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Nikoozad S, Safdari-Dehcheshmeh F, Sharifi F, Ganji F. The effect of prenatal education on health anxiety of primigravid women. BMC Pregnancy Childbirth 2024; 24:541. [PMID: 39143475 PMCID: PMC11325567 DOI: 10.1186/s12884-024-06718-2] [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: 03/24/2024] [Accepted: 07/24/2024] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND AND AIM Health anxiety is a mental disorder that characterized by an excessive fear about health and physical symptoms. High anxiety in pregnancy is associated with adverse outcomes. The aim of this study was to investigate the effect of prenatal education on health anxiety of primigravid women. METHODS The present study was quasi-experimental study. 122 primiparous pregnant women referred to comprehensive health services Shahrekord (A city in the southwest of Iran) clinics in 2019, after receiving consent to participate in the study, randomly divided into two intervention and control groups. The intervention group participated in 8 sessions (1.5-h), once every 2 weeks, from 20 to 37th weeks of gestation. The health anxiety questionnaire was completed on 20th (before the beginning of the courses), 28th and 37th weeks by two groups. Consequences of pregnancy included weight, Apgar score, delivery type, labor time and first breastfeeding time. SPSS version 16 software was used for data analysis. RESULTS No significant difference was found type of delivery, gestational age, height, weight, head length, Apgar score, duration of hospitalization and first breastfeeding time. The duration of the active and latent phase of labor was significantly lower and the weight of newborn was significantly higher in the intervention group than the control group (P < 0.05). At 37th week, the scores of illness concern, negative consequence and total health anxiety in the intervention group decreased by 3.42, 0.93 and 4.36 respectively and in control group increased by 2.82, 0.03 and 2.86. CONCLUSION Pregnancy educational courses has positive effects on health anxiety, decrease duration of labor time and increased newborn weight. In order to improve the outcome of pregnancy, educational classes during pregnancy should be considered.
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Affiliation(s)
- Sahar Nikoozad
- Faculty of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Faranak Safdari-Dehcheshmeh
- Social Determinants of Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
- Department of Midwifery and Reproductive Health, Nursing and Midwifery School, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Farangis Sharifi
- Social Determinants of Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
- Department of Midwifery and Reproductive Health, Nursing and Midwifery School, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Forouzan Ganji
- Social Determinants of Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran.
- Department of Community Medicine, Faculty of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran.
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Vora LK, Gholap AD, Hatvate NT, Naren P, Khan S, Chavda VP, Balar PC, Gandhi J, Khatri DK. Essential oils for clinical aromatherapy: A comprehensive review. JOURNAL OF ETHNOPHARMACOLOGY 2024; 330:118180. [PMID: 38614262 DOI: 10.1016/j.jep.2024.118180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 03/21/2024] [Accepted: 04/08/2024] [Indexed: 04/15/2024]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Aromatherapy, a holistic healing practice utilizing the aromatic essences of plant-derived essential oils, has gained significant attention for its therapeutic potential in promoting overall well-being. Use of phytoconstituent based essential oil has played a significant role in the evolving therapeutic avenue of aromatherapy as a complementary system of medicine. AIM OF THE STUDY This comprehensive review article aims to explore the usage of essential oils for aromatherapy, shedding light on their diverse applications, scientific evidence, and safety considerations. Furthermore, the growing interest in using essential oils as complementary therapies in conjunction with conventional medicine is explored, underscoring the significance of collaborative healthcare approaches. MATERIALS AND METHODS Literature search was performed from databases like PubMed, ScienceDirect, Scopus, and Bentham using keywords like Aromatherapy, Aromatic Plants, Essential oils, Phytotherapy, and complementary medicine. The keywords were used to identify literature with therapeutic and mechanistic details of herbal agents with desired action. RESULTS The integration of traditional knowledge with modern scientific research has led to a renewed interest in essential oils as valuable tools in contemporary healthcare. Various extraction methods used to obtain essential oils are presented, emphasizing their impact on the oil's chemical composition and therapeutic properties. Additionally, the article scrutinizes the factors influencing the quality and purity of essential oils, elucidating the significance of standardization and certification for safe usage. A comprehensive assessment of the therapeutic effects of essential oils is provided, encompassing their potential as antimicrobial, analgesic, anxiolytic, and anti-inflammatory agents, among others. Clinical trials and preclinical studies are discussed to consolidate the existing evidence on their efficacy in treating diverse health conditions, both physical and psychological. Safety considerations are of paramount importance when employing essential oils, and this review addresses potential adverse effects, contraindications, and best practices to ensure responsible usage. CONCLUSIONS This comprehensive review provides valuable insights into the exploration of essential oils for aromatherapy, emphasizing their potential as natural and potent remedies for a wide range of ailments. By amalgamating traditional wisdom and modern research, this article aims to encourage further investigation into the therapeutic benefits of essential oils while advocating for their responsible and evidence-based incorporation into healthcare practices.
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Affiliation(s)
- Lalitkumar K Vora
- School of Pharmacy, Queen's University Belfast, 97 Lisburn Road, BT9 7BL, UK.
| | - Amol D Gholap
- Department of Pharmaceutics, St. John Institute of Pharmacy and Research, Palghar, 401404, Maharashtra, India
| | - Navnath T Hatvate
- Institute of Chemical Technology Mumbai, Marathwada Campus, Jalna, 431213, Maharashtra, India
| | - Padmashri Naren
- Molecular and Cellular Neuroscience Laboratory, Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER)-Hyderabad, Telangana, 500037, India
| | - Sabiya Khan
- Molecular and Cellular Neuroscience Laboratory, Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER)-Hyderabad, Telangana, 500037, India
| | - Vivek P Chavda
- Department of Pharmaceutics and Pharmaceutical Technology, L. M. College of Pharmacy, Ahmedabad, Gujarat, India.
| | - Pankti C Balar
- Pharmacy Section, L. M. College of Pharmacy, Ahmedabad, Gujarat, India
| | - Jimil Gandhi
- Pharmacy Section, L. M. College of Pharmacy, Ahmedabad, Gujarat, India
| | - Dharmendra Kumar Khatri
- Molecular and Cellular Neuroscience Laboratory, Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER)-Hyderabad, Telangana, 500037, India.
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Balikci A, Eryilmaz U, Guler VK, Ilbay G. Tactile stimulation of young WAG/Rij rats prevents development of depression but not absence epilepsy. Front Behav Neurosci 2024; 18:1433431. [PMID: 38993266 PMCID: PMC11236540 DOI: 10.3389/fnbeh.2024.1433431] [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: 05/15/2024] [Accepted: 06/17/2024] [Indexed: 07/13/2024] Open
Abstract
Investigations in Wistar Albino Glaxo from Rijswijk (WAG/Rij) rats that are susceptible to genetic absence epilepsy have demonstrated that environmental modifications affect absence seizures. Previously, we showed that neonatal tactile stimulations produce disease-modifying effect on genetically determined absence epilepsy and associated depression in Wag/Rij rats. The study presented here examined the effect of TS during late ontogenesis (adolescence and young adulthood) on epilepsy and depression outcomes in this genetically epileptic rat strain. On postnatal day (PND) 38, male WAG/Rij rats randomly were assigned to either the tactile stimulation (TS), handled or control group (unhandled) with 8 animals in each group. Following a 7-day adaptation period to their new surroundings, the animals were submitted to tactile stimulation from PND 45 to PND 90, five days per week, for 5 min daily. The tactile-stimulated rat was removed from its cage, placed on the experimenter's lap, and had its neck and back gently stroked by the researcher. The handled rats were taken to another cage and left alone for 5 min daily from PND 45 to PND 90. The control rats were left undisturbed in their home cage, except for regular cage cleaning. After PND 90, all rats were left undisturbed until behavioral testing and EEG recording. When the animals were 7 months old, they were subjected to the sucrose consumption test (SCT) and the forced swimming test (FST). Electroencephalogram (EEG) recordings were made at 8 months of age in order to measure electroencephalographic seizure activity, thus, the spike-wave discharges (SWDs). Tactile-stimulated rats showed increased sucrose consumption and number of approaches to the sucrose solution in the SCT when compared with the handled and control rats. In the FST, rats in TS group showed lower immobility time and greater immobility latency, active swimming time and diving frequency than the handled and control rats. The duration and the number of seizures were not different amongst the groups. The data obtained suggest that TS in young rats is able to prevent depression in WAG/Rij rats.
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Affiliation(s)
- Aymen Balikci
- Department of Physiology, Faculty of Medicine, Kocaeli University, İzmit, Türkiye
| | - Ugur Eryilmaz
- Department of Physiology, Faculty of Medicine, Kocaeli University, İzmit, Türkiye
| | - Vildan Keles Guler
- Department of Physiology, Faculty of Medicine, Kocaeli University, İzmit, Türkiye
| | - Gul Ilbay
- Department of Physiology, Faculty of Medicine, Kocaeli University, İzmit, Türkiye
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McGlone F, Uvnäs Moberg K, Norholt H, Eggart M, Müller-Oerlinghausen B. Touch medicine: bridging the gap between recent insights from touch research and clinical medicine and its special significance for the treatment of affective disorders. Front Psychiatry 2024; 15:1390673. [PMID: 38881553 PMCID: PMC11177324 DOI: 10.3389/fpsyt.2024.1390673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 05/07/2024] [Indexed: 06/18/2024] Open
Abstract
Interpersonal touch represents the primal sensory experience between humans, fostering social bonding from the cradle to the death bed. In recent decades "affective touch" has been intensely studied, stimulated by the discovery of a population of mechanosensitive unmyelinated C-tactile afferents in mammalian skin. A lack of touch in childhood is associated with negative consequences for psychosocial and physical health and the benefits of professional touch techniques in the prevention and treatment of various diseases have been shown over and over again in clinical studies. However, its application in mainstream clinical applications remains limited. To bridge the gap between recent discoveries in touch research and clinical medicine, we propose the establishment of a new discipline: 'Touch Medicine'. Here, we unfold the potential of Touch Medicine by focusing on the treatment of depression, which in our view is primarily a disorder of the lived body. Controlled studies and systematic reviews have demonstrated the antidepressant, anxiolytic and analgesic effects of specific massage techniques. Underlying mechanisms of action are currently under investigation, ranging from interoceptive, endocrinological, to stress-related or psychological underpinnings. Touch Medicine represents a novel interdisciplinary field connected to various medical specialities such as neonatology, pediatrics, pain medicine, neurology, psychiatry, and geriatrics - but also clinical psychology and psychosomatic medicine might benefit from the integration of these findings into their daily practice.
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Affiliation(s)
- Francis McGlone
- Department of Life Sciences, Manchester Metropolitan University, Manchester, United Kingdom
- Department of Neuroscience & Biomedical Engineering, School of Science, Aalto University, Helsinki, Finland
| | - Kerstin Uvnäs Moberg
- Department of Animal Environment and Health, Swedish University of Agricultural Sciences, Skara, Sweden
| | - Henrik Norholt
- SomAffect - The Somatosensory & Affective Neuroscience Group, Liverpool, United Kingdom
| | - Michael Eggart
- Faculty of Health Sciences, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
- Faculty of Social Work, Health and Nursing, Ravensburg-Weingarten University of Applied Sciences, Weingarten, Germany
| | - Bruno Müller-Oerlinghausen
- Faculty of Medicine and Psychology, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
- Charité University Medicine Berlin, Berlin, Germany
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Fogarty S, Heazell AEP, Munk N, Hay P. Swedish massage as an adjunct approach to Help suppOrt individuals Pregnant after Experiencing a prior Stillbirth (HOPES): a convergent parallel mixed-methods single-arm feasibility trial protocol. Pilot Feasibility Stud 2024; 10:67. [PMID: 38689324 PMCID: PMC11059749 DOI: 10.1186/s40814-024-01499-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 04/18/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Women experiencing pregnancy after stillbirth experience high levels of anxiety, fear and depression. Standard antenatal care may be emotionally unsuitable for many women at this time, and there is a lack of evidence on what interventions or approaches to care might benefit these women. Therapeutic massage may assist women after stillbirth by decreasing anxiety, worry and stress. OBJECTIVE This paper outlines the objectives, methodology, outcome and assessment measures for the Helping suppOrt individuals Pregnant after Experiencing a Stillbirth (HOPES) feasibility trial which evaluates massage as an adjunct approach to care for pregnant women who have experienced a prior stillbirth. It also outlines data collection timing and considerations for analysing the data. METHODS HOPES will use a convergent parallel mixed-methods, single-arm repeated measures trial design in trained massage therapists' private clinics across Australia. HOPES aims to recruit 75 individuals pregnant after a previous stillbirth. The intervention is massage therapy treatments, and participants will receive up to five massages within a 4-month period at intervals of their choosing. Primary quantitative outcomes are the feasibility and acceptability of the massage intervention. Secondary outcomes include determining the optimal timing of massage therapy delivery and the collection of measures for anxiety, worry, stress and self-management. A thematic analysis of women's experiences undertaking the intervention will also be conducted. A narrative and joint display approach to integrate mixed-methods data is planned. DISCUSSION The HOPES study will determine the feasibility and preliminary evidence for massage therapy as an intervention to support women who are pregnant after a stillbirth. TRIAL REGISTRATION CLINICALTRIALS gov NCT05636553. Registered on December 3, 2022, and the trial is ongoing.
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Affiliation(s)
- Sarah Fogarty
- School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia.
- Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia.
| | - Alexander E P Heazell
- School of Medical Sciences, Maternal and Fetal Health Research Centre, University of Manchester, Manchester, UK
- Department of Obstetrics, Saint Mary's Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - Niki Munk
- School of Health & Human Sciences, Indiana University, Indianapolis, USA
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Fellow and Visiting Faculty of Health, University of Technology Sydney, Massage & MyotherapyAustralia, Sydney, Australia
| | - Phillipa Hay
- Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
- Mental Health Services, SWSLHD, Campbelltown Hospital, Campbelltown, NSW, Australia
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Janssen LE, Gieskes AA, Kok M, de Groot CJM, Oudijk MA, de Boer MA. Stress-reducing interventions in pregnancy for the prevention of preterm birth: a systematic review and meta-analysis. J Psychosom Obstet Gynaecol 2023; 44:2281238. [PMID: 38064297 DOI: 10.1080/0167482x.2023.2281238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 11/04/2023] [Indexed: 12/18/2023] Open
Abstract
Preterm birth (PTB) is the leading cause of neonatal morbidity and mortality. Maternal stress during pregnancy is an established risk factor for PTB. We aimed to review the effects of stress-reducing interventions during pregnancy on PTB. Studies reporting on stress-reducing interventions during pregnancy and PTB rates in general low-risk obstetric populations were included. PTB rates, low birth weight (LBW) rates, mean gestational age and birth weight, maternal anxiety and stress, and adverse perinatal outcomes were investigated. Data were extracted using a standardized extraction form, pooled effect sizes were calculated with the random effects model. Ten studies with a total of 4.816 women were included. The interventions included Pilates, yoga, a multidisciplinary stress reduction program, combination therapy (combining mindfulness, yoga, music, baby bonding, and education), and hypnosis. The incidence of PTB was significantly lower in the intervention group (RR 0.50, 95% CI 0.35 - 0.71). The overall quality of the included studies was low, and the risk of bias was high. In conclusion, this study provides evidence supporting the potential efficacy of stress-reducing interventions in reducing the incidence of PTB in low-risk women. We propose a RCT of high quality to determine the effectiveness of stress-reducing interventions in reducing PTB risk.
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Affiliation(s)
- Laura E Janssen
- Department of Obstetrics, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
| | - Adelia A Gieskes
- Department of Obstetrics, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
| | - Marjolein Kok
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
| | - Christianne J M de Groot
- Department of Obstetrics, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
| | - Martijn A Oudijk
- Department of Obstetrics, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
| | - Marjon A de Boer
- Department of Obstetrics, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
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Silverwood V, Bullock L, Jordan J, Turner K, Chew-Graham CA, Kingstone T, Dawson S. Non-pharmacological interventions for the management of perinatal anxiety in primary care: a meta-review of systematic reviews. BJGP Open 2023; 7:BJGPO.2023.0022. [PMID: 37217213 PMCID: PMC10646202 DOI: 10.3399/bjgpo.2023.0022] [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: 02/09/2023] [Revised: 05/12/2023] [Accepted: 05/19/2023] [Indexed: 05/24/2023] Open
Abstract
BACKGROUND Perinatal anxiety (PNA), anxiety that occurs during pregnancy and/or up to 12 months postpartum, is estimated to affect up to 21% of women, and may impact negatively on mothers, children, and their families. The National Institute for Health and Care Excellence (NICE) has called for further research around non-pharmacological interventions in primary care for PNA. AIM To summarise the available international evidence on non-pharmacological interventions for women with PNA in a primary care population. DESIGN & SETTING A meta-review of systematic reviews (SRs) with narrative synthesis was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance. METHOD Systematic literature searches were conducted in 11 health-related databases up to June 2022. Titles, abstracts, and full-text articles were dual-screened against pre-defined eligibility criteria. A variety of study designs were included. Data were extracted about study participants, intervention design, and context. Quality appraisal was performed using the AMSTAR 2 tool (A MeaSurement Tool to Assess systematic Reviews). A patient and public involvement group informed and contributed towards this meta-review. RESULTS Twenty-four SRs were included in the meta-review. Interventions were grouped into the following six categories for analysis purposes: psychological therapies; mind-body activities; emotional support from healthcare professionals (HCPs); peer support; educational activities; and alternative or complementary therapies. CONCLUSION In addition to pharmacological and psychological therapies, this meta-review has demonstrated that there are many more options available for women to choose from that might be effective to manage their PNA. Evidence gaps are present in several intervention categories. Primary care clinicians and commissioners should endeavour to provide patients with a choice of these management options, promoting individual choice and patient-centred care.
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Affiliation(s)
| | | | | | - Katrina Turner
- Centre of Academic Primary Health Care, Bristol Medical School, University of Bristol, Bristol, UK
| | - Carolyn A Chew-Graham
- School of Medicine, Keele University, Keele, UK
- Midlands Partnership NHS Foundation Trust,Trust Headquarters, St George's Hospital, Stafford, UK
- Applied Research Collaboration (ARC) West Midlands, Keele University, Keele, UK
| | - Tom Kingstone
- School of Medicine, Keele University, Keele, UK
- Midlands Partnership NHS Foundation Trust,Trust Headquarters, St George's Hospital, Stafford, UK
| | - Shoba Dawson
- Centre of Academic Primary Health Care, Bristol Medical School, University of Bristol, Bristol, UK
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Zhang X, Liang F, Lau CT, Chan JC, Wang N, Deng J, Wang J, Ma Y, Zhong LLD, Zhao C, Yao L, Wu T, Lyu A, Tian G, Shang H, Miao J, Bian Z. STandards for Reporting Interventions in Clinical Trials Of Tuina/Massage (STRICTOTM): Extending the CONSORT statement. J Evid Based Med 2023; 16:68-81. [PMID: 36918992 DOI: 10.1111/jebm.12522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 03/01/2023] [Indexed: 03/16/2023]
Abstract
OBJECTIVES Massage is a common therapy of nonpharmacological treatments, particularly in Tuina (Chinese massage) as its most common style, detailed guidance in reporting the intervention is warranted for its evaluation and replication. Based on the CONSORT (Consolidated Standards of Reporting Trials), we aimed to develop an Extension for Tuina/Massage, namely "The STandards for Reporting Interventions in Clinical Trials Of Tuina/Massage (STRICTOTM)." METHODS A group of professional clinicians, trialists, methodologists, developers of reporting guidelines, epidemiologists, statisticians, and editors has developed this STRICTOTM checklist through a standard methodology process recommended by the EQUATOR (Enhancing the QUAlity and Transparency of Health Research) Network, including prospective registration, literature review, draft of the initial items, three rounds of the Delphi survey, consensus meeting, pilot test, and finalization of the guideline. RESULTS A checklist of seven items (namely Tuina/Massage rationale, details of Tuina/Massage, intervention regimen, other components of the intervention, Tuina/Massage provider background, control or comparator interventions, and precaution measures), and 16 subitems were developed. Explanations and examples (E&E) for each item are also provided. CONCLUSIONS The working group hopes that the STRICTOTM, in conjunction with both the CONSORT statement and extension for nonpharmacologic treatment, can improve the reporting quality and transparency of Tuina/Massage clinical research.
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Affiliation(s)
- Xuan Zhang
- Chinese EQUATOR Centre, Chinese Clinical Trial Registry (Hong Kong), Hong Kong Chinese Medicine Clinical Study Centre, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, China
| | - Feng Liang
- Chinese EQUATOR Centre, Chinese Clinical Trial Registry (Hong Kong), Hong Kong Chinese Medicine Clinical Study Centre, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, China
| | - Chung Tai Lau
- Chinese EQUATOR Centre, Chinese Clinical Trial Registry (Hong Kong), Hong Kong Chinese Medicine Clinical Study Centre, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, China
| | - Jacky Cp Chan
- HKBU Faculty of Science, Department of Computer Science, Hong Kong Baptist University, Hong Kong, China
| | - Nana Wang
- Department of Brain and Behavioural Sciences, University of Pavia, Lombardy, Italy
| | - Jiashuai Deng
- College of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Juan Wang
- Chinese EQUATOR Centre, Chinese Clinical Trial Registry (Hong Kong), Hong Kong Chinese Medicine Clinical Study Centre, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, China
| | - Yanfang Ma
- Chinese EQUATOR Centre, Chinese Clinical Trial Registry (Hong Kong), Hong Kong Chinese Medicine Clinical Study Centre, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, China
| | - Linda L D Zhong
- School of Biological Sciences, Nanyang Technological University Singapore, Nanyang Ave, Singapore
| | - Chen Zhao
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Liang Yao
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Taixiang Wu
- Chinese Cochrane Centre, West China Hospital, Sichuan University, China Trial Registration Center, Chengdu, China
| | - Aiping Lyu
- Chinese EQUATOR Centre, Chinese Clinical Trial Registry (Hong Kong), Hong Kong Chinese Medicine Clinical Study Centre, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, China
| | - Guihua Tian
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Hongcai Shang
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Jiangxia Miao
- School of Chinese medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Zhaoxiang Bian
- Chinese EQUATOR Centre, Chinese Clinical Trial Registry (Hong Kong), Hong Kong Chinese Medicine Clinical Study Centre, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, China
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Fogarty S, Werner R, James JL. Applying Scientific Rationale to the Current Perceptions and Explanations of Massage and Miscarriage in the First Trimester. Int J Ther Massage Bodywork 2023; 16:30-43. [PMID: 36866184 PMCID: PMC9949615 DOI: 10.3822/ijtmb.v16i1.771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Abstract
Miscarriage is a relatively common occurrence, impacting 8-15% of clinically recognised pregnancies, and up to 30% of all conceptions. The public perception of the risk factors associated with miscarriage does not match the evidence. Evidence indicates that there are very few modifiable factors to prevent miscarriage, and the majority of the time little could have been done to prevent a spontaneous miscarriage. However, the public perception is that consuming drugs, lifting a heavy object, previous use of an intrauterine device, or massage can all contribute to miscarriage. While misinformation about the causes and risk factors of miscarriage continues to circulate, pregnant women will experience confusion about what activities they can (and cannot) do in early pregnancy, including receiving a massage. Pregnancy massage is an important component of massage therapy education. The resources that underpin pregnancy massage coursework consist of educational print content that includes direction and caution that massage in the first trimester, if done 'incorrectly' or in the 'wrong' location, can contribute to adverse outcomes such as miscarriage. The most common statements, perceptions and explanations for massage and miscarriage cover three broad areas: 1) maternal changes from massage affects the embryo/fetus; 2) massage leads to damage of the fetus/placenta; and 3) aspects of the massage treatment in the first trimester initiate contractions. The goal of this paper is to use scientific rationale to critically consider the validity of the current perceptions and explanations of massage therapy and miscarriage. Whilst direct evidence from clinical trials was lacking, considerations of physiological mechanisms regulating pregnancy and known risk factors associated with miscarriage provide no evidence that massage in pregnancy would increase a patient's risk of miscarriage. This scientific rationale should be addressed when teaching pregnancy massage courses.
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Affiliation(s)
- Sarah Fogarty
- Department of Medicine, School of Medicine, Western Sydney University, Sydney, Australia,Corresponding author: Sarah Fogarty, Department of Medicine, School of Medicine, Western Sydney University Campbelltown Campus, Narellan Road & Gilchrist Drive, Campbelltown, NSW 2560, Australia,
| | - Ruth Werner
- Author of A Massage Therapist’s Guide to Pathology, and Board Certified in Therapeutic Massage and Bodywork, USA
| | - Joanna L James
- Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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Yang J, Wang Y, Xu J, Ou Z, Yue T, Mao Z, Lin Y, Wang T, Shen Z, Dong W. Acupuncture for low back and/or pelvic pain during pregnancy: a systematic review and meta-analysis of randomised controlled trials. BMJ Open 2022; 12:e056878. [PMID: 36410790 PMCID: PMC9723856 DOI: 10.1136/bmjopen-2021-056878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 06/30/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Acupuncture is emerging as a potential therapy for relieving pain, but the effectiveness of acupuncture for relieving low back and/or pelvic pain (LBPP) during the pregnancy remains controversial. This meta-analysis aims to investigate the effects of acupuncture on pain, functional status and quality of life for women with LBPP pain during the pregnancy. DESIGN Systematic review and meta-analysis. DATA SOURCES The PubMed, EMBASE databases, Web of Science and Cochrane Library were searched for relevant randomised controlled trials (RCTs) from inception to 15 January 2022. ELIGIBILITY CRITERIA FOR SELECTING STUDIES RCTs evaluating the effects of acupuncture on LBPP during the pregnancy were included. DATA EXTRACTION AND SYNTHESIS The data extraction and study quality assessment were independently performed by three reviewers. The mean differences (MDs) with 95% CIs for pooled data were calculated. We assessed the confidence in the evidence using the Grading of Recommendations Assessment, Development and Evaluation framework. MAIN OUTCOMES AND MEASURES The primary outcomes were pain, functional status and quality of life. The secondary outcomes were overall effects (a questionnaire at a post-treatment visit within a week after the last treatment to determine the number of people who received good or excellent help), analgesic consumption, Apgar scores >7 at 5 min, adverse events, gestational age at birth, induction of labour and mode of birth. RESULTS This meta-analysis included 10 studies, reporting on a total of 1040 women. Overall, acupuncture significantly relieved pain during pregnancy (MD=1.70, 95% CI: (0.95 to 2.45), p<0.00001, I2=90%) and improved functional status (MD=12.44, 95% CI: (3.32 to 21.55), p=0.007, I2=94%) and quality of life (MD=-8.89, 95% CI: (-11.90 to -5.88), p<0.00001, I2 = 57%). There was a significant difference for overall effects (OR=0.13, 95% CI: (0.07 to 0.23), p<0.00001, I2 = 7%). However, there was no significant difference for analgesic consumption during the study period (OR=2.49, 95% CI: (0.08 to 80.25), p=0.61, I2=61%) and Apgar scores of newborns (OR=1.02, 95% CI: (0.37 to 2.83), p=0.97, I2 = 0%). Preterm birth from acupuncture during he study period was reported in two studies. Although preterm contractions were reported in two studies, all infants were in good health at birth. In terms of gestational age at birth, induction of labour and mode of birth, only one study reported the gestational age at birth (mean gestation 40 weeks). Thus, prospective randomised clinical studies or clinical follow-up studies were hence desirable to further evaluate these outcomes. CONCLUSIONS Acupuncture significantly improved pain, functional status and quality of life in women with LBPP during the pregnancy. Additionally, acupuncture had no observable severe adverse influences on the newborns. More large-scale and well-designed RCTs are still needed to further confirm these results. PROSPERO REGISTRATION NUMBER CRD42021241771.
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Affiliation(s)
- Jiaman Yang
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yi Wang
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jianmei Xu
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zhiwen Ou
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Ting Yue
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zhitao Mao
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Ying Lin
- The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Tao Wang
- Department of Orthopaedics, Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, China
- The Third Affiliated Hospital of Yunnan University of Chinese Medicine, Kunming, China
| | - Zhen Shen
- Department of Orthopaedics, Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, China
- The Third Affiliated Hospital of Yunnan University of Chinese Medicine, Kunming, China
| | - Wei Dong
- Department of Orthopaedics, Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, China
- The Third Affiliated Hospital of Yunnan University of Chinese Medicine, Kunming, China
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McParlin Z, Cerritelli F, Rossettini G, Friston KJ, Esteves JE. Therapeutic Alliance as Active Inference: The Role of Therapeutic Touch and Biobehavioural Synchrony in Musculoskeletal Care. Front Behav Neurosci 2022; 16:897247. [PMID: 35846789 PMCID: PMC9280207 DOI: 10.3389/fnbeh.2022.897247] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 05/24/2022] [Indexed: 12/05/2022] Open
Abstract
Touch is recognised as crucial for survival, fostering cooperative communication, accelerating recovery, reducing hospital stays, and promoting overall wellness and the therapeutic alliance. In this hypothesis and theory paper, we present an entwined model that combines touch for alignment and active inference to explain how the brain develops "priors" necessary for the health care provider to engage with the patient effectively. We appeal to active inference to explain the empirically integrative neurophysiological and behavioural mechanisms that underwrite synchronous relationships through touch. Specifically, we offer a formal framework for understanding - and explaining - the role of therapeutic touch and hands-on care in developing a therapeutic alliance and synchrony between health care providers and their patients in musculoskeletal care. We first review the crucial importance of therapeutic touch and its clinical role in facilitating the formation of a solid therapeutic alliance and in regulating allostasis. We then consider how touch is used clinically - to promote cooperative communication, demonstrate empathy, overcome uncertainty, and infer the mental states of others - through the lens of active inference. We conclude that touch plays a crucial role in achieving successful clinical outcomes and adapting previous priors to create intertwined beliefs. The ensuing framework may help healthcare providers in the field of musculoskeletal care to use hands-on care to strengthen the therapeutic alliance, minimise prediction errors (a.k.a., free energy), and thereby promote recovery from physical and psychological impairments.
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Affiliation(s)
- Zoe McParlin
- Clinical-Based Human Research Department, Foundation COME Collaboration, Pescara, Italy
| | - Francesco Cerritelli
- Clinical-Based Human Research Department, Foundation COME Collaboration, Pescara, Italy
| | | | - Karl J. Friston
- Institute of Neurology, Wellcome Centre for Human Neuroimaging, London, United Kingdom
| | - Jorge E. Esteves
- Clinical-Based Human Research Department, Foundation COME Collaboration, Pescara, Italy
- Malta ICOM Educational, Gzira, Malta
- University College of Osteopathy, London, United Kingdom
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Massage and touch-based therapy : Clinical evidence, neurobiology and applications in older patients with psychiatric symptoms. Z Gerontol Geriatr 2021; 54:753-758. [PMID: 34812896 PMCID: PMC8609249 DOI: 10.1007/s00391-021-01995-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 10/21/2021] [Indexed: 01/07/2023]
Abstract
Background Massage and touch-based treatment are popular despite limited evidence from high quality clinical trials. This article reviews the rationale and evidence of treating older patients with psychiatric symptoms by touch-based therapy. Methods Narrative literature review, based on Medline search with the following key words: massage, social touch, affective touch, clinical trial, meta-analysis. Citations of identified articles were searched for additional relevant studies. Results Evidence from clinical trials in adult patients with mainly chronic disorders of the musculoskeletal system suggests that massage therapy results in significant short-term improvement of symptoms; however, treatment effects appear not to be sustained. In addition, conclusions are difficult to draw owing to very heterogeneous study interventions, difficulties with definition of control conditions and treatment outcomes. There appears to be better evidence for improvement of psychological variables and subjective symptoms, such as pain and quality of life. A neuronal system of affective and social touch has been identified with specific afferents from C‑fibre coupled low threshold mechanoreceptors projecting into the insular cortex and the limbic system. This system may also mediate effects of massage in adult patients. Positive clinical trials for depressive symptoms of dementia and for behavioral symptoms of advanced dementia are available with encouraging results. Conclusion The neuronal system of social and affective touch suggests a potential mechanism of action of touch-based interventions in geriatric psychiatry. In addition, it provides a rationale for applying and designing novel touch-based treatment strategies as adjunctive treatment for psychiatric disorders of old age.
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