amitriptyline taking. A randomized controlled trial was conducted. Sixty patients diagnosed with CTTH were equally divided into a treatment and a control group. The treatment group received a 45-minute course of CTTM twice per week lasting 4 weeks while the control group was prescribed 25 mg of amitriptyline once a day before bedtime lasting 4 weeks. Outcome measures were evaluated in week 2, week 4 and followed up in week 6 consisting of visual analog scale (VAS), tissue hardness, pressure pain threshold (PPT), and heart rate variability (HRV). The results demonstrated a significant decrease in VAS pain intensity for the CTTM group at different assessment time points while a significant difference occurred in within-group and between-group comparison (P<0.05) for each evaluated measure. Moreover, the tissue hardness of the CTTM group was significantly lower than the control group at week 4 (P<0.05). The PPT and HRV of the CTTM group were significantly increased (P<0.05). CTTM could be an alternative therapy for treatment of patients with CTTHs.

AIM: This paper is a report of a study conducted to evaluate change in health-related quality of life for people with constipation receiving abdominal massage and to estimate the cost-effectiveness of two alternative scenarios developed from the original trial. BACKGROUND: Constipation is a common problem and is associated with decrease in quality of life. Abdominal massage appears to decrease the severity of gastrointestinal symptoms, but its impact on health-related quality of life has not been assessed. METHODS: A randomized controlled trial including 60 participants was conducted in Sweden between 2005 and 2007. The control group continued using laxatives as before and the intervention group received additional abdominal massage. Health-related quality of life was assessed using the EQ-5D and analyzed with linear regression. Two scenarios were outlined to conduct a cost utility analysis. In the self-massage scenario patients learned to give self-massage, and in the professional massage scenario patients in hospital received abdominal massage from an Enrolled Nurse. RESULTS: Linear regression analysis showed that health-related quality of life was statistically significantly increased after 8 weeks of abdominal massage. About 40% were estimated to receive good effect. For 'self-massage', the cost per quality adjusted life year was euro75,000 for the first 16 weeks. For every additional week of abdominal massage, the average dropped and eventually approached euro8300. For 'professional massage', the cost per quality adjusted life year was euro60,000 and eventually dropped to euro28,000. CONCLUSION: Abdominal massage may be cost-effective in the long-term and it is relevant to consider it when managing constipation. A crucial aspect will be to identify those who will benefit.

BACKGROUND: Traditional Chinese acupressure is a noninvasive technique that employs pressure and massage to acupoints in order to stimulate the balance of life energy that promotes health and comfort. Sleep disturbance is common in patients with end-stage renal disease but no intervention studies have addressed this problem. Aim. The purpose of the present study was to test the effectiveness of acupoints massage for patients with end-stage renal disease and experiencing sleep disturbances and diminished quality of life. METHODS: The study was a randomized control trial. A total of 98 end-stage renal disease patients with sleep disturbances were randomly assigned into an acupressure group, a sham acupressure group, and a control group. Acupressure and sham acupressure group patients received acupoints or no acupoints massage three times a week during haemodialysis treatment for a total of 4 weeks. The measures included the Pittsburgh Sleep Quality Index, Sleep Log, and the Medical Outcome Study - Short Form 36. FINDINGS: The results indicated significant differences between the acupressure group and the control group in Pittsburgh Sleep Quality Index subscale scores of subjective sleep quality, sleep duration, habitual sleep efficiency, sleep sufficiency, and global Pittsburgh Sleep Quality Index scores. Sleep log data revealed that the acupressure group significantly decreased wake time and experienced an improved quality of sleep at night over the control group. Medical Outcome Study - Short Form 36 data also documented that acupressure group patients experienced significantly improved quality of life. CONCLUSION: This study supports the effectiveness of acupoints massage in improving the quality of sleep and life quality of end-stage renal disease patients, and offers a noninvasive therapy for sleep-disturbed patients.

BACKGROUND:Treatment of chemotherapy-induced peripheral neuropathy (CIPN), which affects approximately 30% to 40% of patients treated with neuropathy-causing agents, is mainly symptomatic. Currently available interventions are of little benefit.

STUDY DESIGN:This study was conducted as a retrospective analysis of the efficacy of acupuncture and reflexology in alleviating CIPN in breast cancer patients.

METHODS:Medical records of 30 consecutive breast cancer patients who received both chemotherapy and treatment for CIPN according to our Acupuncture and Reflexology Treatment for Neuropathy (ART-N) protocol between 2011 and 2012 were reviewed. Symptom severity was rated at baseline, during, and after treatment.

RESULTS:The records of 30 breast cancer patients who had been concomitantly treated with chemotherapy and ART-N for CIPN were retrieved. Two records were incomplete, leaving a total of 28 patients who were enrolled into the study. Twenty patients (71%) had sensory neuropathy, 7 (25%) had motor neuropathy, and 1 (4%) had both sensory and motor neuropathy. Only 2 (10%) of the 20 patients with grades 1 to 2 neuropathy still reported symptoms at 12 months since starting the ART-N protocol. All 8 patients who presented with grades 3 to 4 neuropathy were symptom-free at the 12-month evaluation. Overall, 26 patients (93%) had complete resolution of CIPN symptoms.

CONCLUSION:The results of this study demonstrated that a joint protocol of acupuncture and reflexology has a potential to improve symptoms of CIPN in breast cancer patients. The protocol should be validated on a larger cohort with a control group. It also warrants testing as a preventive intervention.

OBJECTIVE:Generalized anxiety disorder (GAD) is a prevalent and costly disorder for which many patients may prefer nontraditional treatment. A proof-of-concept study of was conducted to evaluate the acute effects of Swedish massage therapy (SMT) as a monotherapy for the treatment of subjects with GAD.

METHODS:A randomized, single-masked, clinical trial was conducted between March 2012 and May 2013 at the Mood and Anxiety Disorders Program of Emory University. Forty-seven currently untreated subjects with a DSM-IV diagnosis of GAD were randomly assigned to twice-weekly SMT versus a light touch control condition for 6 weeks. The primary outcome measure was reduction in Hamilton Anxiety Rating Scale (HARS) scores after 6 weeks of treatment for SMT versus light touch, as determined by mixed model repeated-measures analysis of 40 evaluable subjects.

RESULTS:Mean HARS baseline scores were 20.05 (SD = 3.34) for SMT and 19.58 (SD = 4.90) for light touch. At week 6, the difference in mean (standard error of the mean [SEM]) HARS score reduction was 3.26 points (SMT: -11.67 [1.09]; light touch: -8.41 [1.01]; t₁₀₆ = -2.19; P = .030; effect size = -0.69). Treatment group differences were significant (P<.05) starting at the end of week 3.

CONCLUSION:This first monotherapy trial suggests that a complementary and alternative manual therapy, SMT, is an effective acute treatment for GAD.

TRIAL REGISTRATION:ClinicalTrials.gov identifier: NCT01337713.

OBJECTIVES: To assess the efficacy of an aromatic essential oil (1% Zingiber officinale and 0.5% Citrus sinesis) massage among the elderly with moderate-to-severe knee pain. METHOD: Fifty-nine older persons were enrolled in a double-blind, placebo-controlled experimental study group from the Community Centre for Senior Citizens, Hong Kong. The intervention was six massage sessions with ginger and orange oil over a 3-week period. The placebo control group received the same massage intervention with olive oil only and the control group received no massage. Assessment was done at baseline, post 1-week and post 4 weeks after treatment. Changes from baseline to the end of treatment were assessed on knee pain intensity, stiffness level and physical functioning (by Western Ontario and McMaster Universities Osteoarthritis index) and quality of life (by SF-36). RESULTS: There were significant mean changes between the three time-points within the intervention group on three of the outcome measures: knee pain intensity (p=0.02); stiffness level (p=0.03); and enhancing physical function (p=0.04) but these were not apparent with the between-groups comparison (p=0.48, 0.14 and 0.45 respectively) 4 weeks after the massage. The improvement of physical function and pain were superior in the intervention group compared with both the placebo and the control group at post 1-week time (both p=0.03) but not sustained at post 4 weeks (p=0.45 and 0.29). The changes in quality of life were not statistically significant for all three groups. CONCLUSION: The aroma-massage therapy seems to have potential as an alternative method for short-term knee pain relief.

INTRODUCTION:Nausea is the worst and most prevalent chemotherapy-induced complication experienced by 70-80% of patients despite mediation therapy. Reduction of nausea is one of the most important roles of oncologist nurses. Today, complementary therapies in addition to classic medicine, because of their lower costs, receive much attention. Nonetheless, their safety and effectiveness are not yet proven. The purpose of this research was to investigate the effect of therapeutic touch plan as a complementary therapy on acute nausea in women with breast cancer in 2012-2013 in Isfahan, Iran.

MATERIALS AND METHODS:A quasi-experimental, single-blind, randomized control trial with three groups (control, placebo and intervention) was performed at the Isfahan Seyedolshohada (AS) Teaching Hospital, Isfahan, in 2012-2013. The intervention was therapeutic touch plan on women with breast cancer, with the three groups receiving the same medicine regimen. Information was recorded by a checklist after infusion of chemotherapy drugs. Data analysis was performed by SPSS, ANOVA and Kruskal-Wallis tests.

RESULTS:The ANOVA test showed that the therapeutic touch plan was significantly effective in reducing the duration of nausea compared with the control and placebo groups (P<0.001). The Kruskal-Wallis test showed that the frequency of occurrence of nausea was also reduced in the intervention and placebo groups compared with the control group (P<0.001). The therapeutic touch plan was significantly effective in delaying the onset of nausea compared with the control and placebo groups (P<0.001).

CONCLUSION:This research showed that the therapeutic touch plan is effective in reducing acute chemotherapy-induced nausea; thus, education and implementation of the therapeutic touch plan is proposed for clinical nurses.

Nineteen women (M age = 26) diagnosed with anorexia nervosa were given standard treatment alone or standard treatment plus massage therapy twice per week for five weeks. The massage group reported lower stress and anxiety levels and had lower cortisol (stress) hormone levels following massage. Over the five-week treatment period, they also reported decreases in body dissatisfaction on the Eating Disorder Inventory and showed increased dopamine and norepinephrine levels. These findings support a previous study on the benefits of massage therapy for eating disorders.

Although blended essential oils are increasingly being used for the improvement of the quality of life and for the relief of various symptoms in patients, the scientific evaluation of the aroma-therapeutic effects of blended essential oils in humans is rather scarce. In this study, we hypothesized that applying blended essential oil would provide a synergistic effect that would have a chance for success in treating depression or anxiety. Therefore, the main objective of this study was to investigate the effects of the blended essential oil on autonomic parameters and on emotional responses in humans following transdermal absorption. The blended essential oil consisted of lavender and bergamot oils. Human autonomic parameters, i.e. blood pressure, pulse rate, breathing rate, and skin temperature, were recorded as indicators of the arousal level of the autonomic nervous system. In addition, subjects had to rate their emotional condition in terms of relaxation, vigor, calmness, attentiveness, mood, and alertness in order to assess subjective behavioral arousal. Forty healthy volunteers participated in the experiments. Blended essential oil was applied topically to the skin of the abdomen of each subject. Compared with placebo, blended essential oil caused significant decreases of pulse rate, and systolic and diastolic blood pressure, which indicated a decrease of autonomic arousal. At the emotional level, subjects in the blended essential oil group rated themselves as 'more calm' and 'more relaxed' than subjects in the control group. This finding suggests a decrease of subjective behavioral arousal. In conclusion, our investigation demonstrates the relaxing effect of a mixture of lavender and bergamot oils. This synergistic blend provides evidence for its use in medicine for treating depression or anxiety in humans.

PURPOSE:Older adults living in long-term care experience high rates of chronic pain. Concerns with pharmacologic management have spurred alternative approaches. The purpose of this study was to examine a nursing intervention for older adults with chronic pain.

DESIGN:This prospective, randomized control trial compared the effect of aromatherapy M technique hand massage, M technique without aromatherapy, and nurse presence on chronic pain. Chronic pain was measured with the Geriatric Multidimensional Pain and Illness Inventory factors, pain and suffering, life interference, and emotional distress and the Iowa Pain Thermometer, a pain intensity scale.

METHOD:Three groups of 39 to 40 participants recruited from seven long-term care facilities participated twice weekly for 4 weeks. Analysis included multivariate analysis of variance and analysis of variance.

FINDINGS:Participants experienced decreased levels of chronic pain intensity. Group membership had a significant effect on the Geriatric Multidimensional Pain Inventory Pain and Suffering scores; Iowa Pain Thermometer scores differed significantly within groups.

CONCLUSIONS:M technique hand massage with or without aromatherapy significantly decreased chronic pain intensity compared to nurse presence visits. M technique hand massage is a safe, simple, but effective intervention. Caregivers using it could improve chronic pain management in this population.

This study explored whether reflexology could improve or sustain the wellbeing of people with Parkinosn's Disease [PD] using the PDQ39 wellbeing tool designed specifically for use with people with PD. The treatmnt protocal involved giving 8 therapy sessions to 16 people with varying derees of PD in a cross-over design to enable a longitudinal survey of impact. Whilst the results reflected the progressive nature of PD deterioration over time there was an improvement in wellbeing over the active therapy phase. These results suggest that continuous two- three weekly reflexology may limit further deteroration or maintain improvement of wellbeing. A further study is indicated to study this hypothesis.

CONTEXT: Therapeutic massage has been proven to be an effective, nonpharmacologic, alternative for managing state and trait anxiety in a variety of clinical situations. However, no controlled study has investigated this effect in an addiction treatment setting. AIM: The aim of this study was to investigate the effectiveness of chair massage for reducing anxiety in persons participating in an inpatient withdrawal management program for psychoactive drugs. DESIGN: The design was a randomized, controlled clinical trial conducted from June 2008 to January 2009. SUBJECTS: Eighty-two (82) adult patients received inpatient treatment for psychoactive drug withdrawal (alcohol, cocaine, and opiates). SETTING: This study was conducted at the Withdrawal Management Services at the Capital District Health Authority, Halifax, Nova Scotia. INTERVENTIONS: Subjects were randomly assigned to receive chair massage (n = 40) or a relaxation control condition (n = 42). Treatments were offered for 3 consecutive days. Standard counseling and pharmacologic management were also offered concurrently to patients in all conditions. MEASUREMENTS: The primary outcome measure was anxiety assessed using the Spielberger State-Trait Anxiety Inventory (STAI). State and trait anxiety scores were determined immediately prior to and following each treatment intervention. RESULTS: Analysis of STAI scores showed a significant reduction in state and trait anxiety for both interventions (p < 0.001). The magnitude in the reduction in state (p = 0.001) and trait (p = 0.045) anxiety was significantly greater in the chair massage group where the effect on state anxiety was sustained, at least in part, for 24 hours. CONCLUSIONS: Within the clinical context of this study, chair massage was more effective that relaxation control in reducing anxiety. Further investigation of chair massage as a potential nonpharmacologic adjunct in the management of withdrawal related anxiety is warranted.

BACKGROUND: During labor, women experience a high level of intense, stressful and steady pain that may negatively affect both mothers and neonates. Painkillers have previously been used for childbearing women, but nowadays, owing to some well-known limitations and serious side effects, nonpharmacologic methods such as massage and music therapies are being broadly recommended. The present clinical trial was conducted to compare the effects of massage and music therapies on the severity of labor pain in the Ilam province of western Iran. MATERIALS&METHODS: Overall, 101 primigravidae who were hospitalized for vaginal delivery were recruited and randomly stratified into two groups of either massage (n = 51) or music (n = 50) therapies. Pain was measured using the visual analog scale and the two groups were compared in terms of pain severity before and after the interventions. RESULTS: Mothers in the massage therapy group had a lower level of pain compared with those in the music therapy group (p = 0.009). A significant difference was observed between the two groups in terms of pain severity after intervention (p = 0.01). Agonizing, or most severe, labor pain was significantly relieved after massage therapy (p = 0.001). CONCLUSION: Massage therapy was an effective method for reducing and relieving labor pain compared with music therapy and can be clinically recommended as an alternative, safe and affordable method of pain relief where using either pharmacological or nonpharmacological methods are optional.

BACKGROUND: During labor, women experience a high level of intense, stressful and steady pain that may negatively affect both mothers and neonates. Painkillers have previously been used for childbearing women, but nowadays, owing to some well-known limitations and serious side effects, nonpharmacologic methods such as massage and music therapies are being broadly recommended. The present clinical trial was conducted to compare the effects of massage and music therapies on the severity of labor pain in the Ilam province of western Iran. MATERIALS&METHODS: Overall, 101 primigravidae who were hospitalized for vaginal delivery were recruited and randomly stratified into two groups of either massage (n = 51) or music (n = 50) therapies. Pain was measured using the visual analog scale and the two groups were compared in terms of pain severity before and after the interventions. RESULTS: Mothers in the massage therapy group had a lower level of pain compared with those in the music therapy group (p = 0.009). A significant difference was observed between the two groups in terms of pain severity after intervention (p = 0.01). Agonizing, or most severe, labor pain was significantly relieved after massage therapy (p = 0.001). CONCLUSION: Massage therapy was an effective method for reducing and relieving labor pain compared with music therapy and can be clinically recommended as an alternative, safe and affordable method of pain relief where using either pharmacological or nonpharmacological methods are optional.

BACKGROUND: The management of diabetic foot ulcers remains a problem. A treatment modality that uses compressed air massage has been developed as a supplement to standard surgical and medical treatment. Compressed air massage is thought to improve local tissue oxygenation around ulcers. The aim of this study was to determine whether the addition of compressed air massage influences the rate of healing of diabetic ulcers. METHODS: Sixty consecutive patients with diabetes, admitted to one hospital for urgent surgical management of diabetic foot ulcers, were randomized into two groups. Both groups received standard medical and surgical management of their diabetes and ulcer. In addition, one group received 15-20 min of compressed air massage, at 1 bar pressure, daily, for 5 days a week, to the foot and the tissue around the ulcer. Healing time was calculated as the time from admission to the time of re-epithelialization. RESULTS: Fifty-seven patients completed the trial; 28 received compressed air massage. There was no difference in the mean age, Wagner score, ulcer size, pulse status, or peripheral sensation in the two groups. The time to healing in the compressed air massage group was significantly reduced: 58.1 +/- 22.3 days (95% confidence interval: 49.5-66.6) versus 82.7 +/- 30.7 days (95% confidence interval: 70.0-94.3) (P = 0.001). No adverse effects in response to compressed air massage were noted. CONCLUSIONS: The addition of compressed air massage to standard medical and surgical management of diabetic ulcers appears to enhance ulcer healing. Further studies with this new treatment modality are warranted.

The objective of this study was to evaluate the efficacy of connective tissue massage to improve blood circulation and intermittent claudication symptoms in type 2 diabetic patients. A randomized, placebo-controlled trial was undertaken. Ninety-eight type 2 diabetes patients with stage I or II-a peripheral arterial disease (PAD) (Leriche-Fontaine classification) were randomly assigned to a massage group or to a placebo group treated using disconnected magnetotherapy equipment. Peripheral arterial circulation was determined by measuring differential segmental arterial pressure, heart rate, skin temperature, oxygen saturation and skin blood flow. Measurements were taken before and at 30 min, 6 months and 1 year after the 15-week treatment. After the 15-week program, the groups differed (P<0.05) in differential segmental arterial pressure in right lower limb (lower one-third of thigh, upper and lower one-third of leg) and left lower limb (lower one-third of thigh and upper and lower one-third of leg). A significant difference (P<0.05) was also observed in skin blood flow in digits 1 and 4 of right foot and digits 2, 4 and 5 of left foot. ANOVA results were significant (P<0.05) for right and left foot oxygen saturation but not for heart rate and temperature. At 6 months and 1 year, the groups differed in differential segmental arterial pressure in upper third of left and right legs. Connective tissue massage improves blood circulation in the lower limbs of type 2 diabetic patients at stage I or II-a and may be useful to slow the progression of PAD.