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Patients' views on the factors which would influence the use of an aromatherapy massage out-patient service.

A descriptive survey was carried out in a private surgical hospital over a 4-week period to ascertain patients' views on the potential use of aromatherapy massage as an out-patient service. A short structured questionnaire was personally distributed to a convenience sample of 240 patients, effecting a response rate of 71% (n = 170). Findings revealed that the majority of respondents would use an aromatherapy massage out-patient service. However, influencing factors were highlighted which would materially affect their decision. Important considerations were: a trained practitioner, reputable premises, the gender of therapist, the cost of treatment, and the degree of confidence in aromatherapy massage. In addition, the influence of the medical profession was interesting. Many respondents prefer to be referred by a GP or consultant. This appeared to be due to lack of knowledge and awareness of aromatherapy massage, and complementary therapies in general. Furthermore, there appeared to be a preferred reliance on the medical profession to take responsibility for health care decisions.

Adult↗

Auditing complementary therapies in palliative care: the experience of the day-care massage service at Mount Edgcumbe Hospice.

The bulk of this paper comprises an audit of the massage service offered to day-care clients at Mount Edgcumbe Hospice. Having had no experience of audit it has been a learning process within which shortcomings of my techniques have become evident. However, during the course of the project, I became enthusiastic about the potential for change, progress and increased validation enabled by the audit process. I realised the significance and importance of audit as an evaluatory tool in relation to complementary and alternative medicine. Still in the earlier stages of acceptance by more orthodox medicine, these therapies require audit, as much as they require quality scientific research. 'Complementary and alternative medical practitioners, teachers and researchers need to understand the advantages of more systematic audit and rigorous research' (Foundation for Integrated Medicine) The objectives of this audit are: To review the performance of the massage in day-care after 2 years of activity. To obtain first hand feedback from clients, staff and carers with a view to introducing improvements. To devise a system of measuring the performance of the day-care service both for comparison internally and with other external hospices. To benefit from the discipline which the audit process itself engenders in complementary medical practice. To lend credibility to the massage service and other complementary therapies in the context of more orthodox palliative care. To arrive at a method of measuring massage as a complementary therapy. To improve communication between the different areas of the hospice. I would encourage other complementary therapists to follow suit and start auditing to help validate the importance of these therapies in today's more holistic approach to health.

Attitude of Health Personnel↗

Improvement of macromolecular clearance via lymph flow in hamster gingiva by topical warming and massage.

The lymphatic system is very important for macromolecular clearance in various tissues, especially in the gingiva. However, the kinetics of macromolecular clearance via the lymph flow in the gingiva are poorly understood. The aim of this study was to investigate whether thermal or mechanical stimulation affects macromolecular clearance via the lymph flow in the gingiva. Carbon black suspension was injected into the mandibular gingiva of anesthetized hamsters and its drainage into cervical lymph nodes was examined. Clearance of 14C-methylated bovine albumin and tritiated water from the gingiva and their drainage into submandibular lymph nodes and blood was quantified. The effect of topical warming or massage on clearance of 14C-methylated albumin from the gingiva during a 15 min period was examined. In addition, the influence of neurochemical antagonists on the stimulatory effect of topical warming on albumin clearance was investigated. Submandibular lymph nodes were clearly delineated by carbon black 10 min after the injection. More radiolabeled albumin appeared in submandibular lymph nodes than in serum, while more tritiated water appeared in serum. Topical warming (45 degrees C, 2 min) and warming plus massage (with a silicon rubber brush, 20 s) decreased the radiolabeled albumin in the gingiva 15 min after the injection. There was less radiolabeled albumin in the gingiva after gingival warming plus massage than after warming. Previous injection of HOE140 or propranolol into the gingiva diminished the stimulatory effect of topical warming on albumin clearance. It was concluded that topical warming plus massage improves macromolecular clearance via the lymph flow in hamster gingiva.

Albumins↗

Physical activity combined with massage improves bone mineralization in premature infants: a randomized trial.

BACKGROUND: Osteopenia of prematurity is a known source for morbidity in preterm infants. Premature infants have shown favorable outcomes in response to massage and physical activity. Whether such intervention can stimulate bone formation or decrease bone resorption is yet to be determined. OBJECTIVE: To test the hypothesis that massage combined with physical activity can stimulate bone formation and ameliorate bone resorption in premature infants. DESIGN/METHODS: A prospective double-blinded randomized trial was conducted at the Neonatal Intensive Care Unit of Ain Shams University in Cairo, Egypt. Thirty preterm infants (28 to 35 weeks' gestation) were randomly assigned to either control group (Group I, n=15) or intervention group (Group II, n=15). Infants in the intervention group received a daily protocol of combined massage and physical activity. Serum type I collagen C-terminal propeptide (PICP) and urinary pyridinoline crosslinks of collagen (Pyd) were used as indices for bone formation and resorption, respectively. PICP and Pyd were measured at enrollment and at discharge for all subjects. t-Test, ANOVA and linear regression analysis were used for statistical analyses. RESULTS: There was no difference between groups I and II in gestational age (32.1+/-1.8 vs 31.5+/-1.4 weeks) or birth weight (1.429+/-0.148 vs 1.467+/-0.132 g). In the control group, serum PICP decreased over time from 82.3+/-8.5 to 68.78+/-14.6 (p<0.01), while urinary Pyd increased from 447.7+/-282.8 to 744.9+/-373.6 (p<0.01) indicating decreased bone formation and increased bone resorption, respectively. In the intervention group, serum PICP increased over time from 62.5+/-13.8 to 73.84+/-12.9 (p<0.01). Urinary Pyd also increased over time from 445.7+/-266.5 to 716.8+/-301.8 (p<0.01). In a linear regression model including gestational age and intervention, serum PICP increased significantly in the intervention group (regression coefficient 18.8+/-4.6, p=0.0001) while urinary Pyd did not differ between groups (regression coefficient=5.6+/-114.3, p=0.961). CONCLUSIONS: A combined massage and physical activity protocol improved bone formation (PICP) but did not affect bone resorption (Pyd). Pyd increased over time in both groups, possibly due to continuous bone resorption and Ca mobilization.

Alkaline Phosphatase↗

The effect of foot massage on patients' perception of care following laparoscopic sterilization as day case patients.

This randomized-controlled study examined the effects of foot massage on patients' perception of care received following surgery. The sample of 59 women who underwent laparoscopic sterilization as day case patients were randomly allocated into two groups. The experimental group received a foot massage and analgesia post-operatively, whilst the control group received only analgesia post-operatively. Each participant was asked to complete a questionnaire on the day following surgery. This examined satisfaction, memory and analgesia taken. The 76% response rate was comparable with other patient satisfaction studies following day-case surgery. Statistical analysis showed no overall significant difference in the pain experienced by the two groups; however, the mean pain scores recorded following surgery showed a significantly different pattern over time, such that the experimental group consistently reported less pain following a foot massage than the control group. This study has attempted to explore the use of foot massage in a systematic way and is therefore a basis for further study.

Ambulatory Surgical Procedures↗

Therapeutic massage: an education program for rural and remote workers in the palliative care field.

This paper, drawing upon data from a Rural Health, Support, Education and Training (RHSET) funded project, focuses on the evaluation of a massage education program developed specifically for rural and remote palliative care workers. An 8 week pilot massage education course was run for palliative care workers in the Albury-Wodonga area and, from this course, an instructional video education package on massage has been developed. The program was evaluated by using a questionnaire, journals and focus group interviews. Feedback from participants was incorporated into both the pilot course and final education package, which was consistent with the action research framework. The major findings of the project were that skill development in the therapeutic use of massage was attained and that job satisfaction was indeed achieved by palliative care workers.

Attitude of Health Personnel↗

Repeated massage-like stimulation induces long-term effects on nociception: contribution of oxytocinergic mechanisms.

Massage-like stroking induces acute antinociceptive effects that can be reversed by an oxytocin antagonist, indicating activation of oxytocin on endogenous pain controlling systems. We now demonstrate an increase in hindpaw withdrawal latencies (HWLs), in response to thermal and mechanical stimuli, which was present after six treatments of massage-like stroking every other day and which continued to increase through the remaining seven treatments. Repeated massage-like stroking also resulted in increased oxytocin-like immunoreactivity (oxytocin-LI) levels in plasma and periaquaductal grey matter (PAG). Furthermore, increases in HWLs were also present after injections of oxytocin into the PAG (0.1, 0.5 and 1.0 nmol). Intra-PAG oxytocin injection of 1 nmol followed by 1 or 20 nmol of naloxone attenuated the increments in HWL. Also, there was a dose-dependent attenuation of the oxytocin-induced antinociceptive effects following intra-PAG injection of the mu-opioid antagonist beta-funaltrexamine (beta-FNA) and the kappa-opioid antagonist nor-binaltorphimine (nor-BNI) but not the delta-antagonist naltrindole. The long-term antinociceptive effects of massage-like stroking may be attributed, at least partly, to the oxytocinergic system and its interaction with the opioid system, especially the mu- and the kappa-receptors in the PAG.

Afferent Pathways↗

Changes in white blood cell counts in men undergoing thrice-weekly prostatic massage, microbial diagnosis and antimicrobial therapy for genitourinary complaints.

OBJECTIVE: To report changes in the white blood cell (WBC) counts in expressed prostatic secretions (EPS) in men with pelvic symptoms undergoing thrice-weekly prostatic massage combined with antimicrobial therapy. PATIENTS AND METHODS: The study comprised a retrospective analysis of the records of 35 patients (mean age 45.3 years, range 28-70, SD, 12.03) with pelvic pain, pain in the lower back, obstructive urinary symptoms, irritative urinary symptoms, or sexual dysfunction, who had undergone the same diagnosis and treatment protocol in a genitourinary clinic in Manila, Philippines, from September 1992 to September 1995. RESULTS: EPS were obtained 347 times in 35 patients (median 9 times per patient, range 6-16). In 26 of the 35 (74%) patients the WBC count in the EPS was < 10 per oil-immersion field (OIF, x1000) at the first prostatic massage. In 34 of 35 (97%) patients the WBC count rose to > or = 10 as prostatic massage continued on a thrice-weekly schedule. The mean (range, SD) initial WBC count in the EPS was 8.4 (1-48, 8.43) and the maximum was 40.9 (6-60, 19.05); the difference between these values was 32.5 (3-57, 18.78; 95% confidence interval 26.1-40.1) and the difference was statistically significant (paired t-test, P < 0.001). CONCLUSIONS: The classification of patients into those with prostatodynia or prostatitis based on one EPS examination is misleading and thrice-weekly massage of the prostate is better than a single collection of EPS to obtain the most purulent sample for Gram staining and culture.

Adult↗

[Randomised trial of acupuncture compared with conventional massage and "sham" laser acupuncture for treatment of chronic neck pain - range of motion analysis].

AIM: The aim of this study was to compare the effects of acupuncture on active motion of the cervical spine in patients with chronic neck pain with those of "sham" laser acupuncture and massage. MATERIAL AND METHODS: 177 patients with chronic neck pain were included in this prospective, randomized, placebo-controlled study. The patients were allocated by external randomization to five treatments over three weeks with acupuncture, massage and "sham" laser acupuncture. The range of active motion was measured by means of a 3D ultrasound real time motion analyzer. RESULTS: The analysis of cervical motion in three directions showed the largest increase in range of motion 14 days after acupuncture. Compared to massage, a significant improvement in total range of motion was seen in those patients treated by acupuncture immediately (p = 0,03) and one week (p = 0,03) weeks after therapy. There was no significant difference in those patients treated by sham laser acupuncture. CONCLUSION: The results of the study indicate that acupuncture is superior to conventional massage for improving active range of motion in patients with chronic neck pain. Because of its positive effects, its acceptance among patients and the lack of severe side effects, acupuncture can be recommended for the treatment of chronic neck pain, although there was no significant difference in results between "sham" laser acupuncture and acupuncture.

Acupuncture Therapy↗

Postburn itching, pain, and psychological symptoms are reduced with massage therapy.

Twenty patients with burn injuries were randomly assigned to a massage therapy or a standard treatment control group during the remodeling phase of wound healing. The massage therapy group received a 30-minute massage with cocoa butter to a closed, moderate-sized scar tissue area twice a week for 5 weeks. The massage therapy group reported reduced itching, pain, and anxiety and improved mood immediately after the first and last therapy sessions, and their ratings on these measures improved from the first day to the last day of the study.

Adult↗

Practice-based randomized controlled-comparison clinical trial of chiropractic adjustments and brief massage treatment at sites of subluxation in subjects with essential hypertension: pilot study.

OBJECTIVE: To determine the feasibility of conducting a randomized clinical trial in the private practice setting examining short- and long-term effects of chiropractic adjustments for subjects with essential hypertension compared with a brief soft tissue massage, as well as a nontreatment control group. DESIGN: Randomized controlled-comparison trial with 3 parallel groups. SETTING: Private practice outpatient chiropractic clinic. PATIENTS: Twenty-three subjects, aged 24 to 50 years with systolic or diastolic essential hypertension. INTERVENTIONS: Two months of full-spine chiropractic care (ie, Gonstead) consisting primarily of specific-contact, short-lever-arm adjustments delivered at motion segments exhibiting signs of subluxation. The massage group had a brief effleurage procedure delivered at localized regions of the spine believed to be exhibiting signs of subluxation. The nontreatment control group rested alone for a period of approximately 5 minutes in an adjustment room. MAIN OUTCOME MEASURES: Cost per enrolled subject, as well as systolic and diastolic blood pressure (BP) measured with a random-0 sphygmomanometer and patient reported health status (SF-36). Pilot study outcome measures also included an assessment of cooperation of subjects to randomization procedures and drop-out rates, recruitment effectiveness, analysis of temporal stability of BPs at the beginning of care, and the effects of inclusion/exclusion criteria on the subject pool. RESULTS: Thirty subjects enrolled, yielding a cost of $161 per enrolled subject. One subject was later determined to be ineligible, and 6 others dropped out. In both the chiropractic and massage therapy groups, all subjects were classified as either overweight or obese; in the control group there were only 2 classified as such. SF-36 profiles for the groups were similar to that of a normal population. The mean change in diastolic BP was -4 (95% confidence interval [CI]: -8.6, 0.5) in the chiropractic care group, 0.5 (95% CI: -3.5, 4.5) in the brief massage treatment group, and -4.9 (95% CI: -9.7, -0.1) in the no treatment control group. At the end of the study period, this change was -6.3 (95% CI: 13.1, 0.4), -1.0 (95% CI: -7.5, 15.6), -7.2 (95% CI: -13.3, -1.1) in the 3 study groups. The mean improvements in the chiropractic care and no treatment control groups remained consistent over the follow-up period. CONCLUSIONS: This pilot study elucidated several procedural issues that should be addressed before undertaking a full-scale clinical trial on the effects of chiropractic adjustments in patients with essential hypertension. A multidisciplinary approach to recruitment may need to be used in any future efforts because of the limited subject pool of patients who have hypertensive disease but are not taking medications for its control. Measures need to be used to assure comparable groups regarding prognostic variables such as weight. Studies such as these demonstrate the feasibility of conducting a full-scale 3-group randomized clinical trial in the private practice setting.

Adult↗

Effects of aromatherapy massage on anxiety and self-esteem in korean elderly women: a pilot study.

This study investigated the effects of aromatherapy massage on the anxiety and self-esteem experienced by Korean elderly women. A quasi-experimental, control group, pretest-posttest design was used. The subjects comprised 36 elderly females: 16 in the experimental group and 20 in the control group. Aromatherapy massage using lavender, chamomile, rosemary, and lemon was given to the experimental group only. Each massage session lasted 20 min, and was performed 3 times per week for two 3-week periods with an intervening 1-week break. The intervention produced significant differences in the anxiety and self-esteem and no significant differences in blood pressure or pulse rate between the two groups. These results suggest that aromatherapy massage exerts positive effects on anxiety and self-esteem. However, more objective, clinical measures should be applied in a future study with a randomized placebo-controlled design.

Aged↗

The motivation of massage therapy students to enter professional education.

In Ontario massage therapy is a regulated health profession, and it has been speculated that massage therapy students are motivated primarily by altruistic values, as has been documented in medicine. Students at Sutherland-Chan School and Teaching Clinic in Ontario were surveyed regarding their motivation to enter massage therapy education, with the intention of assessing the influence of certain value complexes on their decision. The results indicate that their decision was influenced more strongly by intrinsic values related to helping and working with people than by the prospect of extrinsic rewards (p < 0.0005). This supports a belief commonly held within the professional community, and bodies well for the future of massage therapy as a caring profession.

Career Choice↗

Clinical outcomes and patient perceptions of acupuncture and/or massage therapies in HIV-infected individuals.

This paper uses an innovative methodology to evaluate clinical outcomes and patient perceptions of acupuncture and massage therapies in an HIV medical outpatient setting. Using a quasi-experimental retrospective case control design, treatment subjects were matched by intake date and CD4 count with non-treatment subjects. All subjects had equal opportunity to access HAART therapies and other standard treatments for HIV. There were three treatment groups: acupuncture-only (n = 8), massage-only (n = 34) and acupuncture-and-massage (n = 21). Pre-treatment and post-treatment measures were compared within groups, and treatment and non-treatment group clinical outcomes were compared with each other. Using nonparametric statistical analysis, it was found that the means of the treatment groups' differences in pre- and post-CD4 counts showed improvement when compared with the non-treatment control group's pre- and post-CD4 counts. Treatment subjects were then interviewed and asked to rate their experiences of the therapies; the subjective experience was very positive. The reasons for these findings may be complex, including the possibility that some people may choose to manage their disease more aggressively, and may select a range of treatments. While no large claims are made for this study, these findings may be of interest both to clinicians and funders of acupuncture and/or massage therapies.

Acupuncture Therapy↗

Low back muscle activity in an automobile seat with a lumbar massage system.

This investigation was conducted to determine the effects of a massaging lumbar support system on low back muscle activity. The apparatus included a luxury-level automobile seat, six 10-mm diameter bipolar surface electrodes, an amplifier, an analog-to-digital conversion board, data acquisition software, and a personal computer. Six experimental conditions, each involving a variation of massage time, were considered. The dependent variable was the change in the root mean square variation of the EMG signal. One minute of lumbar massage every 5 min was found to have a beneficial effect on low back muscle activity (as compared to no massage). This may prove to be an extremely important result in the quest to combat low back pain attributable to automobile seating.

Analysis of Variance↗

An effect of body massage on voice loudness and phonation frequency in reading.

The effect of massage on voice fundamental frequency (F(0)) and sound pressure level (SPL) was investigated. Subjects were recorded while reading a 3-min passage of prose text. Then, a 30-min session of massage was administered by a trained naprapathy therapist. Sixteen subjects were given the massage, while 15 controls rested, lying down in silence for the same amount of time. The subjects were then recorded reading the same passage again. The F(0), and SPL averages across the whole passage were measured for the pre- and post-treatment recordings. In the post-massage recordings, subjects had lowered their F(0) by 1.1 semitones and their SPL by 1.0 dB, with very high statistical significance. The drop in F(0) was somewhat larger for the males than for the females. The control subjects showed no effect at all.

Adult↗

Practice patterns of massage therapists.

OBJECTIVES: To describe the practice patterns of licensed massage therapists (LMTs). DESIGN: Cross-sectional survey. SUBJECTS: One hundred and twenty-six (126) massage practices randomly selected from the Greater Boston Area yellow pages. OUTCOMES MEASURES: Practitioner demographics, training, practice characteristics, and fees. RESULTS: The response rate was 65%. Most respondents were Caucasian (95%) and female (80%). Their mean age was 41 years old. Half held a college degree; on average, practitioners received 1000 hours of training in massage therapy. The majority were in group practices (59%) and saw an average of 20 patients per week. The typical visit lasted 50-60 minutes; the cost was $60 and rarely covered by insurance (5%). Half of respondents offered sliding scales to patients, but only 11% accepted Medicaid patients. Respondents reported less than 1 visit per week from pediatric and adolescent patients (<21 years old). CONCLUSIONS: Most LMTs are female and Caucasian. The costs of massage therapy are almost entirely paid out-of-pocket by patients (95%). LMTs infrequently care for children.

Adult↗

Heart rate and blood pressure responses to carotid sinus massage in healthy elderly subjects.

The purpose of the study was to define heart rate and blood pressure responses to supine and upright carotid sinus massage in healthy elderly subjects and thus to establish the validity of current diagnostic criteria for carotid sinus syndrome in this age group. Twenty-five healthy asymptomatic subjects (61-87 years) had carotid sinus massage carried out following a standardized technique employing previously defined criteria for abnormal heart rate and blood pressure responses: 3 s asystole and a 50 mmHg fall in systolic blood pressure independent of any heart rate slowing (after intravenous atropine). No cardioinhibitory responses of greater than 3 s were documented. The mean maximal cardioinhibitory response was 1038 +/- 195 msec. Right-sided responses were more marked than left when upright (1040 +/- 202 vs. 946 +/- 135 msec; p < 0.01) but not when supine (1094 +/- 215 vs. 1073 +/- 194 msec; NS). After atropine three subjects (12%) had a significant vasodepressor response when upright, but none when supine. The mean maximal vasodepressor response was 21 +/- 14 mmHg. Right-sided blood pressure responses were more marked than left (p < 0.01). There was no fixed relationship between maximum heart rate slowing and the degree of vasodepression during massage (range 2-80 msec/mmHg). The diagnostic criteria for heart rate and blood pressure responses in carotid sinus syndrome are appropriate for supine carotid sinus massage in elderly subjects. Asymptomatic vasodepressor responses occur in a small proportion of healthy elderly when upright.

Aged↗