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Cobo MM, Moultrie F, Hauck AGV, Crankshaw D, Monk V, Hartley C, Evans Fry R, Robinson S, van der Vaart M, Baxter L, Adams E, Poorun R, Bhatt A, Slater R. Multicentre, randomised controlled trial to investigate the effects of parental touch on relieving acute procedural pain in neonates (Petal). BMJ Open 2022; 12:e061841. [PMID: 36250332 PMCID: PMC9301810 DOI: 10.1136/bmjopen-2022-061841] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Newborn infants routinely undergo minor painful procedures as part of postnatal care, with infants born sick or premature requiring a greater number of procedures. As pain in early life can have long-term neurodevelopmental consequences and lead to parental anxiety and future avoidance of interventions, effective pain management is essential. Non-pharmacological comfort measures such as breastfeeding, swaddling and sweet solutions are inconsistently implemented and are not always practical or effective in reducing the transmission of noxious input to the brain. Stroking of the skin can activate C-tactile fibres and reduce pain, and therefore could provide a simple and safe parent-led intervention for the management of pain. The trial aim is to determine whether parental touch prior to a painful clinical procedure provides effective pain relief in neonates. METHODS AND ANALYSIS This is a multicentre randomised controlled trial. A total of 112 neonates born at 35 weeks' gestation or more requiring a blood test in the first week of life will be recruited and randomised to receive parental stroking either preprocedure or postprocedure. We will record brain activity (EEG), cardiac and respiratory dynamics, oxygen saturation and facial expression to provide proxy pain outcome measures. The primary outcome will be the reduction of noxious-evoked brain activity in response to a heel lance. Secondary outcomes will be a reduction in clinical pain scores (Premature Infant Pain Profile-Revised), postprocedural tachycardia and parental anxiety. ETHICS AND DISSEMINATION The study has been approved by the London-South East Research Ethics Committee (ref: 21/LO/0523). The results will be widely disseminated through peer-reviewed publications, international conferences and via our partner neonatal charities Bliss and Supporting the Sick Newborn And their Parents (SSNAP). If the parental tactile intervention is effective, recommendations will be submitted via the National Health Service clinical guideline adoption process. STUDY STATUS Commenced September 2021. TRIAL REGISTRATION NUMBER NCT04901611; 14 135 962.
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Affiliation(s)
- Maria M Cobo
- Department of Paediatrics, University of Oxford, Oxford, UK
- Colegio de Ciencias Biologicas y Ambientales, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - Fiona Moultrie
- Department of Paediatrics, University of Oxford, Oxford, UK
| | | | | | - Vaneesha Monk
- Department of Paediatrics, University of Oxford, Oxford, UK
| | | | - Ria Evans Fry
- Department of Paediatrics, University of Oxford, Oxford, UK
| | | | | | - Luke Baxter
- Department of Paediatrics, University of Oxford, Oxford, UK
| | - Eleri Adams
- Newborn Care Unit, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Ravi Poorun
- Children's Services, Royal Devon University Healthcare NHS Foundation Trust, Exeter, UK
- College of Medicine & Health, University of Exeter, Exeter, UK
| | - Aomesh Bhatt
- Department of Paediatrics, University of Oxford, Oxford, UK
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Costa TMDS, Oliveira EDS, Silva BVSD, Melo EBBD, Carvalho FOD, Duarte FHDS, Dantas RAN, Dantas DV. Massage for pain relief in newborns submitted to puncture: systematic review. Rev Gaucha Enferm 2022; 43:e20220029. [DOI: 10.1590/1983-1447.2022.20220029.en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 05/16/2022] [Indexed: 11/30/2022] Open
Abstract
ABSTRACT Objective To analyze in the scientific literature the effects of massage on pain relief in newborns submitted to puncture. Method Systematic review with meta-analysis performed in October 2020, using PubMed, Web of Science, CINAHL, Scopus, Cochrane and Gale databases. Studies without time frame were included, which used massage as the main technique for relieving neonatal pain during puncture. Data were extracted using standardized forms and the synthesis of results occurred in a descriptive way. Results From the 12 studies included, massage was effective in pain relief in 83.3% of the studies. The comparative meta-analysis of massage versus routine care that assessed duration of crying obtained a statistically significant result (p = 0.0002; 95% CI -85.51 to -27.09). Conclusion Massage contributes to neonatal pain relief by reducing pain score and reducing crying time in newborns submitted to puncture.
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Costa TMDS, Oliveira EDS, Silva BVSD, Melo EBBD, Carvalho FOD, Duarte FHDS, Dantas RAN, Dantas DV. Massagem para alívio da dor em recém-nascidos submetidos a punção: revisão sistemática. Rev Gaucha Enferm 2022. [DOI: 10.1590/1983-1447.2022.20220029.pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
RESUMO Objetivo Analisar na literatura científica os efeitos da massagem no alívio da dor em recém-nascidos submetidos a punção. Método Revisão sistemática com meta-análise realizada em outubro de 2020, utilizando as bases PubMed, Web of Science, CINAHL, Scopus, Cochrane e Gale. Incluíram-se estudos sem delimitação de recorte temporal, que utilizaram massagem como principal técnica para o alívio da dor neonatal durante a punção. Os dados foram extraídos através de formulários padronizados e a síntese dos resultados ocorreram de forma descritiva. Resultados Dos 12 estudos incluídos, a massagem foi eficaz no alívio da dor em 83,3% dos estudos. A meta-análise comparativa da massagem versus cuidados de rotina que avaliou duração do choro obteve resultado estatisticamente significativo (p = 0,0002; IC 95% -85,51 a -27,09). Conclusão A massagem contribui para o alívio da dor neonatal através da redução do escore de dor e redução do tempo de choro em recém-nascidos submetidos a punção.
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Basso JC, Satyal MK, Rugh R. Dance on the Brain: Enhancing Intra- and Inter-Brain Synchrony. Front Hum Neurosci 2021; 14:584312. [PMID: 33505255 PMCID: PMC7832346 DOI: 10.3389/fnhum.2020.584312] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 12/03/2020] [Indexed: 12/11/2022] Open
Abstract
Dance has traditionally been viewed from a Eurocentric perspective as a mode of self-expression that involves the human body moving through space, performed for the purposes of art, and viewed by an audience. In this Hypothesis and Theory article, we synthesize findings from anthropology, sociology, psychology, dance pedagogy, and neuroscience to propose The Synchronicity Hypothesis of Dance, which states that humans dance to enhance both intra- and inter-brain synchrony. We outline a neurocentric definition of dance, which suggests that dance involves neurobehavioral processes in seven distinct areas including sensory, motor, cognitive, social, emotional, rhythmic, and creative. We explore The Synchronicity Hypothesis of Dance through several avenues. First, we examine evolutionary theories of dance, which suggest that dance drives interpersonal coordination. Second, we examine fundamental movement patterns, which emerge throughout development and are omnipresent across cultures of the world. Third, we examine how each of the seven neurobehaviors increases intra- and inter-brain synchrony. Fourth, we examine the neuroimaging literature on dance to identify the brain regions most involved in and affected by dance. The findings presented here support our hypothesis that we engage in dance for the purpose of intrinsic reward, which as a result of dance-induced increases in neural synchrony, leads to enhanced interpersonal coordination. This hypothesis suggests that dance may be helpful to repattern oscillatory activity, leading to clinical improvements in autism spectrum disorder and other disorders with oscillatory activity impairments. Finally, we offer suggestions for future directions and discuss the idea that our consciousness can be redefined not just as an individual process but as a shared experience that we can positively influence by dancing together.
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Affiliation(s)
- Julia C Basso
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA, United States.,Center for Transformative Research on Health Behaviors, Fralin Biomedical Research Institute, Virginia Tech, Blacksburg, VA, United States.,School of Neuroscience, Virginia Tech, Blacksburg, VA, United States
| | - Medha K Satyal
- Graduate Program in Translational Biology, Medicine, and Health, Virginia Tech, Blacksburg, VA, United States
| | - Rachel Rugh
- Center for Communicating Science, Virginia Tech, Blacksburg, VA, United States.,School of Performing Arts, Virginia Tech, Blacksburg, VA, United States
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Abstract
Measuring brain activity in infants provides an objective surrogate approach with which to infer pain perception following noxious events. Here we discuss different approaches which can be used to measure noxious-evoked brain activity, and discuss how these measures can be used to assess the analgesic efficacy of pharmacological and non-pharmacological interventions. We review factors that can modulate noxious-evoked brain activity, which may impact infant pain experience, including gestational age, sex, prior pain, stress, and illness.
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Affiliation(s)
- Deniz Gursul
- Department of Paediatrics, University of Oxford, John Radcliffe Hospital, Headington, Oxford, OX3 9DU, United Kingdom
| | - Caroline Hartley
- Department of Paediatrics, University of Oxford, John Radcliffe Hospital, Headington, Oxford, OX3 9DU, United Kingdom
| | - Rebeccah Slater
- Department of Paediatrics, University of Oxford, John Radcliffe Hospital, Headington, Oxford, OX3 9DU, United Kingdom.
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Misra SM, Monico E, Kao G, Guffey D, Kim E, Khatker M, Gilbert C, Biard M, Marcus M, Roth I, Giardino AP. Addressing Pain With Inpatient Integrative Medicine at a Large Children's Hospital. Clin Pediatr (Phila) 2019; 58:738-745. [PMID: 30931605 PMCID: PMC7535977 DOI: 10.1177/0009922819839232] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Pediatric integrative medicine (IM) includes the use of therapies not considered mainstream to help alleviate symptoms such as pain and anxiety. These therapies can be provided in the inpatient setting. METHODS This 10-week study involved the integration of acupuncture, biofeedback, clinical hypnotherapy, guided imagery, meditation, and music therapy to address pain in children admitted to a large US children's hospital. RESULTS Of 51 patients enrolled, 60% of the patients, 66% of their mothers, and 56% of their fathers used CAM (complementary and alternative medicine) in the preceding 1 year. Although 51 families requested integrative therapies, only 18 patients received them because of inadequate provider availability. All recorded pain scores improved with integrative therapies. One parent reported a possible side effect of irritability in the child after clinical hypnotherapy while 5 children reported opiate side effects. All participating families interviewed responded that IM services helped their child's pain and helped their child's mood, and that our hospital should have a permanent IM consult service. CONCLUSION Integrative therapies can be helpful to address pain without significant side effects. Further studies are needed to investigate the integration, cost, and cost-effectiveness of integrative therapies in pediatric hospitals.
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Affiliation(s)
- Sanghamitra M. Misra
- Baylor College of Medicine, Houston, TX, USA
- Texas Children’s Hospital, Houston, TX, USA
| | - Evelyn Monico
- Baylor College of Medicine, Houston, TX, USA
- Texas Children’s Hospital, Houston, TX, USA
| | - Grace Kao
- Baylor College of Medicine, Houston, TX, USA
- Texas Children’s Hospital, Houston, TX, USA
| | | | - Esther Kim
- Baylor College of Medicine, Houston, TX, USA
| | | | - Caroyl Gilbert
- Baylor College of Medicine, Houston, TX, USA
- Texas Children’s Hospital, Houston, TX, USA
| | | | - Monica Marcus
- Baylor College of Medicine, Houston, TX, USA
- Texas Children’s Hospital, Houston, TX, USA
| | | | - Angelo P. Giardino
- Baylor College of Medicine, Houston, TX, USA
- Texas Children’s Hospital, Houston, TX, USA
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Pados BF, McGlothen-Bell K. Benefits of Infant Massage for Infants and Parents in the NICU. Nurs Womens Health 2019; 23:265-271. [PMID: 31059673 DOI: 10.1016/j.nwh.2019.03.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 01/07/2019] [Accepted: 03/01/2019] [Indexed: 05/20/2023]
Abstract
Infant massage is an ancient therapeutic technique used around the world. For infants who experience painful procedures, are exposed to the stressful NICU environment, and are separated from their parents, infant massage has been promoted as a method to reduce stress and promote bonding. In this article, we review the current literature on infant massage in the NICU. There is evidence that infant massage has beneficial effects on preterm infants in the NICU, including shorter length of stay; reduced pain; and improved weight gain, feeding tolerance, and neurodevelopment. Parents who performed massage with their infants in the NICU reported experiencing less stress, anxiety, and depression. Neonatal nurses can obtain education and certification in infant massage and can teach parents infant massage techniques, thereby promoting the health and well-being of parent-infant dyads.
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EEG captures affective touch: CT-optimal touch and neural oscillations. COGNITIVE AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2019; 18:155-166. [PMID: 29404917 DOI: 10.3758/s13415-017-0560-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Tactile interactions are of developmental importance to social and emotional interactions across species. In beginning to understand the affective component of tactile stimulation, research has begun to elucidate the neural mechanisms that underscore slow, affective touch. Here, we extended this emerging body of work and examined whether affective touch (C tactile [CT]-optimal speed), as compared to nonaffective touch (non-CT-optimal speed) and no touch conditions, modulated EEG oscillations. We report an attenuation in alpha and beta activity to affective and nonaffective touch relative to the no touch condition. Further, we found an attenuation in theta activity specific to the affective, as compared to the nonaffective touch and no touch conditions. Similar to theta, we also observed an attenuation of beta oscillations during the affective touch condition, although only in parietal scalp sites. Decreased activity in theta and parietal-beta ranges may reflect attentional-emotional regulatory mechanisms; however, future work is needed to provide insight into the potential neural coupling between theta and beta and their specific role in encoding slow, tactile stimulation.
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von Mohr M, Kirsch LP, Fotopoulou A. The soothing function of touch: affective touch reduces feelings of social exclusion. Sci Rep 2017; 7:13516. [PMID: 29044137 PMCID: PMC5647341 DOI: 10.1038/s41598-017-13355-7] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 09/19/2017] [Indexed: 11/29/2022] Open
Abstract
The mammalian need for social proximity, attachment and belonging may have an adaptive and evolutionary value in terms of survival and reproductive success. Consequently, ostracism may induce strong negative feelings of social exclusion. Recent studies suggest that slow, affective touch, which is mediated by a separate, specific C tactile neurophysiological system than faster, neutral touch, modulates the perception of physical pain. However, it remains unknown whether slow, affective touch, can also reduce feelings of social exclusion, a form of social pain. Here, we employed a social exclusion paradigm, namely the Cyberball task (N = 84), to examine whether the administration of slow, affective touch may reduce the negative feelings of ostracism induced by the social exclusion manipulations of the Cyberball task. As predicted, the provision of slow-affective, as compared to fast-neutral, touch led to a specific decrease in feelings of social exclusion, beyond general mood effects. These findings point to the soothing function of slow, affective touch, particularly in the context of social separation or rejection, and suggest a specific relation between affective touch and social bonding.
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Affiliation(s)
- Mariana von Mohr
- Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom.
| | - Louise P Kirsch
- Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
| | - Aikaterini Fotopoulou
- Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
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Krahé C, Drabek MM, Paloyelis Y, Fotopoulou A. Affective touch and attachment style modulate pain: a laser-evoked potentials study. Philos Trans R Soc Lond B Biol Sci 2016; 371:rstb.2016.0009. [PMID: 28080967 PMCID: PMC5062098 DOI: 10.1098/rstb.2016.0009] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2016] [Indexed: 11/15/2022] Open
Abstract
Affective touch and cutaneous pain are two sub-modalities of interoception with contrasting affective qualities (pleasantness/unpleasantness) and social meanings (care/harm), yet their direct relationship has not been investigated. In 50 women, taking into account individual attachment styles, we assessed the role of affective touch and particularly the contribution of the C tactile (CT) system in subjective and electrophysiological responses to noxious skin stimulation, namely N1 and N2-P2 laser-evoked potentials. When pleasant, slow (versus fast) velocity touch was administered to the (non-CT-containing) palm of the hand, higher attachment anxiety predicted increased subjective pain ratings, in the same direction as changes in N2 amplitude. By contrast, when pleasant touch was administered to CT-containing skin of the arm, higher attachment anxiety predicted attenuated N1 and N2 amplitudes. Higher attachment avoidance predicted opposite results. Thus, CT-based affective touch can modulate pain in early and late processing stages (N1 and N2 components), with the direction of effects depending on attachment style. Affective touch not involving the CT system seems to affect predominately the conscious perception of pain, possibly reflecting socio-cognitive factors further up the neurocognitive hierarchy. Affective touch may thus convey information about available social resources and gate pain responses depending on individual expectations of social support. This article is part of the themed issue ‘Interoception beyond homeostasis: affect, cognition and mental health’.
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Affiliation(s)
- Charlotte Krahé
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Marianne M Drabek
- Arthritis Research UK Pain Centre, University of Nottingham, Nottingham, UK
| | - Yannis Paloyelis
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Aikaterini Fotopoulou
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
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Saper R. Exploring This Issue: Whole-Person, Whole-Systems Health and Healing. Glob Adv Health Med 2015; 4:3-4. [PMID: 26331096 PMCID: PMC4533648 DOI: 10.7453/gahmj.2015.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
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