Wound healing and complementary therapies: a review

WITHDRAWN: Therapeutic touch for healing acute wounds

BACKGROUND

Therapeutic Touch (TT) is an alternative therapy that has gained popularity over the past two decades for helping wounds to heal. Practitioners enter a meditative state and pass their hands above the patient's body to find and correct any imbalances in the patient's 'life energy' or chi. Scientific instruments have been unable to detect this energy. The effect of TT on wound healing has been expounded in anecdotal publications.

OBJECTIVES

To identify and review all relevant data to determine the effects of TT on healing acute wounds.

SEARCH METHODS

In January 2014, for this fifth update, we searched The Cochrane Wounds Group Specialised Register; The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library); Ovid MEDLINE; Ovid MEDLINE (In-Process & Other Non-Indexed Citations); Ovid EMBASE; and EBSCO CINAHL.

SELECTION CRITERIA

All randomised or quasi-randomised controlled trials, which compared the effect of TT with a placebo, another treatment, or no treatment control were considered. Studies which used TT as a stand-alone treatment, or as an adjunct to other therapies, were eligible.

DATA COLLECTION AND ANALYSIS

One author (DO'M) determined the eligibility for inclusion of all trials in the review. Both authors conducted data extraction and evaluation of trial validity independently. Each trial was assessed using predetermined criteria.

MAIN RESULTS

No new trials were identified for this update. Four trials in people with experimental wounds were included. The effect of TT on wound healing in these studies was variable. Two trials (n = 44 & 24) demonstrated a significant increase in healing associated with TT, while one trial found significantly worse healing after TT and the other found no significant difference. All trials are at high risk of bias.

AUTHORS' CONCLUSIONS

There is no robust evidence that TT promotes healing of acute wounds.

Therapeutic touch for healing acute wounds

BACKGROUND

Therapeutic Touch (TT) is an alternative therapy that has gained popularity over the past two decades for helping wounds to heal. Practitioners enter a meditative state and pass their hands above the patient's body to find and correct any imbalances in the patient's 'life energy' or chi. Scientific instruments have been unable to detect this energy. The effect of TT on wound healing has been expounded in anecdotal publications.

OBJECTIVES

To identify and review all relevant data to determine the effects of TT on healing acute wounds.

SEARCH METHODS

In January 2014, for this fifth update, we searched The Cochrane Wounds Group Specialised Register; The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library); Ovid MEDLINE; Ovid MEDLINE (In-Process & Other Non-Indexed Citations); Ovid EMBASE; and EBSCO CINAHL.

SELECTION CRITERIA

All randomised or quasi-randomised controlled trials, which compared the effect of TT with a placebo, another treatment, or no treatment control were considered. Studies which used TT as a stand-alone treatment, or as an adjunct to other therapies, were eligible.

DATA COLLECTION AND ANALYSIS

One author (DO'M) determined the eligibility for inclusion of all trials in the review. Both authors conducted data extraction and evaluation of trial validity independently. Each trial was assessed using predetermined criteria.

MAIN RESULTS

No new trials were identified for this update. Four trials in people with experimental wounds were included. The effect of TT on wound healing in these studies was variable. Two trials (n = 44 & 24) demonstrated a significant increase in healing associated with TT, while one trial found significantly worse healing after TT and the other found no significant difference. All trials are at high risk of bias.

AUTHORS' CONCLUSIONS

There is no robust evidence that TT promotes healing of acute wounds.

Therapeutic touch for healing acute wounds

BACKGROUND

Therapeutic Touch (TT) is an alternative therapy that has gained popularity over the past two decades for helping wounds to heal. Practitioners enter a meditative state and pass their hands above the patient's body to find and correct any imbalances in the patient's 'life energy' or chi. Scientific instruments have been unable to detect this energy. The effect of TT on wound healing has been expounded in anecdotal publications.

OBJECTIVES

To identify and review all relevant data to determine the effects of TT on healing acute wounds.

SEARCH METHODS

In January 2014, for this fifth update, we searched The Cochrane Wounds Group Specialised Register; The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library); Ovid MEDLINE; Ovid MEDLINE (In-Process & Other Non-Indexed Citations); Ovid EMBASE; and EBSCO CINAHL.

SELECTION CRITERIA

All randomised or quasi-randomised controlled trials, which compared the effect of TT with a placebo, another treatment, or no treatment control were considered. Studies which used TT as a stand-alone treatment, or as an adjunct to other therapies, were eligible.

DATA COLLECTION AND ANALYSIS

One author (DO'M) determined the eligibility for inclusion of all trials in the review. Both authors conducted data extraction and evaluation of trial validity independently. Each trial was assessed using predetermined criteria.

MAIN RESULTS

No new trials were identified for this update. Four trials in people with experimental wounds were included. The effect of TT on wound healing in these studies was variable. Two trials (n = 44 & 24) demonstrated a significant increase in healing associated with TT, while one trial found significantly worse healing after TT and the other found no significant difference. All trials are at high risk of bias.

AUTHORS' CONCLUSIONS

There is no robust evidence that TT promotes healing of acute wounds.

Nontouch biofield therapy: a systematic review of human randomized controlled trials reporting use of only nonphysical contact treatment

OBJECTIVE AND CONTEXT: This review was designed to assess the quality and review the outcomes of randomized controlled trials (RCTs) of biofield therapies (external qigong, Healing Touch, Johrei, Reiki, and Therapeutic Touch) that report using only nonphysical touch forms of treatment. RCTs of nonphysical contact biofield therapies have the potential to contribute to an evidence base for health-promoting effects mediated through mechanisms outside the present understanding of biomedicine.

METHODS

Articles meeting inclusion criteria were identified from database and reference list searches and evaluated for a range of reporting and design items. Data were extracted to determine the range of protocol parameters and treatment outcomes. The final set of included RCTs were evaluated via a modified 5-item Jadad scale as well as by a set of 20 criteria that included items relevant to the early-phase nature of the trials and to the examination of nonphysical touch biofield therapy interventions.

RESULTS

Of 90 RCTs that assessed effectiveness of a biofield therapy in humans, 28 trials involving 1775 participants met additional inclusion criteria (most importantly a clearly reported use of only nonphysical contact treatment). The research designs of these 28 trials revealed marked heterogeneity in regard to condition treated, number and duration of treatments, nature of the control/comparison group, and outcome measures. Finally, 10 trials were excluded on the basis of low quality assessment scores. Twelve of the remaining 18 trials (7 Therapeutic Touch, 3 external qigong, 1 Reiki, and 1 Healing Touch) reported at least one primary outcome with statistically significant beneficial treatment outcomes.

CONCLUSIONS

The pilot study nature of essentially all the identified nonphysical contact biofield therapy RCTs, as reflected by low sample sizes alone, precludes drawing robust conclusions. Given this perspective, the finding that two thirds of the higher-scoring trials demonstrated at least partial effectiveness favors a continued research effort, especially in light of the translational value of biofield clinical trials for studies exploring the nature and physiologic basis of biofield healing.

Therapeutic touch for healing acute wounds

BACKGROUND

Therapeutic Touch (TT) is an alternative therapy that has gained popularity over the past two decades for helping wounds to heal. Practitioners enter a meditative state and pass their hands above the patient's body to find and correct any imbalances in the patient's 'life energy' or chi. Scientific instruments have been unable to detect this energy. The effect of TT on wound healing has been expounded in anecdotal publications.

OBJECTIVES

To identify and review all relevant data to determine the effects of TT on healing acute wounds.

SEARCH METHODS

In January 2014, for this fifth update, we searched The Cochrane Wounds Group Specialised Register; The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library); Ovid MEDLINE; Ovid MEDLINE (In-Process & Other Non-Indexed Citations); Ovid EMBASE; and EBSCO CINAHL.

SELECTION CRITERIA

All randomised or quasi-randomised controlled trials, which compared the effect of TT with a placebo, another treatment, or no treatment control were considered. Studies which used TT as a stand-alone treatment, or as an adjunct to other therapies, were eligible.

DATA COLLECTION AND ANALYSIS

One author (DO'M) determined the eligibility for inclusion of all trials in the review. Both authors conducted data extraction and evaluation of trial validity independently. Each trial was assessed using predetermined criteria.

MAIN RESULTS

No new trials were identified for this update. Four trials in people with experimental wounds were included. The effect of TT on wound healing in these studies was variable. Two trials (n = 44 & 24) demonstrated a significant increase in healing associated with TT, while one trial found significantly worse healing after TT and the other found no significant difference. All trials are at high risk of bias.

AUTHORS' CONCLUSIONS

There is no robust evidence that TT promotes healing of acute wounds.

Therapeutic touch for healing acute wounds

BACKGROUND

Therapeutic Touch (TT) is an alternative therapy that has gained popularity over the past two decades for helping wounds to heal. Practitioners enter a meditative state and pass their hands above the patient's body to find and correct any imbalances in the patient's 'life energy' or chi. Scientific instruments have been unable to detect this energy. The effect of TT on wound healing has been expounded in anecdotal publications.

OBJECTIVES

To identify and review all relevant data to determine the effects of TT on healing acute wounds.

SEARCH METHODS

For this fourth update, we searched The Cochrane Wounds Group Specialised Register (searched 27 January 2012); The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2012, Issue 1); Ovid MEDLINE (2010 to January Week 2 2012); Ovid MEDLINE (In-Process & Other Non-Indexed Citations, January 26, 2012); Ovid EMBASE (2010 to 2012 Week 03); and EBSCO CINAHL (2010 to January 6 2012).

SELECTION CRITERIA

All randomised or quasi-randomised controlled trials, which compared the effect of TT with a placebo, another treatment, or no treatment control were considered. Studies which used TT as a stand-alone treatment, or as an adjunct to other therapies, were eligible.

DATA COLLECTION AND ANALYSIS

One author (DO'M) determined the eligibility for inclusion of all trials in the review. Both authors conducted data extraction and evaluation of trial validity independently. Each trial was assessed using predetermined criteria.

MAIN RESULTS

No new trials were identified for this update. Four trials in people with experimental wounds were included. The effect of TT on wound healing in these studies was variable. Two trials (n = 44 & 24) demonstrated a significant increase in healing associated with TT, while one trial found significantly worse healing after TT and the other found no significant difference. All trials are at high risk of bias.

AUTHORS' CONCLUSIONS

There is no robust evidence that TT promotes healing of acute wounds.

Molecular imaging-assisted optimization of hsp70 expression during laser-induced thermal preconditioning for wound repair enhancement

Patients at risk for impaired healing may benefit from prophylactic measures aimed at improving wound repair. Several photonic devices claim to enhance repair by thermal and photochemical mechanisms. We hypothesized that laser-induced thermal preconditioning would enhance surgical wound healing that was correlated with hsp70 expression. Using a pulsed diode laser (lambda=1.85 microm, tau(p)=2 ms, 50 Hz, H=7.64 mJ cm(-2)), the skin of transgenic mice that contain an hsp70 promoter-driven luciferase was preconditioned 12 hours before surgical incisions were made. Laser protocols were optimized in vitro and in vivo using temperature, blood flow, and hsp70-mediated bioluminescence measurements as benchmarks. Biomechanical properties and histological parameters of wound healing were evaluated for up to 14 days. Bioluminescent imaging studies indicated that an optimized laser protocol increased hsp70 expression by 10-fold. Under these conditions, laser-preconditioned incisions were two times stronger than control wounds. Our data suggest that this molecular imaging approach provides a quantitative method for optimization of tissue preconditioning and that mild laser-induced heat shock may be a useful therapeutic intervention prior to surgery.

A Randomized Trial of the Effects of Remote Intercessory Prayer: Interactions with Personal Beliefs on Problem-Specific Outcomes and Functional Status

OBJECTIVES

Investigate the relevance of interpersonal belief factors as modifiers of the effectiveness of intercessory prayer.

DESIGN

Randomized clinical trial.

SETTING/LOCATION

Community-dwelling adults recruited from seven local church groups.

SUBJECTS

Eighty-six (86) male and female participants 18-88 years of age were randomly assigned to either treatment (n = 45) or control groups (n = 41).

INTERVENTIONS

Several volunteers committed to daily prayer for participants in the intervention group. Intercessory prayer commenced for 1 month and were directed toward a life concern or problem disclosed by the participant at baseline. Participants were unaware of being prayed for.

OUTCOMES MEASURES

Degree to which their problem had been resolved and the current level of concern they had about a specific life problem they described at baseline. Four component scores from the Medical Outcomes Study SF-20 were also used.

RESULTS

No direct intervention effect on the primary outcomes was found. A marginally significant reduction in the amount of pain was observed in the intervention group compared to controls. The amount of concern for baseline problems at follow-up was significantly lower in the intervention group when stratified by subject's baseline degree of belief that their problem could be resolved. Prayer intervention appeared to effectively reduce the subject's level of concern only if the subject initially believed that the problem could be resolved. Those in the intervention group who did not believe in a possible resolution to their problem did not differ from controls. Better physical functioning was observed in the intervention group among those with a higher belief in prayer and surprisingly, better mental health scores were observed in the control group with lower belief in prayer scores.

CONCLUSIONS

The results of the current study underscore the role of interpersonal belief in prayer efficacy and are consistent with the literature showing the relevance of belief in health and well-being in general. The relevance of interpersonal belief factors of the participants is recommended in future investigations.

Therapeutic touch for healing acute wounds

BACKGROUND

Therapeutic Touch (TT) as a treatment modality has increased in popularity over the past two decades. Its efficacy in relation to the healing of wounds has been expounded in anecdotal publications. To date however there has been no systematic review.

OBJECTIVES

To identify and review all relevant data to determine the effectiveness of TT in the promotion of wound healing.

SEARCH STRATEGY

The Cochrane Wounds Group Specialised Trials Register and the Cochrane Central Register of Controlled Trials were searched in May 2003. The Cochrane Complementary Medicine field database was searched in September 2002. In addition the Sigma Theta Tau International Registry of Nursing Research (1983 to 2002) was also searched in September 2002. Furthermore searches of MEDLINE (1966 to 2003) were conducted in 1997 and May 2003, CINAHL (1982 to 2002) in September 2002 and dissertation abstracts in September 2002.

SELECTION CRITERIA

All randomised or quasi-randomised controlled trials, which compared the effect of TT with a placebo, another treatment, or no treatment control were considered. Studies which used TT as a stand-alone treatment, or as an adjunct to other therapies, were eligible.

DATA COLLECTION AND ANALYSIS

One reviewer (DO) determined the eligibility for inclusion of all trials. Both reviewers conducted data extraction and evaluation of each trial's quality independently. Each trial was analysed based on predetermined criteria and a narrative of each trial's main conclusions was produced.

MAIN RESULTS

Four trials in people with experimental wounds were eligible for inclusion. The effect of TT on wound healing in these studies was variable. Two of the studies (n = 44 & 24) demonstrated a significant effect of TT. However the results of the two other trials favoured the control group (n = 15 & 38), one of these trials demonstrated a significant effect in favour of the control group.

REVIEWER'S CONCLUSIONS

There is insufficient evidence that TT promotes healing of acute wounds.

Spiritual role in healing. An alternative way of thinking

Research shows convincingly that patients with serious medical illnesses commonly use spiritual methods to cope with and manage their illnesses. This reliance on spirituality seems to be associated with a range of positive outcomes in the form of an enhanced sense of well-being, improved feelings of resiliency, and decreased adverse physical symptoms (e.g., pain and fatigue) and psychologic symptoms (e.g., anxiety). The methodologic flaws and limitations of this literature, however, make more research necessary before confident conclusions can be made regarding the objective, biologic benefit. Further efforts should focus on identifying the potential mechanisms through which spirituality enhances both subjective and objective outcomes. Care should be taken to use reliable, valid spirituality assessment measures and more advanced methodologic designs, such as prospective, longitudinal studies, and randomized, controlled trials.

Reiki: A Complementary Therapy for Nursing Practice

1. Reiki is an ancient healing art involving the gentle laying on of hands. It can be practiced anytime and anywhere. 2. Reiki can be used as a complementary treatment to medical protocols. 3. Hand positions customarily correspond to the body's endocrine and lymphatic systems and major organs, focusing on seven main chakras. 4. More research investigating the effects of Reiki on persons with psychiatric and medical disorders is necessary.

The empowering nature of Reiki as a complementary therapy

Reiki is an ancient healing method with roots in both Chinese Medicine and Christian healing. It is a treatment used by individuals as an alternative and complement to Western medical treatment. Reiki has increased in popularity over the past decade, but remains understudied. Methodological and philosophical reasons for why it is difficult to conduct research on the efficacy of Reiki are discussed. The reasons for the increased success of Reiki as an alternative and complementary healing method in the Western world are addressed, as well as the practice of Reiki as a healing method for self and others.

Multisite surface electromyography and complementary healing intervention: a comparative analysis

A comparative analysis was conducted on a series of three experimental studies that examined the effect of various local and nonlocal (distant) complementary healing methods on multisite surface electromyographic (sEMG) and autonomic measures. The series concentrated sEMG electrode placement on specific neuromuscular paraspinal centers (cervical [C4], thoracic [T6], and lumbar [L3]), along with the frontalis region, due to the fact that these sites corresponded to the location of individual chakra centers as delineated in ancient Eastern medical and philosophical texts. It was hypothesized that the sEMG assessment procedure had the potential to provide objective, quantifiable correlates for complementary healing treatment effects, as well as assess the energy flow through the chakras during a healing treatment. The studies were the first of their kind to incorporate randomized, double-blind, placebo-controlled protocols in order to evaluate correlative neuromuscular multisite sEMG paraspinal measures with different complementary healing treatment interventions. Although the measurement protocols were similar between experiments, the results, demonstrated by the individual studies, varied. Whereas the overall findings of the series are encouraging because they indicate a potential objective scientific correlate to complementary healing treatment intervention, the results are considered preliminary in nature and appear to be linked to either the meditational experience of the subjects or dependent on the particular healer(s) used. Additional research is needed in order to establish the multisite sEMG assessment procedure as a reliable correlative measure for complementary healing treatment effects and to determine whether a consistent replicative treatment effect can be demonstrated independent of the specific subject population or practitioner(s) used.

Multisite electromyographic analysis of therapeutic touch and qigong therapy

The influence of complementary healing treatment on paraspinal electromagnetic activity at specific neuromuscular sites was examined in an exploratory pilot study that used a multisite surface electromyographic (sEMG) assessment procedure. The study was a replication and extension of previous research that indicated that complementary healing had a significant effect in normalizing the activity of the "end organ" for the central nervous system (CNS). Multisite sEMG electrodes were placed on the frontalis, cervical (C4), thoracic (T6), and lumbosacral (L3) paraspinals of 44 subjects who were divided into three groups: (1) students/patients of a Qigong practitioner (n = 16); (2) students/patients of a therapeutic touch (TT) practitioner (n = 14); and (3) nonbelievers in complementary healing (n = 14). A traditional ABAC experimental design was used with each subject evaluated for one 20-minute session that included four 5-minute segments. The purpose of this study was to measure the variable energizing effect of Qigong therapy along with the anecdotally and experimentally established relaxation effect of TT therapy relative to patient belief and expectancy. Treatment sessions consisted of Qigong and a modified form of TT intervention for all three groups. Due to the double-blind nature of the study, however, group 1 subjects were aware of only the Qigong intervention; group 2 subjects were aware of only the TT intervention, and group 3 subjects were informed that the study was designed to assess the neuromuscular activity of individuals in a seated position. The results indicated a statistically significant rise in electromagnetic activity for group 1 during the Qigong intervention segment (p < .024). Group 2 demonstrated a modest although overall nonsignificant decrease in multisite sEMG levels for both treatment protocols, whereas group 3 exhibited relatively consistent neuromuscular activity for both control and treatment segments. The results of this study are considered preliminary in nature, however, due to the potential influence of several confounds including psychophysiological factors, established behavior patterns, and the possibility for information transfer due to sensory cues.