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Stewart-Richardson JL, Hopf SC, Crockett J, Southwell P. What is Effective in Massage Therapy? Well, "It Depends…": a Qualitative Study of Experienced Orthopaedic Massage Therapists. Int J Ther Massage Bodywork 2024; 17:4-18. [PMID: 38486839 PMCID: PMC10911828 DOI: 10.3822/ijtmb.v17i1.935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024] Open
Abstract
Background Massage has been used as a treatment for musculoskeletal pain throughout history and across cultures, and yet most meta-analyses have only shown weak support for the efficacy of massage. There is a recognised need for more research in foundational questions including: how massage treatments are constructed; what therapists actually do within a treatment, including their clinical reasoning; and what role therapists play in determining the effectiveness of a massage treatment. Purpose The aim of this study was to explore what experienced orthopaedic massage therapists consider to be the aspects of their work that contribute to effectiveness. Setting and Participants Semi-structured interviews were conducted via Zoom with six experienced orthopaedic massage therapists in Australia. Research Design The interviews were analysed using inductive thematic analysis, seeking insights that might be practically applied, rather than theory-driven interpretations. Results The participants focused on the underlying differences between clients, between therapists, and between treatments, and clearly indicated that this concept of "difference" was foundational to their view of their work and was the underlying context for the comments they made. Within that frame of "difference", three key themes were interpreted from the data: (1) "Everyone is different so every treatment is different": how they individualised treatment based on these differences; (2) "How therapists cope with difference": how they managed the challenges of working in this context; and (3) "What makes a difference": the problem-solving processes they used to target each treatment to meeting the client's needs. Conclusions Participants did not identify specific techniques or modalities as "effective" or not. Rather, a therapist's ability to provide effective treatment was based on an iterative process of treatment and assessment that allowed them to focus on the individual needs of the client. In this case "effectiveness" could be considered a process rather than a specific massage technique.
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Affiliation(s)
- Jennifer L. Stewart-Richardson
- School of Allied Health, Exercise and Sport Sciences, Charles Sturt University, Albury
- Canberra Myotherapy (private practice), Canberra
| | - Suzanne C. Hopf
- School of Allied Health, Exercise and Sport Sciences, Charles Sturt University, Albury
| | - Judith Crockett
- School of Allied Health, Exercise and Sport Sciences, Charles Sturt University, Albury
| | - Phillipa Southwell
- Western NSW Regional Training Hub, The University of Sydney, Sydney, Australia
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Paraskevopoulos E, Karanasios S, Gioftsos G, Tatsios P, Koumantakis G, Papandreou M. The effectiveness of neuromobilization exercises in carpal tunnel syndrome: Systematic review and meta-analysis. Physiother Theory Pract 2023; 39:2037-2076. [PMID: 35481794 DOI: 10.1080/09593985.2022.2068097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 04/10/2022] [Accepted: 04/12/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE To examine the effectiveness of Neuromobilization Exercises (NE) on pain, grip and pinch strength, two-point discrimination, motor and sensory distal latency, symptom severity, and functional status using the Boston Carpal Tunnel Questionnaire (BCTQ) in Carpal Tunnel Syndrome (CTS). METHODS Major electronic databases were searched from inception up to September 2021 for randomized trials comparing the effects of NE with or without other interventions against no treatment, surgery, or other interventions in patients with CTS. Standardized Mean Differences (SMD) and 95% confidence interval (CI) were calculated using a random-effects inverse variance model according to the outcome of interest and comparison group. Methodological quality was assessed with PEDro and quality of evidence with the GRADE approach. RESULTS Twenty-five articles were included and sixteen of them demonstrated high methodological quality. NE was superior to no treatment on pain (very low-quality evidence; SMD = -2.36, 95% CI -4.31 to -0.41). NE was superior to no treatment on the functional scale of the BCTQ (low-quality evidence; SMD = -1.27 95% CI -1.60 to -0.94). Most importantly, NE did not demonstrate evidence of clinical effectiveness. CONCLUSION Low to very low-quality evidence suggests that there are no clinical benefits of NE in patients with mild to moderate CTS.
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Affiliation(s)
- Eleftherios Paraskevopoulos
- Department of Physiotherapy, University of West Attica, Ag. Spiridonos 28 Street, 12243, Athens, Greece
- Laboratory of Advanced Physiotherapy, University of West Attica, Ag. Spiridonos 28 Street, 12243, Athens, Greece
| | - Stefanos Karanasios
- Department of Physiotherapy, University of West Attica, Ag. Spiridonos 28 Street, 12243, Athens, Greece
- Laboratory of Advanced Physiotherapy, University of West Attica, Ag. Spiridonos 28 Street, 12243, Athens, Greece
| | - Georgios Gioftsos
- Department of Physiotherapy, University of West Attica, Ag. Spiridonos 28 Street, 12243, Athens, Greece
- Laboratory of Advanced Physiotherapy, University of West Attica, Ag. Spiridonos 28 Street, 12243, Athens, Greece
| | - Petros Tatsios
- Department of Physiotherapy, University of West Attica, Ag. Spiridonos 28 Street, 12243, Athens, Greece
- Laboratory of Advanced Physiotherapy, University of West Attica, Ag. Spiridonos 28 Street, 12243, Athens, Greece
| | - Georgios Koumantakis
- Department of Physiotherapy, University of West Attica, Ag. Spiridonos 28 Street, 12243, Athens, Greece
- Laboratory of Advanced Physiotherapy, University of West Attica, Ag. Spiridonos 28 Street, 12243, Athens, Greece
| | - Maria Papandreou
- Department of Physiotherapy, University of West Attica, Ag. Spiridonos 28 Street, 12243, Athens, Greece
- Laboratory of Advanced Physiotherapy, University of West Attica, Ag. Spiridonos 28 Street, 12243, Athens, Greece
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Movaghar S, Roostayi MM, Naimi SS, Daryabor A, Jahantigh Akbari N, Mehreganfar B. Comparison of 4 weeks of cupping and Kinesio-taping on clinical and ultrasound outcomes of carpal tunnel syndrome during pregnancy. J Bodyw Mov Ther 2023; 35:57-63. [PMID: 37330803 DOI: 10.1016/j.jbmt.2023.04.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 01/16/2023] [Accepted: 04/12/2023] [Indexed: 06/19/2023]
Abstract
OBJECTIVE To explore effect of cupping and Kinesio-taping techniques on clinical and ultrasound outcomes of carpal tunnel syndrome (CTS) during pregnancy. METHODS Thirty pregnant women suffering from CTS were randomly assigned into Kinesio-taping (n = 15) and cupping (n = 15) groups. In Kinesio-taping group, individuals underwent Kinesio-taping for three days, one day with no treatment, and three days with Kinesio-taping, continuing this procedure for four weeks. In cupping group, cupping was moved for 5 min with pressure of 50 mm-Hg on the carpal tunnel area. This procedure continued longitudinally in forearm area for 2 min. The therapeutic intervention of cupping group continued with eight sessions, two days a week for 4 weeks. Ultrasound outcomes including median nerve cross-sectional area through ultrasonography, and clinical outcomes including pain through visual analog scale and severity of symptoms and functional status through Boston questionnaire were measured in both groups before and after therapeutic program. RESULTS In both groups, a significant reduction was observed in all variables after treatment compared to pre-treatment (P < 0.001). In inter-group comparison, a significant improvement was found in outcomes of Boston questionnaire and ultrasound results about median nerve cross-sectional area at pisiform and hook of hamate in cupping group compared to Kinesio-taping at end of four weeks (P < 0.001). CONCLUSION Both cupping and Kinesio-taping improved clinical and ultrasound outcomes of CTS. However, efficacy of cupping compared to Kinesio-taping was better in improvement of median nerve cross-sectional area at hamate hook and pisiform levels, symptoms severity scale, and functional status scale, which makes the results clinically more applicable.
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Affiliation(s)
- Sara Movaghar
- Physiotherapy Research Center, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Mohsen Roostayi
- Physiotherapy Research Center, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sedigheh Sadat Naimi
- Physiotherapy Research Center, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Aliyeh Daryabor
- Physiotherapy Research Center, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Narges Jahantigh Akbari
- Student Research Committee, Department of Physiotherapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Bahare Mehreganfar
- Student Research Committee, Department of Physiotherapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Lopez G, Eng C, Overman M, Ramirez D, Liu W, Beinhorn C, Sumler P, Prinsloo S, Li Y, Chen M, Bruera E, Cohen L. A randomized pilot study of oncology massage to treat chemotherapy-induced peripheral neuropathy. Sci Rep 2022; 12:19023. [PMID: 36348045 PMCID: PMC9643426 DOI: 10.1038/s41598-022-23372-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 10/31/2022] [Indexed: 11/09/2022] Open
Abstract
This pilot randomized controlled trial investigated massage therapy for symptomatic relief of chemotherapy-induced peripheral neuropathy (CIPN) to determine the ideal weekly frequency and number of weeks of providing massage. We evaluated the feasibility and initial efficacy of a Swedish massage protocol to treat lower extremity (LE) CIPN. Inclusion criteria: LE neuropathy attributed to oxaliplatin, paclitaxel, or docetaxel, with no other attributable causes; ≥ 6 months since last chemotherapy; self-reported neuropathy score ≥ 3, 0-10 scale; age ≥ 18. Participant randomization (2:2:1:1) to one of four groups: LE (2) or head/neck/shoulder (control; 1) massage 3 times (3X) a week for 4 weeks; LE (2) or control (1) massage 2X/week for 6 weeks. Completion rate and the Pain Quality Assessment Scale (PQAS) was measured at baseline and 10 weeks later. 71 patients participated: 77.5% women; 57.7% (breast cancer), and 42.3% (GI cancer); mean age 60.3 y/o (range: 40-77); average > 3 years since last chemotherapy. Massage was deemed feasible: mean completion rates (max = 12) were 8.9 (SD 4.2) for 3X/week and 9.8 (SD 4.0) for 2X/week with no statistically significant differences. There were no statistically significant treatment group interactions in PQAS scores at 10-weeks follow-up. There was a statistically significant treatment schedule main effect for PQAS subscales (p < 0.05) at 10 weeks, with lower CIPN symptoms for 3X/week groups versus 2X/week groups. Improvements considered clinically significant favored the LE 3X/week group. Completion rates met pre-defined feasibility criteria. We seemed to observe better outcomes (CIPN symptom reduction) with the more intensive (3X/week for 4 weeks) massage intervention with no differences in adherence, regardless of whether the massage was directly to the CIPN-affected area or not. However, there was some suggestion that the massage program targeting the CIPN-affected area directly provided 3X a week for 4 weeks resulted in the best outcomes.
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Affiliation(s)
- Gabriel Lopez
- grid.240145.60000 0001 2291 4776Department of Palliative, Rehabilitation and Integrative Medicine, University of Texas, MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1414, Houston, TX 77030 USA
| | - Cathy Eng
- grid.412807.80000 0004 1936 9916Division of Hematology and Oncology, Vanderbilt-Ingram Cancer Center, Nashville, TN USA
| | - Michael Overman
- grid.240145.60000 0001 2291 4776Department of Gastrointestinal Medical Oncology, University of Texas, MD Anderson Cancer Center, Houston, TX USA
| | - David Ramirez
- grid.240145.60000 0001 2291 4776Department of Breast Medical Oncology, University of Texas, MD Anderson Cancer Center, Houston, TX USA
| | - Wenli Liu
- grid.240145.60000 0001 2291 4776Department of Palliative, Rehabilitation and Integrative Medicine, University of Texas, MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1414, Houston, TX 77030 USA
| | - Curtiss Beinhorn
- grid.240145.60000 0001 2291 4776Department of Palliative, Rehabilitation and Integrative Medicine, University of Texas, MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1414, Houston, TX 77030 USA
| | - Pamela Sumler
- grid.240145.60000 0001 2291 4776Department of Palliative, Rehabilitation and Integrative Medicine, University of Texas, MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1414, Houston, TX 77030 USA
| | - Sarah Prinsloo
- grid.240145.60000 0001 2291 4776Department of Palliative, Rehabilitation and Integrative Medicine, University of Texas, MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1414, Houston, TX 77030 USA ,grid.240145.60000 0001 2291 4776Department of Neurosurgery, University of Texas, MD Anderson Cancer Center, Houston, TX USA
| | - Yisheng Li
- grid.240145.60000 0001 2291 4776Department of Biostatistics, University of Texas, MD Anderson Cancer Center, Houston, TX USA
| | - Minxing Chen
- grid.240145.60000 0001 2291 4776Department of Biostatistics, University of Texas, MD Anderson Cancer Center, Houston, TX USA
| | - Eduardo Bruera
- grid.240145.60000 0001 2291 4776Department of Palliative, Rehabilitation and Integrative Medicine, University of Texas, MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1414, Houston, TX 77030 USA
| | - Lorenzo Cohen
- grid.240145.60000 0001 2291 4776Department of Palliative, Rehabilitation and Integrative Medicine, University of Texas, MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1414, Houston, TX 77030 USA
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Jiménez-del-Barrio S, Ceballos-Laita L, Bueno-Gracia E, Rodríguez-Marco S, Caudevilla-Polo S, Estébanez-de-Miguel E. Diacutaneous Fibrolysis Intervention in Patients with Mild to Moderate Carpal Tunnel Syndrome May Avoid Severe Cases in Elderly: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10983. [PMID: 36078691 PMCID: PMC9518553 DOI: 10.3390/ijerph191710983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 08/30/2022] [Accepted: 08/31/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Carpal Tunnel Syndrome (CTS) mainly affects adults of working age. The prevalence of severe cases is higher in elderly patients (>65 years old). Clinical guidelines recommend conservative treatment as the best option in the initial stages of CTS to avoid severe cases. Diacutaneous Fibrolysis (DF) has demonstrated to improve nerve conduction studies and mechanosensitivity. The main purpose was to quantify changes in the cross-sectional area (CSA) of the median nerve, transversal carpal ligament (TCL) thickness, numbness intensity, and the subjective assessment of clinical change after DF treatment in patients with CTS. METHODS a double-blind, randomized, placebo-controlled trial was designed. A number of 44 patients (60 wrists) with CTS were randomized to the DF group or the sham group. CSA and TCL thickness variables were registered by ultrasound. Clinical variables were assessed by the visual analogue scale and GROC scale. SPSS version 24.0 for MAC was used for statistical analysis. The group by time interaction between groups was analyzed using two-way repeated measures analysis of variance. RESULTS The DF group reduced CSA with a mean of 0.45 mm2 (IC 95% 0.05 to 0.86) and TCL thickness with a mean reduction of 0.4 mm (IC 95% 0.6 to 2.1) compared to the sham group (p < 0.01, p < 0,03, respectively). Additionally, the DF group decreased the numbness intensity with a mean reduction of 3.47 (IC 95% 2.50 to 4.44, p < 0.01) and showed a statistically significant improvement on the GROC scale (p < 0.01). CONCLUSIONS DF treatment may significantly reduce CSA and TCL thickness, numbness intensity, and improved clinical perspective. DF applied in patients with mild to moderate CTS may prevent the progression of the disease as they age.
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Affiliation(s)
- Sandra Jiménez-del-Barrio
- Clinical Research in Health Sciences Group, Department of Surgery, Ophthalmology, Otorhinolaryngology, and Physiotherapy, University of Valladolid, 47002 Valladolid, Spain
| | - Luis Ceballos-Laita
- Clinical Research in Health Sciences Group, Department of Surgery, Ophthalmology, Otorhinolaryngology, and Physiotherapy, University of Valladolid, 47002 Valladolid, Spain
| | - Elena Bueno-Gracia
- Department of Physiatrist and Nursery, Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain
| | - Sonia Rodríguez-Marco
- Department of Physiatrist and Nursery, Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain
| | - Santos Caudevilla-Polo
- Department of Physiatrist and Nursery, Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain
| | - Elena Estébanez-de-Miguel
- Department of Physiatrist and Nursery, Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain
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Comparison of Two Manual Therapy Programs, including Tendon Gliding Exercises as a Common Adjunct, While Managing the Participants with Chronic Carpal Tunnel Syndrome. Pain Res Manag 2022; 2022:1975803. [PMID: 35719196 PMCID: PMC9200595 DOI: 10.1155/2022/1975803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 04/06/2022] [Accepted: 05/11/2022] [Indexed: 11/18/2022]
Abstract
Background Carpal tunnel syndrome (CTS) is the symptomatic compression neuropathy of the median nerve at the wrist level that may become a reason for upper limb disability, in the women and men population. Objective This study aimed to compare the efficacy of the neurodynamic technique (NT) and carpal bone mobilization technique (CBMT) incorporated with tendon gliding exercises (TGE) as an effect-enhancing adjunct while managing the participants with chronic CTS. Methods The study followed a two-arm parallel-group randomized comparative design. Thirty participants (aged 30–59 years) with chronic CTS were recruited randomly to both the NT and CBMT groups. In addition to the TGE (a common adjunct), NT and CBMT were performed in the NT and CBMT groups, respectively, for three weeks. The primary outcome measures including pain intensity, functional status, grip strength, and motor nerve conduction study were assessed using a visual analogue scale (VAS), Boston Carpal Tunnel Questionnaire (BCTQ), hand-held dynamometer, and electromyograph, respectively, at baseline, 3 weeks postintervention, and follow-up at one week post end of the intervention. Paired and unpaired t-test were used to calculate the differences in intervention effects within and between the groups with keeping the level of significance α at 0.05. Results The data analysis revealed a significant (95% CI, p < 0.05) difference for all outcomes within each group compared across different time intervals. Similarly, a significant difference was found for all outcomes except pain and grip strength compared between groups at 3 weeks postintervention and follow-up at one week post end of the intervention. Conclusions The NT revealed more effectiveness than the CBMT when incorporated with TGE to improve nerve conduction velocity and functional status of the hand. However, both NT and CBMT were equally effective in improving pain and grip strength while managing the participants with chronic CTS. In addition, the TGE contributed as a beneficial, effect-enhancing adjunct to the NT and CBMT differently. Significance. The study will guide the physiotherapist in applying either of the combination techniques suitable for achieving treatment objectives while managing the participants with chronic CTS.
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Barbe MF, Harris MY, Cruz GE, Amin M, Billett NM, Dorotan JT, Day EP, Kim SY, Bove GM. Key indicators of repetitive overuse-induced neuromuscular inflammation and fibrosis are prevented by manual therapy in a rat model. BMC Musculoskelet Disord 2021; 22:417. [PMID: 33952219 PMCID: PMC8101118 DOI: 10.1186/s12891-021-04270-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 04/07/2021] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND We examined the effectiveness of a manual therapy consisting of forearm skin rolling, muscle mobilization, and upper extremity traction as a preventive treatment for rats performing an intensive lever-pulling task. We hypothesized that this treatment would reduce task-induced neuromuscular and tendon inflammation, fibrosis, and sensorimotor declines. METHODS Sprague-Dawley rats performed a reaching and lever pulling task for a food reward, 2 h/day, 3 days/week, for 12 weeks, while simultaneously receiving the manual therapy treatment 3 times per week for 12 weeks to either the task-involved upper extremities (TASK-Tx), or the lower extremities as an active control group (TASK-Ac). Results were compared to similarly treated control rats (C-Tx and C-Ac). RESULTS Median nerves and forearm flexor muscles and tendons of TASK-Ac rats showed higher numbers of inflammatory CD68+ and fibrogenic CD206+ macrophages, particularly in epineurium, endomysium and epitendons than TASK-Tx rats. CD68+ and CD206+ macrophages numbers in TASK-Tx rats were comparable to the non-task control groups. TASK-Ac rats had more extraneural fibrosis in median nerves, pro-collagen type I levels and immunoexpression in flexor digitorum muscles, and fibrogenic changes in flexor digitorum epitendons, than TASK-Tx rats (which showed comparable responses as control groups). TASK-Ac rats showed cold temperature, lower reflexive grip strength, and task avoidance, responses not seen in TASK-Tx rats (which showed comparable responses as the control groups). CONCLUSIONS Manual therapy of forelimbs involved in performing the reaching and grasping task prevented the development of inflammatory and fibrogenic changes in forearm nerves, muscle, and tendons, and sensorimotor declines.
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Affiliation(s)
- Mary F Barbe
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, 3500 North Broad Street, Philadelphia, PA, 19140, USA.
| | - Michele Y Harris
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, 3500 North Broad Street, Philadelphia, PA, 19140, USA
| | - Geneva E Cruz
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, 3500 North Broad Street, Philadelphia, PA, 19140, USA
| | - Mamta Amin
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, 3500 North Broad Street, Philadelphia, PA, 19140, USA
| | - Nathan M Billett
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, 3500 North Broad Street, Philadelphia, PA, 19140, USA
| | - Jocelynne T Dorotan
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, 3500 North Broad Street, Philadelphia, PA, 19140, USA
| | - Emily P Day
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, 3500 North Broad Street, Philadelphia, PA, 19140, USA
| | - Seung Y Kim
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, 3500 North Broad Street, Philadelphia, PA, 19140, USA
| | - Geoffrey M Bove
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, 3500 North Broad Street, Philadelphia, PA, 19140, USA.,Bove Consulting, Kennebunkport, ME, 04046, USA
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Jiménez Del Barrio S, Ceballos-Laita L, Bueno-Gracia E, Rodríguez-Marco S, Haddad-Garay M, Estébanez-de-Miguel E. Effects of Diacutaneous Fibrolysis on Mechanosensitivity, Disability, and Nerve Conduction Studies in Mild to Moderate Carpal Tunnel Syndrome: Secondary Analysis of a Randomized Controlled Trial. Phys Ther 2021; 101:6054187. [PMID: 33373445 DOI: 10.1093/ptj/pzaa222] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 11/23/2020] [Indexed: 11/14/2022]
Abstract
OBJECTIVE People diagnosed with carpal tunnel syndrome (CTS) have fibrosis between the soft, connective, and neural tissues that could worsen the compression of the median nerve. The diacutaneous fibrolysis (DF) technique may release tissue adhesions and increase the mobility of connective tissues. The purpose of this study was to compare the outcomes of DF in people with mild to moderate CTS on mechanosensitivity, disability, and nerve conduction studies. METHODS This was a secondary analysis of a double-blinded, randomized, placebo-controlled trial. Patients were recruited between April and September 2016 from the Department of Neurophysiology at the Hospital Miguel Servet, Zaragoza, Spain. Thirty-nine people (52 wrists) diagnosed with mild to moderate CTS were included. Participants were randomly assigned to either the DF group (n = 26) or the sham group (n = 26). Both groups received 5 therapy sessions, 2 sessions per week. Mechanosensitivity with the Upper Limb Neurodynamic Test 1, symptom severity and functional status with the Boston Carpal Tunnel Questionnaire, and median nerve sensory conduction velocity with nerve conduction studies were the outcomes measured. Assessments were recorded at baseline and after the intervention. RESULTS The DF group showed significant improvements in the following: mechanosensitivity, with 28.46 degrees of elbow extension range of motion (95% CI = 19.2-37.7); an increase of 1.0 point (95% CI = 0.7-1.4) for the Boston Carpal Tunnel Questionnaire symptom severity and functional status score; and sensory conduction velocity of median nerve, which improved to 5.8 m/s (95% CI = 2.5-9.2). CONCLUSION Participants with mild to moderate CTS experienced improvements in symptom severity, functional status, mechanosensitivity, and nerve conduction studies after 5 sessions of DF. IMPACT This study provides evidence of an approach based on soft and connective tissues around the median nerve in patients with CTS.
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Wahbeh H, Niebauer E, Delorme A, Carpenter L, Radin D, Yount G. A case study of extended human capacity perception during Energy Medicine treatments using mixed methods analysis. Explore (NY) 2020; 17:70-78. [PMID: 33132081 DOI: 10.1016/j.explore.2020.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 10/09/2020] [Accepted: 10/12/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Some "energy medicine" modalities, such as Reiki, continue to show evidence for efficacy, but the underlying mechanisms of action are still uncertain. To help illuminate possible mechanisms, this exploratory mixed-method study using qualitative and quantitative analyses investigated: 1) How do energy medicine sessions function from the perspective of a seer, i.e., an individual trained in techniques to enable perception of purported subtle energies, and 2) Do any of these observations correlate with changes in participants' subjective pain? METHOD One seer reported observations during 30-minute energy medicine sessions delivered by 17 practitioners to participants experiencing chronic hand or wrist pain. Data were coded using an inductive approach, followed by thematic and descriptive analyses. Content analysis was used to assign whether each code was mentioned by the seer for each participant, generating 119 binary variables, one for each code. The relationship between these binary variables and change in participant pain scores after the energy medicine session and three weeks later were explored using linear regression models. RESULTS The qualitative thematic analysis identified six major themes from the seer's notes: "Experience of the Practitioner," "Experience of the Participant," "Space and Other Beings" (referring to the qualities of the physical space the energy medicine session occurred in and ostensible non-physical beings present during session), "Participant-Practitioner Relationship," "Healing Process," and "Attributes of Energy." The energy medicine methods used varied for each participant, according to the practitioners' perceptions of each individual's needs. The linear regression models yielded significant associations between changes in pain scores and various codes, including energy color, practitioner touch and the presence of ostensible non-physical beings supporting the session, although their significance did not persist after correction for multiple comparisons. DISCUSSION Future studies investigating the mechanisms of energy medicine may benefit from including perceptions by seers in their outcome measures.
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Affiliation(s)
- Helané Wahbeh
- Institute of Noetic Sciences, 101 San Antonio Rd., Petaluma, CA, 94952, United States of America.
| | - Erica Niebauer
- Institute of Noetic Sciences, 101 San Antonio Rd., Petaluma, CA, 94952, United States of America
| | - Arnaud Delorme
- Institute of Noetic Sciences, 101 San Antonio Rd., Petaluma, CA, 94952, United States of America; University of California, San Diego, 9500 Gilman Dr., La Jolla, CA, 92093, United States of America
| | - Loren Carpenter
- Institute of Noetic Sciences, 101 San Antonio Rd., Petaluma, CA, 94952, United States of America
| | - Dean Radin
- Institute of Noetic Sciences, 101 San Antonio Rd., Petaluma, CA, 94952, United States of America
| | - Garret Yount
- Institute of Noetic Sciences, 101 San Antonio Rd., Petaluma, CA, 94952, United States of America
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Jiménez Del Barrio S, Estébanez de Miguel E, Bueno Gracia E, Haddad Garay M, Tricás Moreno JM, Hidalgo García C. Effects of diacutaneous fibrolysis in patients with mild to moderate symptomatic carpal tunnel syndrome: a randomized controlled trial. Clin Rehabil 2018; 32:1645-1655. [PMID: 29991270 DOI: 10.1177/0269215518787316] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE: To compare the effects of diacutaneous fibrolysis with sham in patients with mild to moderate carpal tunnel syndrome. DESIGN: Double-blind (patient and evaluator) randomized controlled trial. SETTING: Miguel Servet University Hospital, Zaragoza, Spain. SUBJECTS: A total of 52 patients (72 wrists) with carpal tunnel syndrome, 41 women and 11 men, mean age was 46.9 (8.8) years. They were divided into two groups: diacutaneous fibrolysis group and sham group. INTERVENTIONS: Real diacutaneous fibrolysis in diacutaneous fibrolysis group and sham diacutaneous fibrolysis in sham group. Both groups received five sessions in the forearm, wrist and hand. MAIN MEASURES: Neurophysiological parameters assessed at baseline and at the end of the treatment. Intensity of nocturnal symptoms (visual analogue scale (VAS)) and upper limb functional capacity (Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire) at baseline, at the end of the treatment and one month after treatment. RESULTS: Diacutaneous fibrolysis group (n = 30 wrists) improved in nerve conduction distal motor latency (mean difference: -0.26, 95% confidence interval (CI): -0.49/-0.26), sensory conduction velocity (mean difference: 6.52, 95% CI: 3.52/9.51), intensity of nocturnal symptoms (mean difference: -2.24, 95% CI: -4.08/-2.04) and upper limb functional capacity (mean difference: -19, 95% CI: -26.1/-11.9) compared to the sham group (n = 30 wrists) ( P < 0.02, P < 0.01, P < 0.01 and P < 0.01, respectively). At one-month follow-up, improvements in the nocturnal symptoms and upper limb functional capacity were maintained compared to the sham group ( P < 0.01). CONCLUSION: Diacutaneous fibrolysis provides short-term and one-month follow-up, improvements in sensory conduction velocity, motor distal latency, symptoms and functional capacity in patients with mild to moderate carpal tunnel syndrome.
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Affiliation(s)
| | - Elena Estébanez de Miguel
- 2 University of Zaragoza, Zaragoza, Spain.,3 Universitary Clinical Hospital Miguel Servet, Zaragoza, Spain
| | - Elena Bueno Gracia
- 2 University of Zaragoza, Zaragoza, Spain.,3 Universitary Clinical Hospital Miguel Servet, Zaragoza, Spain
| | | | - José Miguel Tricás Moreno
- 2 University of Zaragoza, Zaragoza, Spain.,3 Universitary Clinical Hospital Miguel Servet, Zaragoza, Spain
| | - César Hidalgo García
- 2 University of Zaragoza, Zaragoza, Spain.,3 Universitary Clinical Hospital Miguel Servet, Zaragoza, Spain
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11
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Dinarvand V, Abdollahi I, Raeissadat SA, Mohseni Bandpei MA, Babaee M, Talimkhani A. The Effect of Scaphoid and Hamate Mobilization on Treatment of Patients with Carpal Tunnel Syndrome. Anesth Pain Med 2017; 7:e14621. [PMID: 29696114 PMCID: PMC5903255 DOI: 10.5812/aapm.14621] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 06/07/2017] [Accepted: 10/09/2017] [Indexed: 11/16/2022] Open
Abstract
Background This study was to evaluate the effect of hamate and scaphoid bone mobilization alongside splinting in women with carpal tunnel syndrome. Methods In this randomized clinical trial, 40 participants were randomly assigned into 2 groups. The intervention group received splinting with scaphoid and hamate mobilization, while the control group received splinting only. Outcome variables were pain (based on visual analogue scale), symptom severity and functional status (based on Boston questionnaire), and nerve conduction study measured before and 10 weeks after the treatments. Results At the end of study, both groups showed an improvement in pain and symptom severity, functional status as well as median nerve conduction study. Although there was no statistically significant difference between groups regarding changes in median nerve sensory and motor distal latencies; the improvement was significantly higher in pain and symptom severity as well as functional status in mobilization group (P-Value < 0.05). Conclusions Hamate and scaphoid mobilization can be used as an effective option in women with mild to moderate carpal tunnel syndrome. Further investigation is required for determining long-term effects and cost-effectiveness of mobilization in carpal tunnel syndrome.
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Affiliation(s)
- Vida Dinarvand
- Physiotherapy Department, University of Social Welfare and Rehabilitation Sciences, Shahid Modarres Hospital, Tehran, Iran
| | - Iraj Abdollahi
- Physiotherapy Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Seyed Ahmad Raeissadat
- Physical Medicine and Rehabilitation Research Center, Clinical Research Development Center of Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Corresponding author: Seyed Ahmad Raeissadat, Physical Medicine and Rehabilitation Department, Shahid Modarres Hospital, Kaj Sq, Saadat Abad, Tehran, Iran. Tel/Fax: +98-2122731112, E-mail:
| | | | - Marzieh Babaee
- Physical Medicine and Rehabilitation Research Center, Clinical Research Development Center of Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ailin Talimkhani
- Physiotherapy Department, University of Social Welfare and Rehabilitation Sciences, Shahid Modarres Hospital, Tehran, Iran
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12
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Nourbakhsh MR, Bell TJ, Martin JB, Arab AM. The Effects of Oscillatory Biofield Therapy on Pain and Functional Limitations Associated with Carpal Tunnel Syndrome: Randomized, Placebo-Controlled, Double-Blind Study. J Altern Complement Med 2016; 22:911-920. [PMID: 27487406 DOI: 10.1089/acm.2016.0083] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Biofield treatments have been used for pain control in patients with cancer and chronic pain. However, research on the effect of biofield treatment on specific somatic disorders is lacking. This study intends to investigate the effect of oscillating biofield therapy (OBFT) on symptoms of carpal tunnel syndrome. DESIGN Randomized, placebo-controlled, double-blind study. PARTICIPANTS Thirty patients with chronic carpal tunnel syndrome participated in the study. INTERVENTION Patients were randomly assigned to active or placebo treatment groups. Those in the treatment group received six sessions of OBFT with intention to treat during a period of 2 weeks. Patients in the placebo group had the same number of treatment sessions with mock OBFT treatment. OUTCOME MEASURE The Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire; Symptom Severity Scale (SSS); and Functional Status Scale (FSS) were used for outcome assessment. RESULTS Both clinically and statistically significant changes in intensity of pain with activity (95% confidence interval [CI], 2.5-4.2; p = 0.000), night pain (p = 0.000, 95% CI, 3.2-5.7), DASH questionnaire (95% CI, 12.0-21.9; p = 0.000), SSS (95% CI, 0.64-1.15; p = 0.003), and FSS (95% CI, 0.41-0.97; p = 0.029) were found between the treatment and placebo groups. Statistically significant reduction in number of patients with positive results on the Phalen test (87%; p = 0.000), Tinel sign (73%; p = 0.000), and hand paresthesia (80%; p = 0.000) was noted in the treatment group. During 6-month follow-up, 86% of patients in the treatment group remained pain free and had no functional limitations. CONCLUSION OBFT can be a viable and effective treatment for improving symptoms and functional limitations associated with chronic carpal tunnel syndrome.
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Affiliation(s)
| | | | | | - Amir Massoud Arab
- 4 Department of Physical Therapy, University of Social Welfare and Rehabilitation Sciences , Tehran, Iran
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13
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Field T. Massage therapy research review. Complement Ther Clin Pract 2016; 24:19-31. [PMID: 27502797 PMCID: PMC5564319 DOI: 10.1016/j.ctcp.2016.04.005] [Citation(s) in RCA: 156] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2016] [Revised: 04/22/2016] [Accepted: 04/22/2016] [Indexed: 12/31/2022]
Abstract
In this review, massage therapy has been shown to have beneficial effects on varying conditions including prenatal depression, preterm infants, full-term infants, autism, skin conditions, pain syndromes including arthritis and fibromyalgia, hypertension, autoimmune conditions including asthma and multiple sclerosis, immune conditions including HIV and breast cancer and aging problems including Parkinson's and dementia. Although many of the studies have involved comparisons between massage therapy and standard treatment control groups, several have compared different forms of massage (e.g. Swedish versus Thai massage), and different active therapies such as massage versus exercise. Typically, the massage therapy groups have experienced more positive effects than the control or comparison groups. This may relate to the massage therapy providing more stimulation of pressure receptors, in turn enhancing vagal activity and reducing cortisol levels. Some of the researchers have assessed physical, physiological and biochemical effects, although most have relied exclusively on self-report measures. Despite these methodological problems and the dearth of research from the U.S., the massage therapy profession has grown significantly and massage therapy is increasingly practiced in traditional medical settings, highlighting the need for more rigorous research.
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Affiliation(s)
- Tiffany Field
- Touch Research Institute, University of Miami/Miller School of Medicine, USA; Fielding Graduate University, USA.
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14
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Bove GM, Harris MY, Zhao H, Barbe MF. Manual therapy as an effective treatment for fibrosis in a rat model of upper extremity overuse injury. J Neurol Sci 2016; 361:168-80. [PMID: 26810536 PMCID: PMC4729290 DOI: 10.1016/j.jns.2015.12.029] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2015] [Revised: 12/16/2015] [Accepted: 12/17/2015] [Indexed: 01/08/2023]
Abstract
Key clinical features of carpal tunnel syndrome and other types of cumulative trauma disorders of the hand and wrist include pain and functional disabilities. Mechanistic details remain under investigation but may involve tissue inflammation and/or fibrosis. We examined the effectiveness of modeled manual therapy (MMT) as a treatment for sensorimotor behavior declines and increased fibrogenic processes occurring in forearm tissues of rats performing a high repetition high force (HRHF) reaching and grasping task for 12 weeks. Young adult, female rats were examined: food restricted control rats (FRC, n=12); rats that were trained for 6 weeks before performing the HRHF task for 12 weeks with no treatment (HRHF-CON, n=11); and HRHF task rats received modeled manual therapy (HRHF-MMT, n=5) for 5 days/week for the duration of the 12-week of task. Rats receiving the MMT expressed fewer discomfort-related behaviors, and performed progressively better in the HRHF task. Grip strength, while decreased after training, improved following MMT. Fibrotic nerve and connective tissue changes (increased collagen and TGF-β1 deposition) present in 12-week HRHF-CON rats were significantly decreased in 12-week HRHF-MMT rats. These observations support the investigation of manual therapy as a preventative for repetitive motion disorders.
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Affiliation(s)
- Geoffrey M Bove
- Department of Biomedical Sciences, University of New England College of Osteopathic Medicine, 11 Hills Beach Rd, Biddeford, ME 04005, USA
| | - Michele Y Harris
- Department of Anatomy and Cell Biology, Temple University School of Medicine, Philadelphia, PA, USA
| | - Huaqing Zhao
- Department of Clinical Sciences and Biostatistical Consulting Center, Temple University School of Medicine, Philadelphia, PA, USA
| | - Mary F Barbe
- Department of Anatomy and Cell Biology, Temple University School of Medicine, Philadelphia, PA, USA.
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15
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Yoo WG. Effect of the release exercise and exercise position in a patient with carpal tunnel syndrome. J Phys Ther Sci 2015; 27:3345-6. [PMID: 26644707 PMCID: PMC4668198 DOI: 10.1589/jpts.27.3345] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 07/23/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] This study examined the effect of the release exercise and exercise position in
carpal tunnel syndrome (CTS). [Subject] A 40-year-old, right-hand-dominant man presented
with CTS, with pain and progressive tingling and numbness in the right hand. [Methods] The
subject performed three exercises: (1) release, (2) wrist flexor stretching, and (3) wrist
extensor stretching. In session 1, the subject performed exercises 2 and 3 in the standing
position for 2 weeks. In session 2, the subject performed all three exercises in the
supine position for 2 weeks. [Results] The pressure pain threshold decreased after session
1 and decreased further after session 2, and the Phalen’s test and Tinel sign became
progressively less positive. [Conclusion] Exercises in the supine position, including
release exercises, are recommended for CTS.
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Affiliation(s)
- Won-Gyu Yoo
- Department of Physical Therapy, College of Biomedical Science and Engineering, Inje University, Republic of Korea
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16
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Kennedy AB, Trilk JL. A Standardized, Evidence-Based Massage Therapy Program for Decentralized Elite Paracyclists: Creating the Model. Int J Ther Massage Bodywork 2015; 8:3-9. [PMID: 26388960 PMCID: PMC4560532 DOI: 10.3822/ijtmb.v8i3.269] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Background and Purpose Evidence suggests that para-athletes are injured more often than able-bodied athletes. The benefits of massage therapy for these disabled athletes are yet to be explored. This paper documents the process followed for creating a massage program for elite paracycling athletes with the goal to assess effects on recovery, rest, performance, and quality of life both on and off the bike. Setting Massage therapists’ private practices throughout the United States. Participants A United States Paracycling team consisting of 9 elite athletes: 2 spinal cord injury, 2 lower limb amputation, 1 upper limb amputation, 1 transverse myelitis, 1 stroke, 1 traumatic brain injury, and 1 visually impaired. Design The process used to develop a massage therapy program for para-cyclists included meetings with athletes, coaching staff, team exercise physiologist, and sports massage therapists; peer-reviewed literature was also consulted to address specific health conditions of para-athletes. Results Team leadership and athletes identified needs for quicker recovery, better rest, and improved performance in elite paracyclists. This information was used to generate a conceptual model for massage protocols, and led to creation of the intake and exit questionnaires to assess patient health status and recovery. Forms also were created for a general health intake, therapist information, and a therapist’s SOAAP notes. Discussion The conceptual model and questionnaires developed herein will help to operationalize an exploratory study investigating the feasibility of implementing a standardized massage therapy program for a decentralized elite paracycling team.
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Affiliation(s)
- Ann B Kennedy
- Arnold School of Public Health/Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, SC, USA
| | - Jennifer L Trilk
- University of South Carolina School of Medicine - Greenville, Department of Biomedical Sciences, Greenville, SC, USA
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17
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Abstract
Background: The carpal tunnel syndrome is a neuralgia of the median nerve of the hand caused by permanent pressure which results in sensation and motion disturbances in the area. Principal symptoms include pain in the hand and wrist, numbness and tingling of the fingers, sensation dysfunctions, and finally, the limitation of mobility and manual flexibility of the hand. The discomfort leads to a significant decrease in the patient’s quality of life. In case of carpal tunnel syndrome surgical and non-surgical treatments with selected elements of physiotherapy are applied. Aim of the study: The aim of this study was to present and evaluate possible methods of treatment such as massage therapy and lymphatic drainage as the form of post-surgery treat-ment in carpal tunnel syndrome.Material and methods: The young woman with the carpal tunnel syndrome after the surgical treatment received 50-minute lymphatic drainage (three sessions) and 30-minute therapeutic massage (four sessions). The procedures were performed every two days.Results: After the application of both kinds of massage in appropriate sequence, the following changes have been notified. The swelling in the area of the hand was reduced and the patient reported definite decrease of pain.Conclusions: The massage might be one of the forms of therapy used after surgical treatment in carpal tunnel syndrome, especially when the symptoms occur. It is also often effective with other components of physiotherapy as non-surgical treatment.
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Affiliation(s)
- Iwona Wilk
- AWF Wrocław, Katedra Fizjoterapii i Terapii Zajęciowej
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18
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Abstract
Moderate pressure massage has contributed to many positive effects including increased weight gain in preterm infants, reduced pain in different syndromes including fibromyalgia and rheumatoid arthritis, enhanced attentiveness, reduced depression and enhanced immune function (increased natural killer cells and natural killer cell activity).Surprisingly, these recent studies have not been reviewed, highlighting the need for the current review. When moderate and light pressure massage have been compared in laboratory studies, moderate pressure massage reduced depression, anxiety and heart rate, and it altered EEG patterns, as in a relaxation response. Moderate pressure massage has also led to increased vagal activity and decreased cortisol levels. Functional magnetic resonance imaging data have suggested that moderate pressure massage was represented in several brain regions including the amygdala, the hypothalamus and the anterior cingulate cortex, all areas involved in stress and emotion regulation. Further research is needed to identify underlying neurophysiological and biochemical mechanisms associated with moderate pressure massage.
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Affiliation(s)
- Tiffany Field
- Touch Research Institute, University of Miami Medical School, USA; Fielding Graduate University, USA.
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Field T, Diego M, Solien-Wolfe L. Massage therapy plus topical analgesic is more effective than massage alone for hand arthritis pain. J Bodyw Mov Ther 2013; 18:322-5. [PMID: 25042302 DOI: 10.1016/j.jbmt.2013.12.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Revised: 11/29/2013] [Accepted: 12/03/2013] [Indexed: 11/16/2022]
Abstract
METHODS 20 adults were randomly assigned to a massage therapy or a massage therapy plus a topical analgesic application group. Both groups received a weekly massage from a therapist and were taught self-massage (same procedure) to be done by each participant once daily over a four-week period. RESULTS The massage plus topical analgesic group as compared to the massage group had greater improvement in hand function as measured by a digital hand exerciser following the first session and across the four-week period. That group also had a greater increase in perceived grip strength and a greater decrease in hand pain, depressed mood and sleep disturbances over the four-week period. Massage therapy has been effective for several pain syndromes including migraine headaches (Lawle and Cameron, 2006)), lower back pain (Hsieh et al., 2004), fibromyalgia (Kalichman, 2010), neck and shoulder pain (Kong et al., 2013), carpal tunnel syndrome (Elliott and Burkett, 2013), and pain related to upper limb arthritis (Field et al., 2013). The purpose of the current study was to determine whether applying a topical analgesic following massage might be more effective than massage alone in treating pain associated with hand arthritis.
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Affiliation(s)
- Tiffany Field
- Touch Research Institute, University of Miami Medical School, PO Box 016820, Miami, FL 33101, USA; Fielding Graduate University, USA.
| | - Miguel Diego
- Touch Research Institute, University of Miami Medical School, PO Box 016820, Miami, FL 33101, USA; Fielding Graduate University, USA
| | - Lynda Solien-Wolfe
- Touch Research Institute, University of Miami Medical School, PO Box 016820, Miami, FL 33101, USA
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