Healing Touch
Guided Imagery
Massage Therapy
AROMATHERAPY Research Summaries
Ceccarelli I, Lariviere WR, Fiorenzani P, Sacerdote P, Aloisi AM. Brain Res. 2004 Mar 19;1001(1-2):78-86. Effects of long-term exposure of lemon essential oil odor on behavioral, hormonal and neuronal parameters in male and female rats.
Rats were given lemon oil aromatherapy for two weeks and measures of stress, anxiety and pain were tracked. Decreased pain behavior and lower corticosterone (a stress hormone) was noted. Conclusion: Lemon EO seems to increase pain threshold, decrease anxiety and decrease physiologic markers of stress.
Anderson LA, Gross JB. Aromatherapy with peppermint, isopropyl alcohol or placebo is equally effective in relieving postoperative nausea. Jrl of Perianesthesia Nursing 2004;19(1): 29-35.
33 patients who underwent surgical procedures, 85% of whom had GA, who reported nausea postop were randomly given aromatherapy with either peppermint EO, saline, or IPA. VAS nausea scale used to track nausea sx's, decreased IV antinausea medication use by 50% , satisfaction with aromatherapy was high and correlated with relief of nausea, 93% of patients stated they would try aromatherapy again if post op nausea. IPA, peppermint and saline inhalation were all equally effective.
For cost savings- This study decreased antinausea medication use by 50%- 52% of study participants didn't need rescue Zofran
Toda M, Morimoto K. Effect of lavender aroma on salivary endocrinological stress markers. Archives of Oral Biology 2008;53:964-68.
30 human subjects did stressful mental tasks with half receiving lavender EO aromatherapy in between tasks. Measurement of salivary cortisol and chromogranin (another stress chemical released with catecholamines) were performed. Cortisol levels were lower in the armonatherapy group but not statistically significant, but there was statistically significant lowering of chomogranin. Lavender EO can have a stress reduction effect.
Lewith GT, Godfrey AD, Prescott P. A single-blinded, randomized pilot study evaluating the aroma of Lavandula augustifolia as a treatment for mild insomnia. J Altern Complement Med 2005;11:631-7.
Ten (10) volunteers (5 male and 5 female) were entered and completed the 4 week study- used lavender EO aromatherapy nightly for a week. Pittsburg Sleep Quality Index showed improvement of -2.5 points (greater than 5 on the scale indicates insomnia). Each intervention was equally credible and belief in CAM did not predict outcome. Women and younger volunteers with a milder insomnia improved more than others. No period or carry-over effect was observed.
Herz R. Aromatherapy facts and fictions: a scientific analysis of olfactory effects on mood, physiology and behavior. International Jrl of Neuroscience 2009;119:263-290.
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Lavender EO exposed patients- EEG findings consistent with sedated state.
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Lavender EO exposed patients undergoing 20 min stressful situation- improved mood
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Orange Oil EO in patients undergoing stressful procedure- decreased anxiety, improved mood.
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Peppermint EO exposed patients during 15 min treadmill test- reduced perceived workload
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Pleasant odor exposures- positive autonomic nervous system responses were associated with pleasing odors- HR decreased.
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Pleasant odor exposures with painful stimulus exposures in patients- self-selected pleasant odors improved mood, decreased anxiety and decreased experience of pain.
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Even suggestion that an odor will create a pleasant experience has a positive effect.-if odor described as "stimulating", HR and skin conductance increased. If described as "relaxing", HR and skin conductance decreased.
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Lavender or orange EO exposed patients undergoing stressful procedure- decreased anxiety, improved mood, increased sense of calmness.
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Lavender EO and effect of sleep on patients- increased slow-wave sleep, patients reported increased vigor on awakening compared to controls.
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Peppermint EO and patients undergoing sleep study- peppermint EO reduced fatigue and depression for all subjects.
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Participants who worked in the presence of a pleasant ambient odor reported higher efficacy, higher goal setting and more efficient work strategies.
Theories of mechanism of action for aromatherapy- Odors have direct and intrinsic ability to interact and affect the autonomic NS/ CNS and endocrine systems. Responses to odors are immediate. Psychological perception of the odorant, not the chemical structure of the molecule, is important
Only two synapses separate the olfactory nerve from the amygdala (structure that controls the expression/experience of human emotion/emotional memory)
Three synapses separate olfactory nerve from the hippocampus, brain structure that controls selection/transmission of working memory information, long-and short-term information transfer.
Kiecolt JK, Graham JE, MalarkeyWB et al. Olfactory influences on mood and autonomic, endocrine and immune function. Psychoneuroimmunology 2008;33:328-339.
56 men and women exposed to either lemon EO (stimulatory) or lavender EO (relaxant odor). Lemon EO increased positive mood, and increased levels of norepinepherine for 20 minutes after exposure...consistent with systemic effects theory that specific scents can evoke catecholamine changes.
Shiina Y, Funabashi N, Lee K et al. Relaxation effects of lavender aromatherapy improve coronary blood flow velocity reserve (CFVR) in healthy men evaluated by transthoracic Doppler echocardiography. International Jrl Cardiology 2008;129:193-7.
Single- blinded (operator) study of 30 healthy men with no cardiac history got baseline echo to measure CFVR (physiologic index for coronary microcirculation), baseline serum cortisol, then received lavender EO aromatherapy for 30 minutes. Statistically significant decrease in serum cortisol, and improved CFVR consistent with relaxation effects and beneficial effects on coronary circulation.
Marmaril ME, Windle PE, Burkard JF. Prevention and management of postoperative nausea and vomiting: a look at complementary techniques. Jrl Perianesthesia Nursing 2006;21(6):404-410. Highlights role of isopropyl alcohol (IPA) inhalation for treatment of postop N/V. IPA may affect neurotransmitters that activate the chemoreceptor trigger zone (CTZ) that stimulate N/V. 2003 study- IPA inhalation provided faster relief than IV odansetron in RDBCT of 100 women who had GYN laproscopic surgery.
Healing Touch References
Cook, C. A., Guerrerio, J. F. & Slater, V. E. (2004). Healing touch and quality of life in women receiving radiation treatment for cancer: A randomized controlled trial. Alternative Therapies in Health and Medicine, 10(3), 34-41. Level II.
78 women with a new diagnosis of breast or gynecological cancer were included in a single blind RCT with N=34 HT, N=28 MT (mock). 6 sessions were given for 30 min each after radiation therapy, from trained practitioner or lay-person. QOL, vitality, pain and function were measured. Vitality, pain and physical function showed a significant increase between HT and mock HT. QOL changes in emotional role function, mental health and health transition measures were observed.
Dowd, T., Kolcaba, K., Steiner, R. & Fashinpaur, D. (2007). Comparison of a healing touch, coaching, and a combined intervention on comfort and stress in younger college students. Holistic Nursing Practice, 21(4), 194-202.Level IV.
Three nursing interventions to increase total comfort and reduce stress-related events in young college students experiencing stress were compared. Healing Touch, coaching, and a combination of both, were compared to a waitlist. For comfort and stress, Healing Touch had better immediate results, while coaching had better carryover effects
Dowd, T., Kolcaba, K., & Steiner, R. (2006). Development of the healing touch comfort questionnaire. Holistic Nursing Practice, 20(3), 122-9. Level IV.
This study provided preliminary evidence for internal consistency reliability (Cronbach alpha = .94) of the newly developed Healing Touch Comfort Questionnaire. Fifty-six Healing Touch (HT) recipients (51 women and 5 men with a mean age of 51) completed the questionnaire. Participants with more than 4 HT treatments had higher comfort levels than those with fewer than 4.
Gronowicz, G. A., Jhaveri, A., Clarke, L. W., Aronow, M. S. & Smith, T. H. (2008). Therapeutic touch stimulates the proliferation of human cells in culture. Journal of Alternative & Complementary Medicine, 14(3), 233-239. Level II.
The effect of Therapeutic Touch (TT) on the proliferation of normal human cells in culture compared to sham and no treatment was assessed. TT administered twice a week for 2 weeks significantly stimulated proliferation of fibroblasts, tenocytes, and osteoblasts in culture (p = 0.04, 0.01, and 0.01, respectively) compared to untreated control. A specific pattern of TT treatment produced a significant increase in proliferation of some cell types.
Hawranik, P., Johnston, P., & Deatrich, J. (2008). Therapeutic touch and agitation in individuals with Alzheimer's disease. Western Journal of Nursing Research, 30(4), 417-34. Level II.
Fifty-one residents of a long-term care facility with Alzheimer's disease were randomly assigned to one of three intervention groups. A multiple time series, blinded, experimental design was used to compare the effectiveness of therapeutic touch, simulated therapeutic touch, and usual care on disruptive behavior. Physical nonaggressive behaviors decreased significantly in those residents who received therapeutic touch compared with those who received the simulated version and the usual care.
Jackson, E., Kelley, M., McNeil, P., Meyer, E., Schlegel, L., & Eaton, M. (2008). Does therapeutic touch help reduce pain and anxiety in patients with cancer? Clinical Journal of Oncology Nursing, 12(1), 113-120. Level I.
Using 12 research studies, the authors examined the evidence concerning the effectiveness of therapeutic touch in reducing pain and anxiety. The research indicates that the therapy does help reduce pain and anxiety. Evidence demonstrates that the body and mind may experience increased health with TT.
Jhaveri, A, S., Walsh, J., Wang, Y., McCarthy, M., & Gronowicz, G.. (2008). Therapeutic touch affects DNA synthesis and mineralization of human osteoblasts in culture. Journal of Orthopaedic Research, 26(11), 1541-6. Level II.
Therapeutic Touch was assessed for effect on osteoblast proliferation, differentiation, and mineralization in vitro. TT was performed twice a week for 10 min each on human osteoblasts (HOBs) and on an osteosarcoma-derived cell line, SaOs-2. Therapeutic Touch was shown to increase human osteoblast DNA synthesis, differentiation and mineralization, and decrease differentiation and mineralization in a human osteosarcoma-derived cell line.
Krucoff, M. W., Crater, S. W., Gallup, D. Blankenship, J. C., Cuffe, M., Guarneri, M. et al. (2005). Music, imagery, touch, and prayer as adjuncts to interventional cardiac care: the Monitoring and Actualisation of Noetic Trainings (MANTRA) II randomised study. Lancet, 366(9481), 211-7.Level II.
748 patients undergoing percutaneous coronary intervention or elective catheterisation in nine USA centres were assigned in a 2x2 factorial randomisation either off-site prayer by established congregations of various religions or no off-site prayer (double-blinded) and MIT therapy or none (unmasked). Mortality at 6 months was lower with MIT therapy than with no MIT therapy. Neither masked prayer nor MIT therapy significantly improved clinical outcome after elective catheterisation or percutaneous coronary intervention.
Kshettry, V. R., Carole, L. F., Henly, S. J., Sendelbach, S. & Kummer, B. (2006). Complementary alternative medical therapies for heart surgery patients: feasibility, safety, and impact. Annals of Thoracic Surgery. 81(1), 201-5.Level II.
One hundred four patients undergoing open heart surgery were prospectively randomized to receive either complementary therapy (preoperative guided imagery training with gentle touch or light massage and postoperative music with gentle touch or light massage and guided imagery) or standard care. Pretreatment and post treatment pain and tension scores decreased significantly in the complementary alternative medical therapies group on postoperative days 1. Complementary medical therapy was not associated with safety concerns and appeared to reduce pain and tension during early recovery from open heart surgery.
Lafreniere, K. D., Mutus, B., Cameron, S., Tannous, M., Giannotti, M., Abu-Zahra, H. et al. (1999). Effects of therapeutic taouch on biochemical and mood indicators in women. Journal of Alternative and Complimentary Medicine, 5(4), 367-370.Level II.
41 female volunteers were assessed for hormones and neurotransmitter levels in an RCT. TT group showed a significant decrease in mood disturbances, tension, confusion, anxiety, and NO. Increase in vigor seen.
Lin, Y., & Taylor, A. G. (1998). Effects of therapeutic touch in reducing pain and anxiety in an elderly population. Integrative Medicine, 1(4), 155-62.
TT shown to be more effective than mock TT for mixed musculoskeletal problems.
MacIntyre, B., Hamilton, J., Fricke, T., Ma, W., Mehle, S., & Michel, M. (2008). The efficacy of healing touch in coronary artery bypass surgery recovery: a randomized clinical trial. Alternative Therapies in Health & Medicine. 14(4), 24-32.Level III
237 Patients undergoing first-time elective coronary artery bypass surgery were randomized into 1 of 3 treatment groups: no intervention, partial intervention (visitors), and an HT group. All HT patients showed a greater decrease in anxiety scores when compared to the visitor and control groups. In addition, there was a significant difference in outpatient HT length of stay.
MacNeil, M. S. (2006). Therapeutic touch, pain, and caring: implications for nursing practice. International Journal for Human Caring, 10(1), 40-8. Level VI.
This descriptive study was to investigate therapeutic touch (TT) on adult tension headache pain. Ten tension headache pain sufferers were randomly assigned to control and experimental groups. Results suggested that one application of TT was useful in reducing tension headache pain in all subjects who received authentic TT.
Mackenzie, G., Sample, S., Macdonald, J. (2007). Twenty years of therapeutic touch in a Canadian cancer agency: lessons learned from a case study of integrative oncology practice. Supportive Care in Cancer, 15 (8), 993-998. Level VII.
The objectives are to describe TT practice within a conventional cancer agency and to identify the important issues and success factors of this program and, secondly, to discuss TT research and our approach to the issues. TT is a safe and beneficial intervention for cancer patients that can be integrated within a conventional setting, providing that the program evolves with changing patient and organizational needs. Lessons gleaned include (1) positioning TT within the context of research and evidence-based practice, (2) developing and adhering to standards of practice and professionalism, and (3) maintaining a nonpartisan attitude and communicating a plausible rationale.
Maville, J. A., Bowen, J. E., & Benham, G. (2008). Effect of healing touch on stress perception and biological correlates. Holistic Nursing Practice, 22 (2), 103-110.
The article focuses on a study that examines the effect of healing touch treatment for stress in healthy adults. The study emphasizes that healing touch can alter anxiety and physiological measures of the heart rate, blood pressure, muscle tension, skin conductance and skin temperature. The result of the treatment is connected with both physiological and psychological relaxation. Movaffaghi, Z., Hasanpoor, M., Farsi, M., Hooshmand, P. & Abrishami, F. (2006). Effects of therapeutic touch on blood hemoglobin and hematocrit level. Journal of Holistic Nursing. 24(1), 41-8. Level IV.
This study investigated the effects of TT on hemoglobin and hematocrit level in students who were basically healthy. The volunteers with a hemoglobin level less than 12 grams per deciliter (g/dl) were randomly assigned to three groups of TT, mimic therapeutic touch (MT), and control. It was found that TT increased hemoglobin more effectively than MT.
Post-White, J., Kinney, M. E., Savik, K., Gau, J. B., Wilcox, C. & Lerner, I. (2003). Therapeutic massage and healing touch improve symptoms in cancer. Integrative Cancer Therapies, 2(4), 332-344.
164 patients undergoing chemotherapy showed a decrease in blood pressure, pain, and fatigue, and increased mood in a randomized prospective 2 period crossover design to measure HT presence and therapeutic massage.
Seskevich, J. E., Crater, S.W., Lane, J. D., & Krucof, M.W. (2004). Beneficial effects of noetic therapies on mood before percutaneous intervention for unstable coronary syndromes. Nursing Research, 53(2), 116-21. Level II.
150 cardiac patients were randomized to one of five treatment groups: no treatment, imagery, stress management, prayer and HT provided for 30 minutes sessions before cardiac intervention. HT was shown to decrease worry and increase satisfaction. They found HT to be more effective than other modalities tested, and showed it is possible to use HT in the hectic environment of a coronary unit.
So, P. S., Jiang, Y.Touch therapies for pain relief in children and adults. CochraneDatabase of Systematic Reviews 2008. Issue 2, Art. No.: CD006535. DOI: 10.1002/14651858.CD006535.Level I.
The purpose of this review was to evaluate the effectiveness of touch therapies (including HT, TT, and Reiki) on relieving both acute and chronic pain; to determine any adverse effect of touch therapies. Participants exposed to touch had on average of 0.83 units (on a 0 to ten scale) lower pain intensity than unexposed participants. Results of trials conducted by more experienced practitioners appeared to yield greater effects in pain reduction. Two of the five studies evaluating analgesic usage supported the claim that touch therapies minimized analgesic usage.
Wardell, D. W., Rintala, D. H., Duan, Z., & Tan, G. (2006). A pilot study of healing touch and progressive relaxation for chronic neuropathic pain in persons with spinal cord injury. Journal of Holistic Nursing, 24 (4), 231-40.
This pilot study assessed the role of Healing Touch (HT), an energy-based therapy, in modulating chronic neuropathic pain and the associated psychological distress from post spinal cord injury. Twelve veterans were assigned to either HT or guided progressive relaxation for six weekly home visits. The study showed increased well-being in the HT group. Participants reported various experiences with HT sessions indicating that it may have benefit in the complex response to chronic pain.
Weze, F., Leathard, H. L., Grange, J., Tiplady, R., & Stevens, G. (2004). Evaluation of healing by gentle touch in 35 clients with cancer. European Journal of Oncology Nursing, 8(1), 40-49.Level IV.
Wilkinson, D. S., Knox, P. I., Chatman, J. E., Barbour, V., Myles, Y., et al. (2002). The clinical effectiveness of healing touch. Journal of Alternative and Complimentary Medicine, 8(1), 33-41
22 patients randomized to discover if level of training in HT is related to its effectiveness. The study found an increase in IgA by more experienced practitioners, and a decrease in stress. 55% experienced pain relief with p=0.109. Greater positive changes were seen for those with highly trained practitioners.
Wood,s D. L., Craven, R. F., & Whitney, J. (2005). The effect of therapeutic touch on behavioral symptoms of persons with dementia. Alternative Therapies in Health & Medicine, 11(1), 66-74.Level II.
The objective was to examine the effect of therapeutic touch on the frequency and intensity of behavioral symptoms of dementia. A randomized, double-blind, three-group experimental study: experimental (therapeutic touch), placebo (placebo therapeutic touch), and control (usual care).
Fifty-seven residents, were randomized to one of the three groups The intervention consisted of therapeutic touch given twice daily for 5-7 minutes for three days. Analysis of variance indicated a significant difference in overall behavioral symptoms of dementia, manual manipulation and vocalization. The experimental (significant) was more effective in decreasing behavioral symptoms of dementia than usual care.
Guided Imagery Research Summaries
The aim of this study was to gather information on the immediate and long-term effects of six sessions of group Progressive Muscle Relaxation with Guided Imagery on the psychological distress of self-referred cancer patients. 86 patients' psychological distress and coping with cancer showed improvement on the Impact of Events Scale (IES), and the Brief Symptom Inventory (BSI), which was maintained over the next 6 months in 58 patients who continued assessment through the follow-up period.
The purpose of this clinical investigation was to explore the effect of guided imagery on pelvic pain and urinary symptoms in women with IC symptoms. Thirty women with diagnosed IC were randomized into 2 equal groups. One group (treatment) listened to a 25-minute guided imagery compact disc (CD), twice a day for 8 weeks. The control group rested for 25 minutes twice daily for 8 weeks. More than 45% of the treatment group were responders to guided imagery therapy noting a moderate or marked improvement on the global response assessment. Pain scores and episodes of urgency significantly decreased in the treatment group. Guided imagery is an intervention without negative side-effects, is readily available, and shows a trend toward improvement of IC symptoms.
To determine whether pulmonary function, asthma symptoms, quality of life, depression, anxiety, and power differ over time in adults with asthma who do and do not practice mental imagery (MI). Sixty-eight adults with symptomatic asthma, after 4 weeks of baseline data collection and analysis, met requirements for this randomized controlled study. There was little evidence of statistical change in this feasibility study; yet, valuable lessons were learned. 47% in the MI group reduced or discontinued their medications compared to 19% in the control group reduced their medications. The study also demonstrated that imagery is inexpensive, safe and, with training, can be used as an adjunct therapy by patients themselves.
Eighty women undergoing multimodality treatment for large (>4cm) or locally advanced (T3, T4, Tx, N2), breast cancers participated in a randomized controlled trial (RCT) to evaluate the immuno-modulatory effects of relaxation training and guided imagery. Significant between-group differences were found in the number of CD25+ (activated T cells) and CD56+ (LAK cell) subsets. The number of CD3+ (mature) T cells was significantly higher following chemotherapy and radiotherapy, in patients randomized to relaxation and guided imagery. Using a median split, women who rated their imagery ratings highly had elevated levels of NK cell activity at the end of chemotherapy and at follow-up. Relaxation training and guided imagery beneficially altered putative anti-cancer host defenses during and after multimodality therapy.
In 1998, the cardiac surgery team implemented a guided imagery program to compare cardiac surgical outcomes between two groups of patients: with and without guided imagery. Data from the hospital financial cost/accounting database and patient satisfaction data were collected and matched to the two groups of patients. A questionnaire was developed to assess the benefits of the guided imagery program to those who elected to participate in it. Patients who completed the guided imagery program had a shorter average length of stay, a decrease in average direct pharmacy costs, and a decrease in average direct pain medication costs while maintaining high overall patient satisfaction with the care and treatment provided.
This un-blinded experimental study investigated the effectiveness of imagery, in addition to routine analgesics, in reducing tonsillectomy and/or adenoidectomy pain and anxiety after ambulatory surgery (AS) and at home. Seventy-three children, aged 7-12, were recruited from five AS settings. The study showed significantly lower pain and anxiety in the treatment group 1-4 h after surgery, but not 22-27 h after discharge.
Data from a pilot study suggested that noetic therapies-healing practices that are not mediated by tangible elements-can reduce pre-procedural distress and might affect outcomes in patients undergoing percutaneous coronary intervention. 748 patients undergoing percutaneous coronary intervention or elective catheterization in nine USA centers were assigned in a 2x2 factorial randomization either off-site prayer by established congregations of various religions or no off-site prayer (double-blinded) and music, imagery, touch (MIT) therapy or none (unmasked). Mortality at 6 months was lower with MIT therapy than with no MIT therapy.
An experimental pilot study was conducted to determine the effects of guided imagery and music therapy on postoperative pain, PONV, and length of stay for GYN laparoscopic patients (n = 84). During the perioperative period, patients were randomly assigned to one of 3 interventions: guided imagery audiotapes (GI), music audiotapes (MU), or standard care (C), and outcome measures were evaluated. Results indicated that patients in both the guided imagery and music groups had significantly less pain on PACU discharge to home than the patients in the control group.
The randomized study aimed to determine the efficacy of psychological intervention consisting of relaxation and guided imagery to reduce anxiety and depression in gynecologic and breast cancer patients undergoing brachytherapy during hospitalization. Sixty-six patients programmed to receive brachytherapy. The study group demonstrated a statistically significant reduction in anxiety, depression and body discomfort compared with the control group.
Descriptive comparative and correlational design using surveys and chart audits was used to compare pain and anxiety in sixty-five orthopedic patients scheduled for elective total hip or knee arthroplasty who have received a kit of non-pharmacologic strategies for pain and anxiety in addition to their regularly prescribed analgesics to those who receive the usual pharmacologic management alone. The study showed providing a kit of non-pharmacologic strategies can increase the use of these methods for postoperative pain and anxiety and decrease the amount of opioid taken.
This study aimed to test the efficacy of imagery and relaxation in hospitalized children's postoperative pain relief. Sixty children aged 8-12 years who had undergone appendectomy or upper/lower limb surgery and had been randomly assigned to the experimental group (n(1) = 30) listened to an imagery trip CD, whereas those in the control group (n(2) = 30) received standard care. The children in the experimental group reported having significantly less pain (p < .001) than the control children. The imagery trip CD can be used to reduce children's postoperative pain in a hospital setting, although its effect is short-lasting.
In this review non-pharmacological aspects of acute pain management were examined under two headings: 1. Psychological approaches: including preoperative information giving, cognitive methods, relaxation training, distraction, guided imagery, humor, hypnosis, music and biofeedback. 2. Complementary therapies and other techniques: including both hands on and other physical therapies using equipment: massage, aromatherapy, reflex zone therapy, acupuncture, shiatsu, therapeutic touch and TENS. There is a sound body of knowledge to support the use of many of the established non-pharmacological methods in the management of acute pain. These include: appropriate preoperative information giving, preoperative relaxation, guided imagery and breathing training, cognitive reframing, distraction in both visual and auditory (music) forms, massage, acupuncture, TENS.
The purpose of this study was to determine if the addition of guided imagery to a standard antiemetic regimen decreased nausea, vomiting, and retching occurrence and distress in patients receiving cisplatin-based chemotherapy. A convenience sample of patients (N = 28) was selected from an oncologist's patient population and randomized into two groups. The guided-imagery group expressed a significantly more positive experience with chemotherapy.
This study evaluated the therapeutic effect of guided imagery on 22 children, aged 5-18 years with recurrent abdominal pain. Children who learned guided imagery with progressive muscle relaxation had significantly greater decrease in the number of days with pain than those learning breathing exercises alone and significantly greater decrease in days with missed activities at one and two months.
Massage Therapy Research Summaries
Anderson, P. G., Cutshall, S. M. (2007). Massage therapy: a comfort intervention for cardiac surgery patients. Clinical Nurse Specialist, 21(3), 161-165.
This article provides an overview of the benefits of massage in the reduction of pain, anxiety, and tension in cardiac surgical patients. Reports of benefits seen with integration of massage in 1 cardiac surgical unit as part of evidence-based practice initiative for management of pain are described.
Billhult, A., Lindholm, C., Gunnarsson, R., & Stener-Victorin, E. (2009). The effect of massage on immune function and stress in women with breast cancer: A randomized controlled trial. Autonomic Neurosciences.
This randomized controlled study compares the short-term effects of light pressure effleurage on circulating lymphocytes, salivary cortisol levels, heart rate and blood pressure in patients with breast cancer compared to a control group. Thirty women, aged 50 to 75 years were enrolled. A short-term effect on NK cell activity, systolic blood pressure and heart rate was shown.
Billhult, A., Bergbom, I., & Stener-Victorin, E. (2007). Massage relieves nausea in women with breast cancer who are undergoing chemotherapy. Complementary Medicine, 13(1), 53-57.
The aim of this single-center, prosoective, randomized controlled trial was to examine the effect of massage on nausea, anxiety, and depression in patients with breast cancer undergoing chemotherapy. Thirty-nine (39) women (mean age = 51.8) with breast cancer undergoing chemotherapy were enrolled. Massage treatment significantly reduced nausea compared with control treatment.
Currin, J. & Meister, E. A. (2008). A hospital-based intervention using massage to reduce distress among oncology patients. Cancer Nursing, 31i(3), 214-221.
The objective of this study was to assess the impact of a Swedish massage intervention on oncology patients' perceived level of distress. A total of 251 oncology patients volunteered to participate in this nonrandomized single-group pre- and post design study for over a 3-year period at a university hospital setting in southeastern Georgia. The analysis found a statistically significant reduction in patient-reported distress for all 4 measures: pain, physical discomfort, emotional discomfort, and fatigue. This reduction in patient distress was observed regardless of gender, age, ethnicity, or cancer type. These results lend support for the inclusion of a complementary massage therapy program for hospitalized oncology patients as a means of enhancing their course of treatment.
Flaherty, J. H. (2008). Insomnia among hospitalized older persons. Clinical Geriatric Medicine, 24(1), 51-67.
This paper presents evidence supporting the use of non-pharmacologic interventions, which are preferable to the use of sedating drugs because of the risk associated with their use.
Garner, B., Phillips, L. J., Schmidt, H. M., Markulev, C., O'Connor, J., Wood, S. J., Berger, G. E., Burnett, P., & McGorry, P. D. (2008). Pilot study evaluating the effect of massage therapy on stress, anxiety and aggression in a young adult psychiatric inpatient unit. Australian New Zealand Journal of Psychiatry, 42(5), 414-422.
The aim of the present pilot study was to examine the effectiveness of a relaxation massage therapy program in reducing stress, anxiety and aggression on a young adult psychiatric inpatient unit. This was a prospective, non-randomized intervention study comparing treatment as usual (TAU) with TAU plus massage therapy intervention (MT). Massage therapy had immediate beneficial effects on anxiety-related measures and may be a useful de-escalating tool for reducing stress and anxiety in acutely hospitalized psychiatric patients.
Jane, S. W., Wilkie, D. J., Gallucci, B. B., & Beaton, R. D. (2008). Systematic review of massage intervention for adult patients with cancer: a methodological perspective. Cancer Nursing, 31(6), E24-35.
Findings from studies of massage, one of the most commonly used non-pharmacological nursing interventions for managing cancer pain, are inconsistent. The purpose of this article was to elucidate the methodological underpinnings of these inconsistencies with a systematic review of study design, methods, and massage efficacy in adult patients with cancer. Areas for future study include determination of appropriate cutoff values of selected outcome measures, delivery of equal doses along with standardized massage protocols, examination of length of massage effects over time, and use of single-blinding randomized clinical trials with large sample sizes.
Livingston, K., Beider, S., Kant, A. J., Gallardo, C. C., Joseph, M. H., & Gold, J. I. (2007). Touch and massage for medically fragile infants. Evidence Based Complementary Alternative Medicine.
The purpose of this study was to develop, implement and demonstrate the feasibility and safety of a parent-trained compassionate touch/massage program for infants with complex medical conditions and to conduct a longitudinal randomized control trial (RCT) of hand containment/massage versus standard of care. Preliminary data from this study indicates feasibility and safety of infant massage and satisfaction among the caregivers, CIMIs and the nurses in the CNICC. An important contribution from this study was the demonstration of the infants' safety based on physiological stability and no change in agitation/pain scores of the infants receiving massage.
Lemanek, K. L., Ranalli, M., & Lukens, C. (2009). A randomized controlled trial of massage therapy in children with sickle cell disease. Journal of Pediatric Psychology.
This randomized controlled trial investigated the short-term effects of massage therapy on youth with SCD and their parents. Thirty-four children and adolescents, and their parents were assigned to a massage therapy or an attention control group. Youth in the massage therapy group showed higher levels of functional status, and lower levels of depression, anxiety, and pain.
Mackereth, P. A., Booth, K., Hillier, V. F., & Caress, A. L. (2009). Reflexology and progressive muscle relaxation training for people with multiple sclerosis: a crossover trial. Complementary Therapeutic Clinical Practice, 15(1), 14-21.
This study compared the effects of reflexology and progressive muscle relaxation training for n=50 people with multiple sclerosis, provided by nurse therapists, on psychological and physical outcomes. A crossover design was chosen with a 4-week break between treatment phases. Salivary cortisol levels, State Anxiety Inventory, systolic and diastolic blood pressure and heart rate data were collected pre and post the weekly sessions. Positive effects of both treatments following sessions and over the 6 weeks of treatment are reported, with limited evidence of difference between the two treatments, complicated by ordering effects.
Mendes, E. W., & Procianov, R. S. (2008). Massage therapy reduces hospital stay and occurrence of late-onset sepsis in very preterm neonates. Journal of Perinatology, 28(12), 815-820.
A randomized study was performed including infants of birth weight >or=750 and Hinshaw, D. B. (2007). Acute postoperative pain management using massage as an adjuvant therapy: a randomized trial. Archives of Surgery, 142(12), 1158-1167.
This randomized controlled trial explored the effects of adjuvant massage therapy on pain management and postoperative anxiety. Six hundred five veterans (mean age, 64 years) undergoing major surgery were assigned to (1) control (routine care), (2) individualized attention from a massage therapist (20 minutes), or (3) back massage by a massage therapist each evening for up to 5 postoperative days. Patients in the massage group experienced short-term decreases in pain intensity, pain unpleasantness, and anxiety. In addition, patients in the massage group experienced a faster rate of decrease in pain intensity and unpleasantness during the first 4 postoperative days compared with the control group.
