Effects of Parent-Delivered Traditional Thai Massage on Gait and Heart Rate Variability in Children with Autism: A Randomized Controlled Trial

Aim: To examine the effects of parent-delivered traditional Thai massage (TTM) intervention on heart rate variability (HRV) and gait in children with autism. Methods: This was a two-armed, randomized controlled trial conducted at the Haikou Special Education School in Haikou Province, China, between October 2021 and March 2022. A total of 48 children with autism, aged between 7 and 12 years, were selected from the school and randomly divided into either the parent-delivered TTM group or the control group (no intervention) in a 1:1 ratio. In addition to their regular daily school routines, the TTM group received 16 TTM interventions (twice a week), with each session lasting ∼50 min. HRV and gait parameters were measured at baseline, completion of the 8-week intervention, and 2 months follow-up. Results: The results of this study showed that the TTM intervention had a notable positive effect on HRV, with a significant reduction in low-frequency value (p = 0.001), and increased high-frequency value (p = 0.001), compared with the controls, and the advantages persisted during the follow-up period. However, only the stride length in the TTM group was significantly longer than that in the control group at the post-test (p = 0.039) and follow-up test (p = 0.043), while none of the other parameters of gait comparison showed statistical significance. Conclusions: Parent-delivered Thai massage increased HRV levels and stride length in comparison to the control group, and some effects of the intervention were maintained over the follow-up period. Clinical Trials Registry Identifier ChiCTR2100051355; September 21, 2021.

Standardised 25-Step Traditional Thai Massage (TTM) Protocol for Treating Office Syndrome (OS)

Traditional Thai massage (TTM) is a unique form of whole body massage practiced to promote health and well-being in Thailand since ancient times. The goal of the present study was to create a standardised TTM protocol to treat office syndrome (OS) diagnosed based on the identification of the palpation of at least one so-called myofascial trigger point (MTrP) in the upper trapezius muscle. The new 90 min TTM protocol, which was developed following appropriate review of the literature and in consultation with relevant experts, has 25 distinct steps (20 pressing steps, 2 artery occlusion steps, and 3 stretching steps). Eleven TTM therapists treated three patients each using the new 90 min TTM protocol. All of the therapists reported scores greater than 80% in respect to their satisfaction and confidence to deliver the protocol, and all of the patients gave the treatment a satisfaction score of greater than 80%. The treatment produced a significant reduction in pain intensity measured on a Visual Analogue Scale (VAS), with minimum and maximum values of 0 and 10 cm, of 2.33 cm (95% CI (1.76, 2.89 cm), p < 0.001) and significant increase in pain pressure threshold (PPT) of 0.37 kg/cm² (95% CI (0.10, 0.64 kg/cm²), p < 0.05). The protocol was revised based on the feedback and the results obtained, and the new standardised TTM protocol will be applied in a randomised control trial (RCT) to compare the efficacy of TTM and conventional physical therapy (PT) for treating OS.

The benefits of Shuai Shou Gong (SSG) demonstrated in a Randomised Control Trial (RCT) study of older adults in two communities in Thailand

INTRODUCTION

Shuai Shou Gong (SSG) is a type of Arm Swing Exercise (ASE) developed and practiced especially by older people in China for over one thousand years to maintain physical health and well-being. Until now the potential benefits of SSG have not been investigated in a Randomised Control Trial (RCT).

MATERIALS AND METHODS

Fifty six older women were recruited from each of two urban communities in Khon Kaen, Thailand. One community was randomly assigned as the Exercise Group (mean age 68.3 years, standard deviation 5.6 years) and the other as the Control Group (69.4 years, 4.4 years). The Exercise Group performed SSG for 40 minutes, three days per week for two months, whereas the Control Group maintained their usual daily life. Measurements of Posture (C7 to Wall Distance (C7WD), Standing Height (SH), Flexibility (Back Scratch of Left and Right arms (BSL and BSR) and Chair Sit and Reach of Left and Right legs (CSRL and CSRR), Gait (Timed Up and Go (TUG)), and Cognition (Barthel Activities of Daily Living Index (BADL) and Rosenberg Self Esteem Scale (RSES) questionnaires) were recorded for each group prior to, on day 1, week 4, and week 8 of the SSG training.

RESULTS

The 8 week SSG training course produced a significant interaction between group and time for the combined set of all outcome measures (C7WD, SH, BSL, BSR, CSRL, CSRR, TUG, BADL, and BSES) (Modified ANOVA-Type Statistic (MATS) p-value < 0.001) and for the four categories of Posture, Flexibility, Gait, and Cognition (all Wald-Type Statistic (WTS) p-values < 0.05) and in all cases the changes in the Exercise Group were in the direction predicted to be beneficial. No significant interaction effect between time and group was found after either one session or four weeks of SSG training for any of the categories (all WTS p > 0.05) with significant effects only arising after eight weeks (all WTS p < 0.05). Thus although alterations were shown to be increasingly beneficial over time the minimum period required to produce a statistically significant benefit from performing SSG training was 8 weeks. For the Control Group no significant changes were identified for Posture, Flexibility and Cognition however a significant deterioration was observed in TUG (WTS p = 0.003).

CONCLUSIONS

SSG is a holistic, gentle, rhythmic, whole body sequence of movements that may be readily learned and enjoyed in a group setting and has been confirmed in an RCT study of older adult females to produce significant benefits in Posture, Flexibility, Gait and Cognition.

Physiological and Psychological Effects of Parent-Delivered Traditional Thai Massage in Children With Autism: Protocol for a Randomized Controlled Trial

BACKGROUND

Although many autistic children receive massage as a complementary therapy, it is not included in evidence-based practice for autism because evidence of its efficacy is lacking. Further, prior studies have failed to identify objective indicators of core symptoms or elucidate their mechanisms.

OBJECTIVE

We developed a parent-delivered traditional Thai massage (TTM) intervention for children with autism, aiming to experimentally determine whether children with autism truly experience positive effects from parent-delivered TTM and determine possible mechanisms of the observed effects.

METHODS

A 2-armed, parallel randomized controlled trial was conducted between February 2022 and June 2022. Forty-eight children with autism (aged 7-12 years) were recruited from the Hainan Special Education School and randomly assigned to either a parental TTM or control group at a ratio of 1:1 based on random numbers generated with Online Research Randomizer. The generated sequences were concealed in an opaque envelope. Individuals in the parental TTM group received 16 parent-delivered TTM sessions over 8 weeks at the school's health room after school, and the control group maintained a normal daily routine. Outcomes were assessed on admission, after 8 weeks, and at a 2-month follow-up and included the effect of massage treatment on autism symptoms, measured with the Autism Treatment Evaluation Checklist score (evaluated by parents and a blinded teacher), physiological parameters (ie, heart rate variability and gait), and the Parenting Stress Index, Fourth Edition-Short Form.

RESULTS

We finished all data collection on June 20, 2022. Data analysis will be started, and we expect to publish results in 2023.

CONCLUSIONS

This study will provide further evidence for massage treatment of autism and provide support for family-based care.

TRIAL REGISTRATION

Chinese Clinical Trial Registry ChiCTR2100051355; https://tinyurl.com/3dwjxsw5.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/41839.

Acute Effects of Percussive Massage Therapy on Thoracolumbar Fascia Thickness and Ultrasound Echo Intensity in Healthy Male Individuals: A Randomized Controlled Trial

Percussive massage therapy (PT) has been widely used by therapists and the fitness population to treat myofascial-related conditions. However, there is no evidence to confirm the effects of PT on the fascia. This study aimed to investigate the effects of PT on thoracolumbar fascia (TLF) morphology and other related outcomes.

METHODS

Sixty-six healthy males participated and were randomly allocated into a percussive massage group (PT group) and a control group. The PT group received 15 min of back percussion massage, while the control group rested prone lying in the same environment for 15 min. Thoracolumbar fascia (TLF) thickness and echo intensity, perceived stiffness, lumbar flexibility, and skin temperature were measured in both groups before and immediately after the intervention.

RESULT

TLF thickness and lumbar flexibility did not change when compared in the two groups. However, the echo intensity (left side, difference -3.36, 95% CI -5.1 to -1.6; right side, difference -4.39, 95% CI -6.1 to -2.7) and perceived stiffness (difference, -1.18, 95% CI -1.84 to -0.52) in the TLF region were significantly lower in the PT group than in the control group and were accompanied by increased skin temperature (difference 0.29, 95% CI 0.11 to 0.48).

CONCLUSION

We suggest that a 15 min PT with 30 Hz on the back region could reduce TLF echo intensity and perceived stiffness and increase skin temperature in healthy men individual.

Effect of behavioral activation on time and frequency domain heart rate variability in older adults with subthreshold depression: a cluster randomized controlled trial in Thailand

BACKGROUND

Increased prevalence of depression highlights the need for effective interventions. Behavioral activation (BA), which can easily be adapted for non-clinical populations, has been the recommended treatment for depression. It is based on a model of psychopathology explaining that losses or chronically low levels of positive reinforcement yield behavioral and emotional changes in depression and that encouraging individuals to increase their engagement in reinforcing activities can improve their mood and enhance their valuable life experiences. Heart rate variability (HRV) provides indices of autonomic function related to depression, but only a few studies have investigated the effect of BA on HRV, particularly among older adults with subthreshold depression. Accordingly, we aimed to investigate the effect of BA on HRV in older adults with subthreshold depression.

METHODS

We conducted a 9-month cluster randomized controlled trial in two Health Promoting Hospitals (HPHs). Eighty-two participants were randomized into either intervention (BA with usual care) or control (usual care only) groups, with 41 participants per group. Daily step count was collected weekly during the 12-week BA intervention period, while HRV parameters, including the Standard Deviation of the Normal-to-Normal interval (SDNN), High Frequency (lnHF), Low Frequency (LF), and Low Frequency/High Frequency ratio (LF/HF), were examined at 0, 3, 6 and 9 months. Generalized Estimating Equations (GEEs) were used in the data analysis.

RESULTS

Over nine months, the intervention and control groups differed significantly in the unadjusted mean change of HRV, SDNN [7.59 ms (95% CI: 1.67, 13.50)], lnHF [0.44 ms2 (95% CI: 0.04, 0.85)], and LF [0.53 ms2 (95% CI: 0.09, 0.98)], whereas the groups did not differ significantly in LF/HF ratio [0.01 ms2 (95% CI: -0.04, 0.06)].

CONCLUSION

Our results suggest that BA may have a therapeutic effect on depression symptoms of older adults with subthreshold depression via improved HRV.

TRIAL REGISTRATION

TCTR20211019003 , thaiclinicaltrials.org, retrospectively registered on 19 October 2021.

Relationship between motor fitness, fundamental movement skills, and quality of movement patterns in primary school children

Seefeldt`s classic motor development pyramid model recognizes the significance of fundamental movement skills (FMS) in physical activities and proposes a "proficiency barrier" between FMS and higher-level specific sports skills during middle childhood. However, the relationship between the layers of the conceptual model has not been empirically tested. This study investigated motor fitness (MF), FMS, and quality of movement patterns (QMP) in 7-10 years old children and evaluated the relationships among them. A total of 117 children were randomly selected to take tests of MF, the Test of Gross Motor Development-2 (TGMD-2), and the Functional Movement Screen (FMS™). MF and FMS levels were classified according to percentile ranges. Two multiple (R×C) Chi-Square tests were applied to analyze the relationships between MF, FMS, and QMP. Post-hoc testing estimated the possibility of FMS and QMP to predict MF. The results showed that boys scored significantly higher on the object-control subtest and on the TGMD-2 compared to girls (p<0.001), while girls scored significantly higher on the FMS™ (p = 0.001). FMS score and QMP level were weakly correlated with MF (FMS: χ2 = 14.605, p = 0.006, Cramer`s V = 0.25; QMP: χ2 = 13.943, p = 0.007, Cramer`s V = 0.24). Thus, 60.5% of children with "excellent" FMS and 59.6% with "high" QMP were categorized as having a "good" MF. In contrast, only 23.1% of children with "poor" FMS and 24.3% with "low" QMP were classified as having a "good" MF. Our results confirm MF, FMS, and QMP are correlated with each other, although this relationship is weak. Further, a possible motor skill proficiency barrier exists already in children 7-10 years old. The study results support the promotion of physical activity and motor skill development in primary school children.

Effects of mechanical bed massage on biochemical markers of exercise-induced back muscle fatigue in athletes: A randomized controlled trial

BACKGROUND

Many previous studies have explored the effects of manual massage on back muscle fatigue, and most of the mechanical massage techniques imitate manual massage. However, it is unknown whether mechanical and manual massage have the same functions for exercise-induced back muscle fatigue.

OBJECTIVE

To investigate the effects of mechanical bed massage on the biochemical markers of exercise-induced back muscle fatigue in male collegiate athletes.

METHODS

Twenty-eight male collegiate athletes who met the experimental criteria were recruited in this randomized controlled trial, and randomly assigned to a mechanical bed massage group (experimental group) or resting group (control group). The subjects performed eight bouts of reverse sit-up in the prone position and received 20 minutes of the intervention. Creatine kinase, blood lactate, and serum cortisol levels were measured at baseline, after fatigue, after intervention, and after 24 hours.

RESULTS

The level of serum cortisol of the control group was significantly higher than that of the experimental group after the intervention (p< 0.05). The comparison of the two groups for blood lactate levels showed no significant differences at any of the measurement time-points (p> 0.05). There was no significant difference in creatine kinase levels immediately after the intervention (p> 0.05), but a significant difference in creatine kinase level was observed between the two groups 24 hours later (p< 0.05).

CONCLUSIONS

Significant differences were observed between mechanical bed massage and rest condition on serum cortisol and creatine kinase for exercise-induced muscle fatigue. Therefore, mechanical bed massage may reduce stress and muscle damage for the athlete after training or competition.

Immediate Effects and Acceptability of an Application-Based Stretching Exercise Incorporating Deep Slow Breathing for Neck Pain Self-management

Objectives

This study evaluated the immediate effects and acceptability of a smartphone application named NeckProtector to promote neck pain self-management through stretching incorporating deep slow breathing, among smartphone users with neck pain.

Methods

One-hundred participants were recruited in the study. Participants were divided into two groups by block randomized allocation. The researchers gave the NeckProtector application to all participants for acceptability testing by navigation of the application for 20–30 minutes. Next, the treatment group (n = 50) conducted the exercise program via smartphone application for 15–20 minutes, while the control group (n = 50) rested for 20 minutes. Evaluations were performed at baseline and after intervention for pain intensity, muscle tension, pressure pain threshold (PPT), and cervical range of motion (CROM). Quantitative and qualitative feedback was then obtained by an acceptability survey and open-ended questionnaires.

Results

The immediate effects showed statistically significant improvements in pain intensity, muscle tension, PPT, and CROM in the treatment group in comparison to the control group. Participants reported a high level of acceptability through ratings on a Likert scale. The qualitative questionnaires received positive responses that the application was easy to use and the exercise program was useful to cope with neck pain.

Conclusions

NeckProtector can be an alternative treatment for neck pain self-management via smartphone application among smartphone users with neck pain. Further studies should examine the long-term effectiveness (Clinical trials registry: TCTR20160523001).

Progressive decrease in leg-power performance during a fatiguing badminton field test

[Purpose] This study aimed to evaluate the changes in leg-power generation that accompany competitive badminton, as simulated in a badminton field test (FT). [Participants and Methods] Fifteen male badminton players with 1–2 years of experience performed five repetitions of an FT involving rapid and randomly assigned shuttle-run movements between markers distributed around a badminton court. Repetitions were separated by a 1-minute rest period. Peak mechanical power, obtained from the serial vertical jump tests, was used to estimate fatigue and performance reduction. [Results] Decreases in distance and time were significantly different in each of the five FT repetitions while maintaining the same speed for the condition. The peak mechanical power and fatigue index significantly declined. The reduction in the peak mechanical power percentage (11.78–35.49%) was in the acceptable peak mechanical power range for each FT set. These results were confirmed by the significant increase in the participants’ blood lactate concentration levels, the rating of perceived exertion, and heart rate. [Conclusion] Leg-power generation could gradually be decreased in badminton competition as indicated by a badminton field test.

Effects of the Short Foot Exercise With Neuromuscular Electrical Stimulation on Navicular Height in Flexible Flatfoot in Thailand: A Randomized Controlled Trial

OBJECTIVES

Flatfoot, or low medial longitudinal arch, contributes to back and lower extremity injuries and is caused by weak abductor hallucis (AbdH) muscles. The purpose of this study was to investigate the effects of short foot exercise (SFE) alone or with neuromuscular electrical stimulation (NMES) on navicular height, the cross-sectional area (CSA) of the AbdH muscle, and AbdH muscle activity in flexible flatfoot.

METHODS

Thirty-six otherwise healthy people with flexible flatfoot were randomly assigned to a group that received SFE with placebo NMES treatment (the control group) or a group that received both SFE and NMES treatment (the experimental group). Each group received 4 weeks of treatment (SFE alone or SFE with NMES). Navicular height, the CSA of the AbdH muscle, and AbdH muscle activity were assessed before and after the intervention.

RESULTS

No significant differences were found in navicular height or the CSA of the AbdH muscle between the control and experimental groups, while AbdH muscle activity showed a statistically significant difference between the groups (SFE=73.9±11.0% of maximal voluntary isometric contraction [MVIC]; SFE with NMES=81.4±8.3% of MVIC; p<0.05). Moreover, the CSA of the AbdH muscle showed a statistically significant increase after treatment in the SFE with NMES group (pre-treatment=218.6±53.2 mm2; post-treatment=256.9±70.5 mm2; p<0.05).

CONCLUSIONS

SFE with NMES was more effective than SFE alone in increasing AbdH muscle activity. Therefore, SFE with NMES should be recommended to correct or prevent abnormalities in people with flexible flatfoot by a physiotherapist or medical care team.

Muscle stretching with deep and slow breathing patterns: a pilot study for therapeutic development

Background Chronic neck pain is frequently found in office workers affecting quality of life; also, stress is one participating factor. Though stretching incorporating deep-slow breathing (DSB) has benefits on health, an effective and suitable technique for office workers to perform in the workplace is a gap in need of fulfilment. Methods We explored the effective pattern of stretching with DSB to reduce neck tension and promote relaxation within the shortest time. Thirty-two female participants with neck tension were allocated into two steps totaling five patterns (n=8 for each pattern). Firstly, they performed two patterns; two other patterns were developed and compared with DSB alone. Muscle tension, pain score, and heart rate variability (HRV) were immediately measured. Results All patterns performed with the eyes closed decreased muscle tension more than those performed with the eyes open; the pain amid all stretching groups subsequently decreased. Only a bout of slow stretching, performed synchronously with the eyes closed along with a period of deep inhalation increased the parasympathetic activity of HRV; an increase in pain was reported after stretching. Conclusions A slowed and synchronized pattern between stretching with DSB and eyes closed period, performed at least four times repeatedly rendered benefits in reducing neck pain and tension, in addition to promoting relaxation within a short period; however, the DSB pattern and the feeling of the stretched muscle to promote relaxation were individual differences. Thus, future studies should come up with apposite training methods adjusted to fit individuals; self-awareness toward these aspects ought to be encouraged.

Effects of mechanical-bed massage on exercise-induced back fatigue in athletes

[Purpose] The study aimed to preliminarily investigate the effects of mechanical-bed massage on exercise-induced back fatigue in athletes. [Subjects and Methods] Twelve male college athletes, randomly allocated to experimental or control groups, were instructed to perform reverse sit-up for 8 sessions until they became fatigued. The experimental group received a 20-min mechanical-bed massage session, while the control group rested on a bed for the same period of time. Visual Analogue Scale (VAS) on perceived back muscle fatigue, back muscle endurance, and Heart Rate Variability (HRV) parameters including stress index (SI), HRV index, SDNN, RMSSD, pNN50, LF, HF, and LF/HF were analyzed. [Results] Immediately and 24 hours after the intervention, the VAS significantly differed between the groups. Experimental group's HF was significantly higher immediately after the intervention than control group. Experimental group's LF and LF/HF were significantly lower immediately after the intervention than the control group. [Conclusion] Mechanical bed massage may help athletes overcome the subjective feelings of exercise-induced fatigue, modulate the automatic nervous system activity, especially for balancing sympathetic and parasympathetic activities. Therefore, mechanical bed massage may facilitate recovery from muscle and central fatigue after athlete training or competition.

Effect of yoga on the menstrual pain, physical fitness, and quality of life of young women with primary dysmenorrhea

The aim of the present study was to investigate effect of specially designed yoga program on the menstrual pain, physical fitness, and quality of life (QOL) of non-athlete women with primary dysmenorrhea (PD) aged 18-22 years. Thirty-four volunteers were randomly assigned into control and yoga groups. Menstrual pain, physical fitness, and QOL were evaluated at baseline and at the end of the 12-week study period. The yoga group was asked to practice yoga for 30 min per day, twice a week, for 12 weeks at home, while the control group did not receive any form of exercise over the study period. There were significant improve in menstrual pain, physical fitness, and QOL in the yoga group more than the control group. Therefore, this specially designed yoga program may be a possible complementary treatment for PD.

Short-Term Pulmonary Rehabilitation for a Female Patient with Chronic Scleroderma under a Single-Case Research Design

Although previously proposed that chronic scleroderma should be cared for clinically and early rehabilitation should be performed in hospital by a chest physical therapist, little evidence is currently available on its benefits. Therefore, this study demonstrated the benefits of short-term pulmonary rehabilitation during hospitalization in a female patient with chronic scleroderma. The aim of rehabilitation was to improve ventilation and gas exchange by using airway clearance, chest mobilization, and breathing-relearning techniques, including strengthening the respiratory system and the muscles of the limbs by using the BreathMax^® device and elastic bands. Gross motor function and activities of daily life were regained by balancing, sitting, and standing practices. Data on minimal chest expansion, high dyspnea, high respiratory rate, and low maximal inspiratory mouth pressure were recorded seven days before rehabilitation or at the baseline period. But there was a clinically significant improvement in dyspnea, chest expansion, maximal inspiratory mouth pressure, and respiratory rate, when compared to baseline data, which were recorded by a chest physical therapist during seven days of rehabilitation. Furthermore, physicians decided to stop using a mechanical ventilator, and improvement in functional capacity was noted. Therefore, in the case of chronic and stable scleroderma, short-term rehabilitation during hospitalization for chest physical therapy possibly shows clinical benefits by improving both pulmonary function and physical performance.

Effects of manual percussion during postural drainage on lung volumes and metabolic status in healthy subjects

OBJECTIVE

The aim of this study was to evaluate the influence of manual percussion during three different positions of postural drainage (PD) on lung volumes and metabolic status.

METHODS

Twenty six healthy volunteers (13 women and 13 men), with a mean age of 20.15 ± 1.17 years, participated. They were randomized into three standard positions of PD (upper, middle, or lower lobes) and given manual percussion at a frequency of 240 times per minute for 5 min. Lung volumes, including tidal volume (TV), inspiratory reserve volume (IRV), expiratory reserve volume (ERV) and vital capacity (VC); and metabolic status, such as oxygen consumption (VO2), carbon dioxide (VCO2), respiratory rate (RR), and minute ventilation (VE) were evaluated.

RESULTS

The lung volumes showed no statistical difference in VC or IRV from percussion during PD in all positions, except for the lower lobe, where increased TV and decreased ERV were found when compared to PD alone. Furthermore, percussion during PD of the upper and middle lobes did not affect RR or VE, when compared to PD alone. In addition, percussion during PD of the middle and lower lobes increased VO2 and VCO2 significantly, when compared to PD alone, but it did not influence PD of the upper lobe.

CONCLUSION

This study indicated that up to 5 min of manual percussion on PD of the upper and middle lobes is safe mostly for lung volumes, RR, and VE, but it should be given with care in PD conditions of the lower lobe.

Effects of traditional Thai self-massage using a Wilai massage stick(TM) versus ibuprofen in patients with upper back pain associated with myofascial trigger points: a randomized controlled trial

[Purpose] The aim of this study was to examine the effects of traditional Thai self-massage using a Wilai massage stick^TM versus ibuprofen on reducing upper back pain associated with myofascial trigger points. [Subjects and Methods] Sixty patients who were diagnosed as having upper back pain associated with myofascial trigger points were randomly allocated to either a massage group using a Wilai massage stick^TM or a medication group taking ibuprofen for 5 days. Both groups were advised to perform the same daily stretching exercise program. Pain intensity, pressure pain threshold, tissue hardness, and cervical range of motion were assessed at baseline, immediately after the first treatment session, and on the fifth day after the last treatment session. [Results] The massage group had significant improvement in all parameters at all assessment time points. Similar changes were observed in the medication group except for the pressure pain threshold and tissue hardness. The adjusted post-test mean values for each assessment time point were significantly better in the massage group than in the medication group. [Conclusion] Tradition Thai self-massage using a Wilai massage stick^TM provides better results than taking ibuprofen for patients who have upper back pain associated with myofascial trigger points. It could be an alternative treatment for this patient population.

Immediate Effects of Traditional Thai Massage on Psychological Stress as Indicated by Salivary Alpha-Amylase Levels in Healthy Persons

BACKGROUND Stress can cause psychological and physiological changes. Many studies revealed that massage can decrease stress. However, traditional Thai massage has not been well researched in this regard. The purpose of this study was to investigate the immediate effects of traditional Thai massage (TTM) on salivary alpha-amylase levels (sAA), heart rate variability (HRV), autonomic nervous system (ANS) function, and plasma renin activity (PRA). MATERIAL AND METHODS Twenty-nine healthy participants were randomly allocated into either a traditional Thai massage (TTM) group or Control (C) group, after which they were switched to the other group with a 2-week wash-out period. Each of them was given a 10-minute mental arithmetic test to induce psychological stress before a 1-hour session of TTM or rest. RESULTS Within-groups comparison revealed that sAA was significantly decreased (p<0.05) in the TTM group but not in the C group. HRV and ANS function were significantly increased (p<0.05) and PRA was significantly decreased (p<0.05) in both groups. However, low frequency per high frequency ratio (LF/HF ratio) and ANS balance status were not changed. Only sAA was found to be significantly different between groups (p<0.05). CONCLUSIONS We conclude that both TTM and rest can reduce psychological stress, as indicated by decreased sAA levels, increased parasympathetic activity, decreased sympathetic activity, and decreased PRA. However, TTM may have a modest effect on stress reduction as indicated by a reduced sAA.

Psychological Stress Can Be Decreased by Traditional Thai Massage

OBJECTIVE

The purpose of this study was to investigate the immediate effects of traditional Thai massage (TTM) on psychological stress and heart rate variability (HRV).

MATERIAL AND METHOD

Thirty healthy participants were randomly allocated in two groups, a TTM group (n = 15) who received a 1-hour session with moderate pressure of whole body TTM or a control group (n=15) who rested on the bedfor 1 hour All ofthem were given a 10-minute mental arithmetic test to induce psychological stress after which they received a 1-hour session of TTM or bed rest. Psychological stress and HR V were measured at baseline and immediately after mental arithmetic test, and immediately after TTM or bed rest.

RESULTS

The studyfound that psychological stress was signficantly increased (p<0.05) after mental arithmetic test in both groups. Comparison on these measures between immediately after mental arithmetic test and after TTM or bed rest revealed that psychological stress was significantly decreased (p<0.05) and HR Vwas significantly increased (p<0.05) in both groups. Root mean square of successive differences (RMSSD) and low frequency were significantly increased (p<0.05) only in the TTM group. However; all of these measures were found without significant difference when groups were compared.

CONCLUSION

TTM and bed rest could decrease psychological stress and HRV

Effect of Kaempferia parviflora Extract on Physical Fitness of Soccer Players: A Randomized Double-Blind Placebo-Controlled Trial

Background

Physical fitness is a fundamental prerequisite for soccer players. Kaempferia parviflora is an herbal plant that has been used in some Asian athletes with the belief that it might prevent fatigue and improve physical fitness. This study aimed to determine the effects of Kaempferia parviflora on the physical fitness of soccer players.

Material/Methods

Sixty soccer players who routinely trained at a sports school participated in a double-blind placebo-controlled trial and were randomly allocated to the treatment group or the placebo group. The participants in both groups were given either 180 mg of Kaempferia parviflora extract in capsules or a placebo once daily for 12 weeks. Baseline data were collected using the following 6 tests of physical performance: a sit-and-reach test, a hand grip strength test, a back-and-leg strength test, a 40-yard technical test, a 50-metre sprint test, and a cardiorespiratory fitness test. All of the tests were performed every 4 weeks throughout the 12-week study period.

Results

The study showed that after treatment with Kaempferia parviflora, the right-hand grip strength was significantly increased at weeks 4, 8, and 12. The left-hand grip strength was significantly increased at week 8. However, the back-and-leg strength, the 40-yard technical test, the sit-and-reach test, the 50-metre sprint test, and the cardiorespiratory fitness test results of the treatment group were not significantly different from those of the placebo group.

Conclusions

Taking Kaempferia parviflora supplements for 12 weeks may significantly enhance some physical fitness components in soccer players.

Effects of thai foot massage on balance performance in diabetic patients with peripheral neuropathy: a randomized parallel-controlled trial

BACKGROUND Peripheral neuropathy is the most common complications of diabetic patients and leads to loss of plantar cutaneous sensation, movement perception, and body balance. Thai foot massage is an alternative therapy to improve balance. Therefore, the purpose of this study was to investigate the effects of Thai foot massage on balance performance in diabetic patients with peripheral neuropathy. MATERIAL AND METHODS Sixty patients with type-2 diabetes were recruited and randomly assigned into either the Thai foot massage or control groups. The Thai foot massage group received a modified Thai traditional foot massage for 30 min, 3 days per week for 2 weeks. We measured timed up and go (TUG), one leg stance: OLS), the range of motion (ROM) of the foot, and foot sensation (SWMT) before treatment, after the first single session, and after the 2-week treatment. RESULTS After the single treatment session, only the Thai foot massage group showed a significant improvement in TUG. After the 2-week treatment, both Thai foot massage and control groups showed a significant improvement of TUG and OLS (P<0.05); however, when comparing between 2 groups, the Thai foot massage group showed better improvement in TUG than the control group (p<0.05). The Thai foot massage group also showed significant improvements in ROM and SWMT after the 2-week treatment. CONCLUSIONS The results of this study suggest that Thai foot massage is a viable alternative treatment for balance performance, ROM of the foot, and the foot sensation in diabetic patients with peripheral neuropathy.

Effects of Thai massage on physical fitness in soccer players

[Purpose] The aim of this study was to determine the effects of Thai massage on physical fitness in soccer players. [Subjects and Methods] Thirty-four soccer players were randomly assigned to receive either rest (the control group) or three 30-minute sessions of Thai massage over a period of 10 days. Seven physical fitness tests consisting of sit and reach, hand grip strength, 40 yards technical agility, 50-meter sprint, sit-ups, push-ups, and VO_{2, max} were measured before and after Thai massage or rest. [Results] All the physical fitness tests were significantly improved after a single session of Thai massage, whereas only the sit and reach, and the sit-ups tests were improved in the control group. [Conclusion] Thai massage could provide an improvement in physical performance in soccer players.

Ability of obstacle crossing is not associated with falls in independent ambulatory patients with spinal cord injury

STUDY DESIGN

A 6-month prospective design.

OBJECTIVE

To investigate the relationship between ability of obstacle crossing and falls in independent ambulatory participants with spinal cord injury (SCI).

SETTING

A tertiary rehabilitation center.

METHODS

Ninety-four participants were evaluated for their SCI characteristics, ability of walking over small obstacles and functional ability relating to dynamic balance control, lower-extremity motor strength (LEMS) and walking ability. Their fall data were then prospectively monitored every month for 6 months.

RESULTS

Twenty-four participants failed in obstacle crossing. However, only eight of the thirty-three participants who fell during the follow-up period were unable to clear the obstacle while walking. The LEMS and functional ability of the participants who failed were significantly poorer than those of individuals who passed an obstacle-crossing test (P⩽0.001). For the falls, significant differences between the groups were found only in age and tactile scores. The findings further indicated that failures on obstacle crossing were not significantly associated with falls (P>0.05).

CONCLUSION

Ability of obstacle crossing in a closed/controlled environment clearly correlated with intrinsic causes, whereas a fall in an open environment may be associated with not only intrinsic but also extrinsic causes. Therefore, apart from functional ability, rehabilitation professionals may need to consider extrinsic factors around falls in order to manage risk of injury to the patients.

Tai chi improves oxidative stress response and DNA damage/repair in young sedentary females

[Purpose] This study was to examine the effects of 12 weeks of Tai Chi (TC) exercise on antioxidant capacity, and DNA damage/repair in young females who did not perform regular physical exercise. [Subjects and Methods] Ten female students from a Chinese university voluntarily participated in this program. All of them practiced the 24-form simplified Tai Chi, 5 times weekly, for 12 weeks. Plasma levels of superoxide dismutase (SOD), glutathione peroxidase (GPx), malondialdehyde (MDA), glutathione (GSH), hydroxyl radical inhibiting capacity (OH·-IC), 8-hydroxy-2'-deoxyguanosine (8-OHdG), and 8-oxoguanine DNA glycosylase (OGG1) were measured at 0, 8, and 12 weeks. Heart rate (HR) was monitored during the last set of the training session at 4, 8, and 12 weeks. [Results] Plasma SOD and OH·-IC levels were increased at 8 and 12 weeks compared to the baseline (0 weeks). Gpx and GSH levels did not change significantly throughout the study period. The plasma MDA level was decreased significantly at 8 weeks but not at 12 weeks compared to the baseline value. While the plasma 8-OHdG level did not change throughout the study period, the plasma OGG1 level was significantly increased at 8 and 12 weeks compared to the baseline value. [Conclusion] TC practice for 12 weeks efficiently improved the oxidative stress response in young females who did not perform regular physical exercise. The TC exercise also increased the DNA repairing capacity.

The short-term effect of gloving in combination with Traditional Thai Massage, heat, and stretching exercise to improve hand mobility in scleroderma patients

BACKGROUND

Systemic sclerosis (SSc) is a chronic, multisystem connective tissue disorder characterized by autoimmune activation, microvascular endothelium damage, and excessive collagen proliferation. The most affected hand presents claw hand deformity and microvascular disease. Deformed hands can cause functional disability and decrease the quality of life. A daily home program can improve mobility of scleroderma patients.

OBJECTIVE

We sought to determine the effect of a daily home exercise program on hand mobility among scleroderma patients.

MATERIALS AND METHODS

This was a randomized control trial. Twenty-eight participants were divided into two groups, both of which received the same daily home treatment: Group 1 with gloves (n = 14) and Group 2 without gloves (n = 14). The 2-week daily home program combined traditional Thai massage (TTM) with stretching exercises and heat. Hand mobility was assessed using hand mobility in scleroderma (HAMIS). The study was conducted in patients who were already on vasodilator drugs.

RESULTS

Both groups showed a significant improvement in hand mobility after 2 weeks of daily home exercise program (P < 0.05). Wearing the glove, however, resulted in better thumb mobility.

CONCLUSIONS

A daily home exercise program improved hand mobility among patients with scleroderma and wearing gloves may improve thumb mobility.

The Effectiveness of Thai Exercise with Traditional Massage on the Pain, Walking Ability and QOL of Older People with Knee Osteoarthritis: A Randomized Controlled Trial in the Community

[Purpose] This study investigated the effectiveness of a class- and home-based exercise with massage between Thai traditional and standardized physical therapy (TPT and SPT) in older people with knee osteoarthritis (KOA). [Subjects and Methods] Thirty-one subjects with KOA (aged 50-85 years) in two selected villages were randomly assigned into the TPT or SPT programs. Seventeen TPT subjects received Thai exercise with traditional massage, and 14 SPT individuals performed strengthening exercise with Swedish massage. Both programs consisted of a class with supervision plus home self-care for 8 weeks; the subjects then managed home self-care for 1 year. [Results] After 2 months, the six-minute walk test (6MWT), Western Ontario and McMaster Universities Arthritis Index (WOMAC), and SF-36 testing showed significant improvement in both groups, but the improvement of the TPT group was greater. After 1year, only the score for the 6MWT was greater in the TPT group than in the SPT group. [Conclusion] The TPT program yielded better results for the 6MWT, but, both programs had beneficial effects on the pain, function, and QOL of middle-aged and older patients with KOA in the community setting.

Effects of restrictive clothing on lumbar range of motion and trunk muscle activity in young adult worker manual material handling

The objective of this study was to examine the effect of wearing restrictive trousers on lumbar spine movement, trunk muscle activity and low back discomfort (LBD) in simulations of manual material handling (MMH) tasks. Twenty-eight young adults participated in the study performing box lifting, liquid container handling while squatting, and forward reaching while sitting on a task chair when wearing tight pants (sizes too small for the wearer) vs. fit pants (correct size according to anthropometry). Each task was repeated three times and video recordings were used as a basis for measuring lumbar range of motion (LRoM). The response was normalized in terms on baseline hip mobility. Trunk muscle activity of rectus abdominis (RA) and erector spinae (ES) muscles were also measured in each trial and normalized. At the close of each trial, participants rated LBD using a visual analog scale. Results revealed significant effects of both pants and task types on the normalized LRoM, trunk muscle activity and subjective ratings of LBD. The LRoM was higher and trunk muscle (ES) activity was lower for participants when wearing tight pants, as compared to fit pants. Discomfort ratings were significantly higher for tight pants than fit. These results provide guidance for recommendations on work clothing fit in specific types of MMH activities in order to reduce the potential of low-back pain among younger workers in industrial companies.

Therapeutic effects of traditional Thai massage on pain, muscle tension and anxiety in patients with scapulocostal syndrome: a randomized single-blinded pilot study

The purpose of this study was to investigate the therapeutic effects of traditional Thai massage (TTM) on pain intensity, pressure pain threshold (PPT), muscle tension and anxiety associated with scapulocostal syndrome (SCS). Twenty patients were randomly allocated to receive a 30-min session of either TTM or physical therapy modalities (PT: ultrasound therapy and hot pack) for 9 sessions over a period of 3 weeks. Pain intensity, PPT, muscle tension and anxiety were measured before and immediately after the first treatment session, 1 day after the last treatment session and 2 weeks after the last treatment session. Results indicated that the TTM group showed a significant improvement in all parameters after the first treatment session and at 1 day and 2 weeks after the last treatment session (p < 0.05). For all outcomes, similar changes were observed in the PT group except for PPT (p < 0.05). The adjusted post-test mean values of each assessment time point for pain intensity and muscle tension were significantly lower in the TTM group than those of the PT group (p < 0.01). In addition, the values for PPT were significantly higher in the TTM group (p > 0.05). We therefore suggest that TTM could be an alternative treatment for the patient with SCS.

Effectiveness of pelvic floor muscle training in incontinent women at Maharaj Nakorn Chiang Mai Hospital: a randomized controlled trial

OBJECTIVE

To compare the effects ofthree different pelvic floor muscle training (PFMT) in stress urinary incontinence (SUI) women.

MATERIAL AND METHOD

Sixty-eight eligible SUI women who could perform pelvic floor muscle contraction correctly were randomly allocated to the three diferent PFMT protocols, exercise every day (GJ), exercise three days per week (G2), and exercise plus abdominal training three days per week (G3). The primary outcome was pad test. The secondary outcomes were pelvic floor muscle strength, and treatment satisfaction. The outcomes were evaluated before and after a 12-week of exercise.

RESULTS

The weights ofpad were decreased by 2.6 +/- 0.8, 2.3 +/- 1.3, and 3.1 +/- 1.3 grams for group 1, 2, and 3, respectively. There was no statistical significant difference among the three groups. The pelvic floor muscle strength was increased by 18.4 +/- 2.7, 13.9 +/- 2.9, and 17.3 +/- 3.0 cmH2O for group 1, 2, and 3, respectively, with statistical significant difference among groups (p < 0.00). The increased muscle strength in group 2 was significant less than the other two groups (p < 0.00). Treatment Satisfaction showed the leakage was improved with non-significant difference between groups (p > 0.05). No complications were seen in any of the groups.

CONCLUSION

Even though the results showed non-significant decrease in pad's weight among the three training groups, the pelvic floor muscle strength were increased in all groups.