Impact of Massage Therapy on Fatigue, Pain, and Spasticity in People with Multiple Sclerosis: a Pilot Study

The Use of Traditional and Complementary Medicine Among Patients With Multiple Sclerosis in Morocco

BACKGROUND

Multiple sclerosis (MS) is an acquired chronic, autoimmune, and neurodegenerative disease of the central nervous system. In addition to conventional MS therapy, patients are interested in traditional and complementary medicine (T&CM). Our study aims to describe the use of T&CM in a cohort of Moroccan patients with MS.

METHODS

A quantitative descriptive study was adopted to study this subject. For data collection, we opted for an anonymous questionnaire for 98 patients with MS. We gathered data via an electronic survey, using multivariable analysis to examine the effect of specific factors on T&CM use. Data collection took place from March 2022 to June 2022.

RESULTS

The results show that 52% of patients use T&CM. Of those, 29.6% use cupping, 23.5% recite the Holy Quran, 15.3% use phytotherapy, 13.2% use apitherapy, and 10.2% use acupuncture. In addition, 66.3% of the surveyed respondents stated that alternative medicine positively affects their health. Finally, 49.1% of surveyed patients who use alternative medicine are between 30 and 40 years old. The results also show that the rate of T&CM use is higher in patients with progressive MS (OR = 2.540) and patients without financial access to disease-modifying therapy (OR = 2.100).

CONCLUSIONS

This study invites us to consider societal, cultural, and economic factors when studying the use of T&CM among people with MS. Further research is needed to understand the motivations for using T&CM.

The Efficacy and Safety of Manual Therapy for Symptoms Associated with Multiple Sclerosis: A Systematic Review and Meta-Analysis

Background:

Multiple sclerosis (MS) is a chronic neurological autoimmune disease, affecting the psychological and physical health of patients. Manual therapies have been proven to relieve pain, strengthen muscles, and improve bladder and bowel problems with a high safety and low adverse event profile. Previous studies have reported the results of manual therapy in alleviating symptoms associated with MS, but the conclusions were controversial.

Objective:

The purpose of this meta-analysis is to comprehensively analyze and determine the efficacy and safety of manual therapy in relieving symptoms associated with MS.

Methods:

Eight electronic databases were searched from inception of the database to April 30, 2021. Randomized controlled trials (RCTs) using manual therapy in patients to relieve symptoms associated with MS were considered eligible for this study. Two reviewers independently extracted data using pre-established standards.

Results:

Finally, 10 eligible RCTs with 631 subjects were included in this meta-analysis. These data establish that massage therapy can significantly ameliorate fatigue, pain, and spasms, while reflexology was only effective in relieving pain in MS patients. No adverse events were reported in eligible RCTs.

Conclusions:

The present study provides strong evidence that massage therapy could alleviate fatigue, pain, and spasms in MS patients, while reflexology plays a positive role in relieving pain. Physicians could consider massage therapy or reflexology as a safe and effective complementary and alternative treatment. Larger RCTs with higher methodological quality are needed in the future, which aim to provide more meaningful evidence for further proof of efficacy.

Virtual Reality-Based Therapy Improves Fatigue, Impact, and Quality of Life in Patients with Multiple Sclerosis. A Systematic Review with a Meta-Analysis

Patients with multiple sclerosis (PwMS) have a high level of fatigue and a reduced quality of life (QoL) due to the impact of multiple sclerosis (MS). Virtual reality-based therapy (VRBT) is being used to reduce disability in PwMS. The aim of this study was to assess the effect of VRBT on fatigue, the impact of MS, and QoL in PwMS. Methods: A systematic review with meta-analysis was conducted through a bibliographic search on PubMed, Scopus, Web of Science, and PEDro up to April 2021. We included randomized controlled trials (RCTs) with PwMS that received VRBT in comparison to conventional therapy (CT) including physiotherapy, balance and strength exercises, and stretching or physical activity, among others; or in comparison to simple observation; in order to assess fatigue, MS-impact, and QoL. The effect size was calculated using Cohen’s standardized mean difference with a 95% confidence interval (95% CI). Results: Twelve RCTs that provided data from 606 PwMS (42.83 ± 6.86 years old and 70% women) were included. The methodological quality mean, according to the PEDro Scale, was 5.83 ± 0.83 points. Our global findings showed that VRBT is effective at reducing fatigue (SMD −0.33; 95% CI −0.61, −0.06), lowering the impact of MS (SMD −0.3; 95% CI −0.55, −0.04), and increasing overall QoL (0.5; 95% CI 0.23, 0.76). Subgroup analysis showed the following: (1) VRBT is better than CT at reducing fatigue (SMD −0.4; 95% CI −0.7, −0.11), as well as in improving the mental dimension of QoL (SMD 0.51; 95% CI 0.02, 1); (2) VRBT is better than simple observation at reducing the impact of MS (SMD −0.61; 95% CI −0.97, −0.23) and increasing overall QoL (SMD 0.79; 95% CI 0.3, 1.28); and (3) when combined with CT, VRBT is more effective than CT in improving the global (SMD 0.6, 95% CI 0.13, 1.07), physical (SMD 0.87; 95% CI 0.3, 1.43), and mental dimensions (SMD 0.6; 95% CI 0.08, 1.11) of QoL. Conclusion: VRBT is effective at reducing fatigue and MS impact and improving QoL in PwMS.

The Effects of Massage Therapy on a Patient with Migraines and Cervical Spondylosis: a Case Report

Background

Migraines involve moderate-to-severe neck and face pain that lasts four to 72 hours, and are followed by fatigue and stiffness. Migraines are treated using medications, massage therapy (MT), and non-pharmacological alternatives. Cervical spondylosis (CS) is characterized by degeneration of the intervertebral discs, neck pain, and involvement of soft tissues in the cervical area. CS is treated using medications and manual therapy, including MT.

Objective

To determine the effects of MT on cervical range of motion and daily function in a patient with migraines and CS.

Case Presentation

The patient was an active 56-year-old female diagnosed with migraines and CS. Initial evaluation included cervical range of motion (ROM), goniometry, reflexes, myotomes, dermatomes, local sensation testing and orthopedic tests. Assessment was followed by five MT treatments. Swedish massage, myofascial trigger point release, and proprioceptive neuromuscular facilitation (PNF) stretching were applied to the back, neck, head, and face. The Headache Disability Index (HDI) was administered on the initial and final visits to evaluate patient function. Cervical ROM was measured pre- and posttreatment using a universal goniometer. Treatment was conducted by a second-year MT student at the MacEwan Massage Therapy Teaching Clinic in Edmonton, Alberta.

Results

All cervical ranges of motion improved. The Headache Disability Index score decreased, but was not considered significant. The patient reported decreased stiffness in the upper back and shoulders, reduced migraines, and better sleeping patterns after the MT intervention.

Conclusion

MT was effective in increasing cervical ROM, but had no significant effect on daily function. Further research is warranted on effects of MT on CS and migraines.

Effectiveness of massage therapy on fatigue and pain in patients with multiple sclerosis: A systematic review and meta-analysis

Background

Fatigue and pain are prevalent symptoms of multiple sclerosis (MS) and frequent complaint in MS patients, which reduce their quality of life. This study aimed to assess the effect of massage therapy on pain and fatigue in MS Patients.

Method

The original and Persian databases were searched included PubMed, web of science, embase, ovid, scopus, and the Cochrane Library, SID, and Iranedex from inception to November 2020. Studies that reported the effect of massage on fatigue and pain were included. Two investigators extracted all relevant data, independently. For deriving analysis, mean difference (MD) and standardized mean difference (SMD) were used.

Result

Ten studies were eligible acoording criteria. The effect of massage on fatigue showed significant improvement (-1.62; 95% CL -2.40, -0.83; p < .00001), also results of the systematic review showed a significant reduction in pain severity.

Conclusion

Massage as a complementary and non-pharmacological therapy might have been associated with alleviating fatigue and pain in M.S. patients. Based on the current study, massage intervention for MS patients could have possible clinical value for palliating pain and fatigue and improving quality of life; however, this matter needs further and more significant trial studies.

The Effectiveness of Massage Therapy for Improving Sequelae in Post-Stroke Survivors. A Systematic Review and Meta-Analysis

Objective: To assess the effect of therapeutic massage for improving sequelae in stroke survivors. Methods: A systematic review of the nine medical databases from January 1961 to December 2020 was carried out. The bibliography was screened to identify randomized controlled clinical trials (RCTs). Two reviewers independently screened references, selected relevant studies, extracted data and assessed the risk of bias using the PEDro scale. The primary outcome was upper and lower limb motor function and spasticity. Results: A total of 3196 studies were identified and 18 RCT were finally included (1989 individuals). A meta-analysis of RCTs in the comparison of Chinese massage (Tuina) plus conventional physiotherapy versus conventional physiotherapy was performed. The mean difference (MD) in the subacute stage on upper limb motor-function using the Fugl Meyer Assessment was 2.75; (95% confidence interval (CI) from 0.97 to 4.53, p = 0.002, I² = 36%). The MD on upper limb spasticity using modified Ashworth scale was −0.15; (95% CI from −0.24 to −0.06, p < 0.02, I² = 0%).The MD on lower limb spasticity was −0.59; (95% CI from −0.78 to −0.40, p < 0.001, I² = 0%) in the endpoint. Conclusions: Therapeutic massage, especially Tuina, in addition to conventional therapy is effective for improving motor function and for reducing spasticity in stroke survivors.

Effects of Massage Therapy on Multiple Sclerosis: a Case Report

BACKGROUND

Multiple Sclerosis (MS) is characterized by degeneration of the myelin sheath of an axon resulting in decreased transmission of nerve impulses. It is an autoimmune disease with periods of exacerbation and remission. Types of MS include relapsing-remitting, acute progressive, chronic progressive attack-remitting, and benign. Symptoms vary from patient to patient. Common symptoms include fatigue, spasticity, swelling, and altered gait. MS is commonly treated with medications that help relieve symptoms and prolong disease progression. Massage Therapy (MT), specifically Swedish techniques, have been effective in treating MS.

OBJECTIVE

To examine the effects of MT on mobility, fatigue, and edema in a patient with MS.

METHODS

An MT student from MacEwan University's 2,200-hour Massage Therapy program administered five MT treatments over a six-week period to a 58-year-old female diagnosed with MS 11 years earlier. She presented with symptoms of decreased mobility, fatigue, and left ankle edema. Assessment included active and passive range of motion (ROM), myotomes, dermatomes, reflexes, and orthopedic tests. Goals for the treatment sessions were to increase mobility, decrease fatigue, and decrease edema. Assessment measures included the Timed-Up-and-Go (TUG) test for mobility, the Modified Fatigue Impact Scale (MFIS) to measure fatigue, and Figure-8 ankle measurement to measure edema. Techniques used included Swedish massage, passive ROM, manual lymphatic drainage (MLD), and home-care exercises.

RESULTS

Little change was noted in mobility. The patient's fatigue level and left ankle edema decreased.

CONCLUSION

The results suggest that MT is effective in reducing fatigue and edema in a patient with MS. Future studies are needed to evaluate the correlation between mobility and massage.

Mirror and Vibration Therapies Effects on the Upper Limbs of Hemiparetic Patients after Stroke: A Pilot Study

Background/Aim

To evaluate, in this pilot study, the effects of the mirror (MT) and vibration therapies (VT) on the functionality of hemiparesis patients after stroke.

Materials and Methods

Twenty-one individuals after stroke with upper limb hemiparesis were randomized into control group (CG), Mirror Therapy Group (MTG), and Vibration Therapy Group (VTG). The functionality was evaluated before and after 12 sessions with three tests (i) Mobility Index Rivermead, (ii) Motor Function Wolf Test (time, functional ability), and (iii) Jebsen Taylor Test.

Results

Significant findings were observed for MTG or VTG when compared to the CG, obtaining improvements in the three functional tests: Mobility Index Rivermead, Motor Function Test Wolf (time) and Motor Function Test Wolf (functional ability), and Jebsen Test Taylor.

Conclusions

MT or VT showed enhancements on the functionality of subjects with poststroke hemiparesis. In consequence, these interventions may be used in the rehabilitation of these individuals in order to promote improvements of the affected upper limb functionality. Probably, neuromuscular responses of the used therapies would be related to these desirable effects. However, it is necessary conducting further controlled studies with more subjects.