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The aim of this systematic review study was investigating the effect of massage on the sleep and awake pattern of premature infants. All articles published in English and Persian until the end of 2020 in databases including Medline, Scopus, Embase, Cochran library, Google scholar and the Farsi databases (SID and IranMedex) were searched. The included studies were randomized, controlled, clinical trials and quasi-experimental studies that investigated the effect of massage therapy or Tactile-kinesthetic stimulation on sleep/awake pattern. The heterogeneity was examined using I2. Five studies were entered in this systematic review. The mean total awake time was significantly higher in the massage group compared to the standard care group (SMD = 1.00; 95%CI: 0.09 to 1.90; P = 0.03). However, there was no significant difference between the massage group and standard care group in terms of total sleep. NICU nurses can incorporate massage into daily routine care based on the results of this present review. Registration number in the prospero CRD42020153546.

Background Using Reiki and back massage to support pharmacological treatments is increasingly common in nursing. This study aimed to determine the effects of Reiki and back massage on pain, analgesic use, and vital signs among women who had undergone an open abdominal hysterectomy. Methods This experimental study involved a single, blinded, pretest-posttest design. The study population comprised women who had undergone an abdominal hysterectomy at the obstetrics clinics of Gazi Yasargil Training and Research Hospital and Dicle University Hospital between July 2017 and February 2018. Patients were divided into three groups: a Reiki group, a back massage group, and a control group. Each group comprised 34 patients. Reiki or back massage was applied to patients in the respective non-control groups for 20 min once a day. Data were collected using a patient information form, the “Numeric Pain Rating Scale,” and the “Vital Signs and Postoperative Analgesic Follow-up Form.” Results Statistically significant differences in pain intensity and analgesic use were observed between the women in the Reiki group and the women in the back massage and control groups (p Conclusion This study's findings confirmed that pain, analgesic use, and vital signs decreased after Reiki among women who had undergone an abdominal hysterectomy.

Introduction: Palpitation is a common complaint among patients presenting to emergency departments or cardiologists. Palpitation caused by organic heart diseases, such as coronary atherosclerotic heart disease and hypertensive heart disease, may be a sign of a life-threatening condition. In such cases, treatment with western medicines or surgeries is warranted. However, for patients with palpitation caused by non-cardiac factors, western medicine treatment is often ineffective, and traditional Chinese medicine has comparatively superior advantage. With the change in people's lifestyle and habits in the past decades, the time spent sitting and that with a forward head posture is increasing, which has accelerated the process of spinal aging and increased the incidence rate of spinal diseases. Case presentation: A 54-year-old female presented with paroxysmal palpitations, chest depression, and neck pain that had lasted for more than 2 months. Western medicine diagnosis was palpitations due to spinal disorders, while the traditional Chinese medicine diagnosis was palpitation (heart and spleen deficiency). The patient was treated with traditional Chinese massage, 30 min sessions, 5 times a week, 3 weeks totally. Subsequently, the patient's neck pain and numbness disappeared and the palpitations, chest tightness, and dizziness ameliorated. The patient resumed regular appetite, experienced better sleep, and had further improvement of spirit, enabling her to lead a normal life. Conclusions: Traditional Chinese massage therapy can relieve muscle spasm, regulate cervical facet joint disorder and dislocation, release adhesion, relieve synovial incarceration, restore the dynamic and static balance of the cervical spine, improve blood circulation of the cervical spine, increase the nutritional supply of the cervical spine and surrounding soft tissue, and promote metabolism and tissue repair. All these advantages make it a good complementary and alternative therapy for palpitation caused by spine disorders.

Objective The aim of this randomized experimental study is to analyze the effect of massage, wipe bathing and tub bathing on physiological measurements of late premature newborns. Design and Methods: This randomized experimental study was conducted on 192 newborns at the gestational week of 34 or higher in the neonatal intensive care unit of a university hospital. The researchers applied massage (n: 48), tub bathing (n: 48), and wipe bathing (n: 48) to the newborns. The control group (n: 48) received no intervention except for the routine clinical practices. The newborns' physiological measurements before, immediately after and 30 min after the interventions were taken and recorded on the “Newborn Follow-up Form.” The newborns’ physiological measurements were assessed by independent evaluators who were blinded to the purpose of the study at different phases across the massage, wipe bathing and tub bathing protocols. The statistical analysis was performed using percentages, means, repeated analysis, variance analysis, Bonferroni analysis. Results No difference was found in the massage, wipe bathing, tub bathing and control groups' mean physiological measurements (pulse, respiration, oxygen saturation, blood pressure, body temperature) (p > 0.05).

Scar massage is a widely used treatment modality in hand therapy. This intervention is thoroughly discussed in the literature relating to burns rehabilitation, however, the evidence for its use in treating linear scars following surgery is limited.To collate the empirical literature on scar massage for the treatment of postsurgical cutaneous scars.Scoping review.Medline, EMBASE, CINAHL, AMED, Scopus, ProQuest DissertationsTheses Global, and the Joanna Briggs Institute were searched from inception to December 2020. Two researchers used a data extraction tool to record key demographic, intervention and outcome data, and to apply the Oxford Levels of Evidence for each study.Twenty-five studies met the inclusion criteria, reporting on a combined sample of 1515 participants. Only two papers addressed hand or wrist scars (92 participants). While all studies reported favorable outcomes for scar massage, there were 45 different outcome measures used and a propensity towards non-standardized assessment. Intervention protocols varied from a single session to three treatments daily for 6 months. The results from 13 studies were confounded by the implementation of additional rehabilitation interventions.The overall findings suggest that while there may be benefits to scar massage in reducing pain, increasing movement and improving scar characteristics; there is a lack of consistent research methods, intervention protocols and outcome measures. This scoping review highlights the heterogenous nature of research into scar massage following surgery and supports the need for further research to substantiate its use in the clinical setting.

The incidence of opioid use disorder (OUD) is increasing worldwide, and the opioid-related overdose crisis is currently a major global challenge. This study investigated the effects of adjuvant laser meridian massage (LMM) in men with OUD undergoing methadone maintenance treatment (MMT).A case-controlled study was conducted from February 2019 to April 2020. Fourteen men with OUD on MMT were enrolled from an addiction treatment center as an experimental group. An age-matched control group comprising 13 men was also enrolled. The experimental group received LMM on the back, including over the Bladder meridian and Governor Vessel, three times weekly for 4 weeks. The control group received only MMT. Urinary morphine levels, patients' self-reports of the number of episodes or days of heroin use, and visual analog scale scores for heroin craving/refusal to use heroin during the previous week were evaluated. Quality of life was reported using the Short Form (SF)-12v2.The experimental group showed a significant decrease in heroin use (p 0.05), whereas the control group showed a significant increase in heroin craving (p 0.05). The SF-12v2 Health Survey revealed a significant improvement in physical health in the experimental group (P 0.05).The results of this study suggest that laser meridian massage can be considered a safe, well-tolerated, and potentially useful adjuvant intervention for opioid use disorder.

Heart rate variability (HRV) is one of the tools that can assess autonomic activities during exercise or recovery. Massage is an often-used recovery method with varying recovery outcome. This study was to investigate the effect of lower limb massage on recovery HRV following repeated knee flexion and extension exercise-to-exhaustion.Nine healthy men aged between 20 and 30 years old were recruited and randomly assigned to a control group (n = 5) and massage group (n = 4). The HRV spectral analysis was performed at baseline, pre-exercise, post-exercise and immediately post-intervention. For intervention, the participants in the massage group received a 10-min massage on the quadriceps and hamstring muscles of the dominant leg whereas the control group received none. The HRV was presented as low-frequency (LF) peak (Hz), power (msSpectral power analysis showed there were no significant differences in the LF indices and LF/HF ratio with massage. HRV normalisation data revealed a within-subject difference with massage.Massage caused an immediate parasympathetic activation during recovery from a single exhaustive muscle contraction exercise. Hence, massage may be used to potentiate recovery.

Background Coconut oil supplies essential nutrients, prevents heat loss by forming barrier, and enhances skin maturity. Massage also provides benefit of tactile stimulation. Objectives To detect the effect of coconut oil massage in the newborn period on weight gain, skin maturity, neurodevelopment, and brain growth. Study design Randomized controlled trial. Participants This study included 585 consecutively born children over 1 year and followed them up for 2 years. Newborns with congenital anomaly, whose parents denied consent, and severely ill newborns were excluded from the study. Intervention Newborns of group A received coconut oil massage four times daily in the newborn period. Newborns of group B received massage without any emollient. Outcomes Primary outcome was weight gain/day in the newborn period. Secondary outcomes were weight loss in the initial part of life, hypothermia, sepsis, serum 25-hydroxy vitamin D level at day 30, skin maturity at day 14 and 28, head circumference and neurodevelopmental outcome at 6th, 12th, 18th, and 24th months, and brain volume at 2 years. Results Mean weight loss in early part of life was significantly less [223.5 (35.5) g vs 238.7 (40.2) g, P 0.05). Conclusion Coconut oil massage is a promising, cost-effective, and socially acceptable intervention for lowering neonatal morbidity and mortality, particularly in preterms.

To evaluate the effect of combined perineal massage and warm compress to the perineum (MassComp) compared to perineal massage alone during pushing in the second stage of labour in reducing perineal trauma requiring suturing in nulliparas.A randomised trial was performed in a University hospital, Malaysia from June 2020 to May 2021. 281 term nulliparas who were about to start pushing in the second stage of labour were randomised to combined perineal massage and warm compress or perineal massage alone to the perineum. Primary outcome was suturing for perineal injury (episiotomy or tear). The Chi-square test was used to analyse categorical data, Student t test to compare means and distributions for normally distributed continuous data and Mann Whitney U test for appropriate ordinal data.Data from 277 participants (140 MassComp arm, 137 perineal massage alone arm) were analysed based on modified intention to treat basis. Perineal suturing rates were 133/140(95.0%) [MassComp] vs. 128/137(93.4%) [perineal massage alone] RR 1.02(95%CI 0.96-1.08), P = 0.615. Of the secondary outcomes, Likert scale response to recommend allocated treatment to a friend was 103/140(73.6%) vs. 84/137(61.3%) RR 1.20(95%CI 1.02-1.42)NNTMassage and warm compress during pushing did not decrease the likelihood of perineal injury requiring suturing in nulliparas when compared to perineal massage alone. Women were more likely to recommend massage and warm compress during pushing to a friend.

Recent findings have shown that the neurophysiological mechanisms involved in human massage and caress are similar to those involved in grooming of nonhuman primates. In contrast, little is known about the neurophysiological mechanisms of brief touch in both human and other primates. Here we review evidence for brief touch in nonhuman primates and contrast its patterns and potential functions with those better known of grooming. We show that brief touch is not an affiliative behavior as it functions to assess the competitive tendencies of unfamiliar individuals and former opponents, to test the state of a social relationship and to signal benign intent. Thus, brief touch plays an important role, complementary to that of grooming, in the regulation of social relationships.

Pleasant sensation is an underexplored avenue for modulation of chronic pain. Deeper pressure is perceived as pleasant and calming, and can improve sleep. Although pressure can reduce acute pain, its effect on chronic pain is poorly characterized. The current remote, double-blind, randomized controlled trial tested the hypothesis that wearing a heavy weighted blanket – providing widespread pressure to the body – relative to a light weighted blanket would reduce ratings of chronic pain, mediated by improvements in anxiety and sleep. Ninety-four adults with chronic pain were randomized to wear a 15-lb. (heavy) or 5-lb. (light) weighted blanket during a brief trial and overnight for one week. Measures of anxiety and chronic pain were collected pre- and post-intervention, and ratings of pain intensity, anxiety, and sleep were collected daily. After controlling for expectations and trait anxiety, the heavy weighted blanket produced significantly greater reductions in broad perceptions of chronic pain than the light weighted blanket (Cohen's f = .19, CI [-1.97, -.91]). This effect was stronger in individuals with high trait anxiety (P = .02). However, weighted blankets did not alter pain intensity ratings. Pain reductions were not mediated by anxiety or sleep. Given that the heavy weighted blanket was associated with greater modulation of affective versus sensory aspects of chronic pain, we propose that the observed reductions are due to interoceptive and social/affective effects of deeper pressure. Overall, we demonstrate that widespread pressure from a weighted blanket can reduce the severity of chronic pain, offering an accessible, home-based tool for chronic pain. The study purpose, targeted condition, study design, and primary and secondary outcomes were pre-registered in ClinicalTrials.gov (NCT04447885: “Weighted Blankets and Chronic Pain”). Perspective: This randomized-controlled trial showed that a 15-lb weighted blanket produced significantly greater reductions in broad perceptions of chronic pain relative to a 5-lb weighted blanket, particularly in highly anxious individuals. These findings are relevant to patients and providers seeking home-based, nondrug therapies for chronic pain relief.

Summary Objectives This study aims to evaluate the relationship between application of the MGDRx thermal eyebag and dry eye signs and symptoms in young and older subjects and to compare the results between the two groups. Methods Thirty young, healthily volunteers between 18 and 31 years of age (23.95 ± 3.94 years) and thirty older subjects between 61 and 90 years of age (77.97 ± 8.11 years) participated in this study. Ocular surface parameters were assessed using the Oculus Keratograph 5 M, following the guidelines of the Tear Film and Ocular Surface Dry Eye Workshop II Diagnostic Methodology report. Only subjects with a positive score on at least one questionnaire and an initial Non-Invasive Keratograph Break-Up Time (NIKBUT) under 10 seconds were included in the study. After thermal bag self-application in both eyes every day for 2 weeks, the protocol was carried out again. Lid massage was performed after lid warming. Compliance and degree of improvement were also assessed. Main results The young volunteer group showed an improvement in NIKBUT, lipid layer score, upper eyelid gland drop-out percentage and dry eye symptoms over the two week treatment period. Improvements in meibum quality, gland obstruction, telangiectasia scores, and dry eye symptoms were found in the older subjects. Mixed ANOVA revealed better NIKBUT and lipid layer values in the young subjects. Despite the treatment compliance being statistically higher in the older group than in the younger subjects (P = 0.002), there were no significant differences in subjective improvement between groups (P = 0.097). Conclusion Dry eye-related symptoms were improved after thermal bag application, while NIKBUT and lipid layer thickness were improved only in the younger subjects.

Low back pain (waja-uz-zahr) due to lumbar spondylosis affects approximately 60-80% of the population at any point of life. The present study was aimed to evaluate the efficacy of soft and prolonged massage with roghan-i-suranjan on low back pain.Clinically and radiologically diagnosed patients of low back pain were randomized into test and control groups consisting 20 patients in each group. The patients in test group received soft and prolonged massage with roghan-i-suranjan; while, in control group, short wave diathermy was given on every alternate day up to 20 min for 3 weeks. The patients were assessed before and after the treatment using the VAS and ODI (OLBP) scales.VAS score was reduced to 42.14%, (p 0.001) in massage and 13.94%, (p 0.008) in control group after the treatment [Percentual Change (PC) between the groups = 54.35%, p 0.001]. OLBP score was improved to 37.16% (p 0.001) in massage and 5.93% (p 0.0012) in control group after the treatment [PC between the groups = 29.57%, p 0.02].Apart from the muhallil-i-awram (anti-inflammatory), mulattif (attenuative), daf-i-alam (analgesic), and musakkin (sedative) activities of the tested-drugs, the specific strokes soft and prolonged massage further enhances the evacuative and rejuvenative process through its own action of tahleel (dissolution), talteef (attenuation), taskeen (sedation), and taskheen (diaphoresis) induced by the various manipulations used in this massage. Soft and prolonged massage with tested oil was found effective in reducing the pain and improving the quality of life in the patients of low back pain.

Background Patients admitted to the intensive care units encounter many complications due to the nature of the disease and invasive medical procedures such as intubation and mechanical ventilation. Among these complications, agitation is a frequently-observed and serious problem. Objectives This study aimed to investigate the effect of Shiatsu massage on agitation in mechanically ventilated patients. Methods In this randomized controlled trial, a total of 68 mechanically ventilated patients were selected and then randomly assigned to two groups of intervention and control. Patients in the intervention group received three 5-minute periods of Shiatsu massage with a 2-minute break between them, while patients in the control group only received a touch on the area considered for the message. Data were collected before and after the intervention using the Richmond Agitation-Sedation Scale (RASS) and then analyzed using IBM SPSS Statistics for Windows, version 25.0 (IBM Corp., Armonk, N.Y., USA). Results The results showed that the level of agitation significantly decreased in the intervention group compared to the control group (p=.001). Conclusion Application of shiatsu massage seems to be effective in managing agitation in mechanically ventilated patients. Further studies with greater sample size and longer follow-up period are needed to confirm the current findings.

Background and purpose Foot reflexology is safe and suitable for preschoolers. The purpose of this study was to determine the effect of foot reflexology on behavioral and emotional problems in preschool children. Method As many as 31 preschool children in Nurul Islam Kindergarden involved in pre-experimental study with one group pre-test and post-test design using Preschool Pediatric Symptom Checklist Score (PPSC). Foot reflexology was applied 30 min every day for 4 consecutive days on April 22–April 25, 2019. Paired t-test and Wilcoxon was used to analyze behavioral and emotional problems. Results Foot reflexology can reduce emotional problems (95% CI: 2.466–4.309; p = 0.001), attention problems (95% CI: 0.349–1.256; p = 0.001) and parental challenges, but there was no effect on behavioral problems (CI: −0.174 to 0.293; p = 0.566). Conclusion Foot reflexology is useful for reducing preschool children's behavioral and emotional problems, especially emotional and attention problems. Future study is expected to use control group and measurement of cortisol, endorphins, dopamine, acetilcholine, etc. were not carried out before and after foot reflexology massage for future study.

PURPOSE This randomized controlled phase II study investigated the efficacy, safety and underlying mechanism of maxillofacial and oral massage (MOM) in nasopharyngeal carcinoma (NPC) patients receiving intensity-modulated radiotherapy. METHODS A total of 158 NPC patients were randomly assigned 1:1 to routine oral care and medication (the control group) or that with additional MOM (the treatment group). The primary endpoint was the incidence of severe radiotherapy-induced oral mucositis (SRTOM). In addition, the time of initiation and duration of RTOM and SRTOM, adverse events, dynamic changes of lipid metabolites in peripheral blood were analyzed. RESULTS Seventy-six patients in the treatment group and seventy-nine in the control group completed the trial. The incidence of SRTOM in the treatment group was lower than the control (26.3% vs. 46.8%, P = 0.008). The median initiation time to RTOM and SRTOM was significantly longer in the treatment group than the control (RTOM:12 vs 10 days, hazard ratio [HR] 0.52, P

Aim: Complementary and alternative medicine (CAM) is becoming increasingly used globally, although there is variability in nurses' knowledge and attitudes. This study was conducted to examine Turkish nurses' levels of knowledge of CAM methods. Methods: The research was designed as a cross-sectional and descriptive study. The study population consisted of all nurses (N = 1350) working in three hospitals in the province of Istanbul, Turkey, with an interview survey of 300 nurses working in these three hospitals conducted between February 2016 and January 2017. All data were collected by the authors at face-to-face interviews using a questionnaire containing 36 items investigating nurses' socio-demographic characteristics and knowledge of CAM. The questionnaire was prepared by the authors based on the previous literature. p values

Sleep disruption is common among older adults. Non-pharmacological interventions involving music has emerged as a promising approach to address sleep disruption. The purpose of this systematic review was to examine the effects of music interventions on sleep outcomes among older adults (age ≥ 50). We searched five databases through May 2020 and found 16 eligible studies focused on two types of music interventions: music listening (n = 11) and multi-component (n = 5). We found mixed evidence in the efficacy of music interventions to improve sleep outcomes in older adults, which included sleep quality, objective and subjective sleep characteristics. Music listening interventions contained relaxing music with research teams personalizing music choice based on participants’ preferences. Multi-component interventions included listening to music in addition to one other approach, such as massage, tai chi, and nature scenes. Future higher-quality studies should provide a detailed description of music interventions and tailor music selections to older adults’ preferences.

Objective The purpose of this study was to understand emerging roles of parents of hospitalized children with life threatening conditions and to explore how complementary therapies integrated into conventional pediatric care may shift and/or support these roles. Design This study is part of a larger research study that examined the introduction of a pediatric integrative medicine service at an acute care children's hospital in Canada. A qualitative descriptive study was conducted using one-on-one telephone interviews with a sample of parents of children included in the larger study. Children had had access to complementary therapies including Reiki, massage therapy, and acupuncture. Results A total of 36 interviews were conducted between May 2014 and January 2016. This study found that parents of hospitalized children assume complex roles including that of caregiver, expert and patient (due to high levels of stress and anxiety). Moreover, the study reveals that the integration of complementary therapies with conventional care supports these parental roles. Conclusion This study reveals that complementary therapies, introduced as a part of integrated approach to pediatric hospital care, and aimed primarily at managing distressing symptoms in patients, had simultaneously a positive contribution in providing parents with the means to navigate the complexities of parenting in the pediatric oncology and cardiology hospital wards and addressing some of their own needs.

Introduction Pain-inducing massage results in greater pain inhibition than pain free massage, suggesting a mechanism dependent on conditioned pain modulation (CPM). The purpose of this study was to test the hypothesis that pain inducing massage produces similar magnitude of reduction in pain sensitivity as a cold pressor task and that baseline conditioned pain modulation efficiency predicts pain inducing massage related hypoalgesia. Methods Sixty healthy participants were randomly assigned to receive either pain inducing massage to the neck, cold pressor task to the hand, or pain free massage to the neck. Participants also underwent pre and immediate post-intervention quantitative sensory testing. A repeated measures ANCOVA determined between group differences in pain sensitivity changes. Results Pain inducing massage used as a conditioning stimulus resulted in comparable experimental pain sensitivity changes as a cold pressor task (p > 0.05). Pain intensity during the intervention demonstrated a weak correlation (r = 0.20, p = 0.12) with changes in pain sensitivity at a remote site. Individuals with an efficient CPM at baseline who received the pain inducing massage displayed greater increases in pressure pain threshold compared to individuals with a less efficient CPM indicating the potential benefit of treatment stratification by mechanism. Conclusion Although pain inducing massage resulted in less self-reported pain than a cold pressor task, both resulted in similar magnitude of the CPM response, suggesting shared underlying mechanisms. Understanding mechanisms of interventions can move us closer to mechanistic based treatments for pain which is consistent with a personalized medicine approach to care.

Introduction Maintaining flexibility, often defined as range of motion (ROM), is important. Recently, self-massage using a foam roller (FR) has been used in clinical and/or sports settings to effectively and immediately improve ROM. Many studies have found significant increases in ROM following the FR intervention; however, the mechanism of the effect is unclear. We aimed to clarify this mechanism regarding the ROM effects following the FR intervention by evaluating local tissue and autonomic nervous system responses. Method The study employed a crossover design that included a comparison between non-intervention (CON trial: left leg) and intervention (FR trial: right leg) groups. Fourteen volunteers participated. Nine outcomes (passive maximum ankle ROM [ROM with a specified and non-specified passive strength], tissue hardness, skin temperature, water contents, circumference, blood flow velocity, pressure pain threshold, autonomic nervous system, and heart rate) were investigated before (PRE) and 0 min (POST0), 20 min (POST20), 40 min (POST40), and 60 min (POST60) post intervention. Results Skin temperature, impedance, and circumference changed significantly following the intervention, and increased ROM with non-specified strength was observed. Discussion Although we found that the FR intervention influenced skin temperature, impedance, circumference, and ROM, adaptability to the intervention may differ depending on an individual's characteristics. Females and/or individuals with a high body water content could obtain greater positive ROM effects than males and/or individuals with a low body water content. Conclusion These findings suggest that the FR intervention may be an effective method to improve ROM, with alterations of skin temperature, impedance, and circumference.

Background Idiopathic scoliosis is associated, among others, to muscular imbalance, functional limitations, and the most prevalent, back pain. The treatments usually applied are exercise, bracing or surgery. The objective of corrective exercise is to reduce symptoms and improve functional capacity and quality of life. Myofascial release (MFR) or Self-Myofascial release (SMFR) are manual techniques, intended to restore optimal muscle and fascia length, decrease pain, and improve function. Purpose to analyze the effects of MFR and postural control programs in lower back pain and scoliosis curves. Methods A systematic literature review was conducted in high quality databases to identify the existing evidence of the effects of MFR and postural control on reducing back pain and scoliosis curves. Results Seventeen studies met inclusion criteria. 533 subjects and 94 MFR/SMFR applied interventions lasting one to 24 weeks/sessions were identified. Ten studies used MFR, six SMFR and one mixes techniques. Seven MFR and five SMFR studies shown positive result. One study using MFR and one using SMFR applied also postural control exercises. MFR was useful to reduce back pain in all studies included that aimed in that matter. In addition, 12 studies reported improvements in flexibility and/or stiffness reduction, and two studies observed improvements in postural control and balance. Conclusions The combination of MFR and postural control programs might be suitable for reducing scoliosis and back pain. However, due to the reduced number of studies and the relatively small sample sizes used, results may be carefully interpreted, and more studies are needed.

This perspective article discusses the various practices classified as complementary and alternative medicine (CAM) and reviews the benefits and uncertainties with respect to nutritional supplements in patients with hematological disease. It considers the high prevalence of CAM use especially among cancer survivors, particularly patients with hematologic malignancies and allogeneic stem cell transplant survivors, many of whom believe (because of extensive advertising) that supplements are anticancer/antitoxic agents, despite the paucity of evidence to support any benefit and the enormous cost to the individual. CAM constitutes various practices and nutritional behaviors including prayers, relaxation, spiritual healing, nutritional supplements, meditation, religious counseling, massage, and support groups. We highlighted the current literature regarding CAM practices and focused our discussion on the omnipresent nutritional supplements in particular to further expound on their benefits and adverse effects. As the number of survivors after HSCT increases over the next several years along with prevalence of CAM use, it becomes imperative to ascertain any beneficial potential, as well as toxicities associated with CAM use in this population.

Background : Insomnia is a more and more common sleep disorder, which affects health and quality of life. Aromatherapy is one of the effective treatments to improve sleep quality. This paper is to comprehensively evaluate the existing research on aromatherapy as a treatment of insomnia to verify its therapeutic effect. Results : 16 studies (19 comparisons) met inclusion and exclusion criteria were used for meta-analysis. The results showed that aromatherapy had a significant effect on improving sleep quality (WMD: -2.52; 95% CI: -3.24 to -1.79). Subgroup analysis showed that different types of patients from different countries can improve their sleep quality through aromatherapy. The inhalation group, rather than the massage group had an obvious therapeutic effect, which may be due to the number of studies using massage included in our analysis is too small. What's more, different intervention duration does not seem to have a significant effect on the efficacy of aromatherapy. Conclusion : Aromatherapy has a significant effect on improving sleep quality. It can be used as one of the non-pharmacological treatments for insomnia, and relevant guide should be formulated to facilitate future clinical applications.

Background Anxiety and depression affects many pregnant women. Massage may be beneficial for supporting mental wellbeing during this time. The aim of this study was to assess the feasibility and acceptability of a partner-delivered relaxation massage program for pregnant women, and its impact on symptoms of antenatal anxiety, stress and depression. Methods A feasibility randomised controlled trial was conducted to compare partner-delivered relaxation massage (intervention) with self-directed stress management (control). Women attended an initial workshop at 28–32 weeks gestation followed by completion of a self-directed massage or stress management program. Qualitative data about the feasibility and acceptability (primary outcomes) were collected via online participant diaries and post-birth interviews. Anxiety, depression and stress symptoms (secondary outcomes) were assessed using the Depression and Anxiety Stress Scale (DASS-21). Birth outcomes were collected at the post- birth interview. Results A total of 14 women/partner dyads in the massage group and 13 women in the self-directed stress management group, attended the initial workshops. When interviewed, participants from both groups reported that the programs were feasible and acceptable. Women’s mean scores on all subscales of the DASS-21significantly decreased over time in both the intervention and the control group. Conclusion Pregnant women found the partner-delivered massage program to be feasible and acceptable. Both programs decreased women’s symptoms of anxiety, depression and stress with no significant differences identified between the two groups. An adequately powered experimental study with a large representative sample is needed to determine whether partner-delivered relaxation massage reduces pregnant women’s symptoms of anxiety, depression and stress.

Objectives To evaluate the Helping Hands Project which offers parents who have experienced a miscarriage, stillbirth or neonatal loss a free massage. Approach Demographic data was collated and analysed for differences between those that booked in for a massage and those that did not. Post treatment feedback from open-ended questions were analysed qualitatively using content analysis. Results Ninety-seven people registered, and 58 people booked in for a massage. Those that did not book in had a significantly higher impact of events score. Four qualitative themes were identified: 1) a sense of relaxation, 2) Being supported and cared for, 3) Taking time out for self, 4) The importance of understanding and kindness. Conclusions Parents felt the program was important in providing a sense of relaxation and taking time out for self. Higher average impact of events scores may be a contributing factor in parents not booking in for a massage.

This article provides an overview of nonpharmacologic options for the treatment of pain in patients with inflammatory arthritis, such as peripheral spondyloarthritis, psoriatic arthritis, ankylosing spondylitis, and rheumatoid arthritis. The experience of pain in chronic disease is a complex process influenced by multiple domains of health. The discussion focuses on the establishment of a framework for pain control that engages with factors that influence the experience of pain and explores the evidence base that supports specific modalities of nonpharmacologic pain control, such as mindfulness, cognitive behavioral therapy, exercise, massage, splinting, and heat therapy. Rheumatoid and spondyloarthritides are considered separately.

Background Most causes of hyperbilirubinemia is babies born premature. Their bilirubin levels should be checked regularly, this causes the baby to feel pain. Newborns may experience a greater sensitivity to pain and are more susceptible to the long-term effects of painful stimulation. Pain management is needed for decreased clinical complications and decreased mortality. Breastfeeding and massage were the options for treating mild pain because they were safe, non-invasive, inexpensive and could be done independently. Objective The aim of this study was to compare the effects of breastfeeding and massage on neonatus pain during intravenous blood sampling procedures. Methods Post test-only non equivalent control group design with non-probability sampling technique. The sample were 40 respondents divided into control and intervention groups. The neonatus was taken intraveinous blood sampling for the first time. The intervention group was given breast feeding and massage. Breast milk was given 2 min before intravenous puncture and massage was carried out on the back to the lower extremities for 2 min. Measurement of pain scores using NIPS. Data analysis used independent t-test. Results The mean of neonatus pain in the intervention group was 1.60 SD 1.562 and control group 5.20, SD 1.361. There was significant difference in mean neonatal pain when intravenous blood sampling procedures in the intervention and control groups with a difference of 3.60. The paired samples test was p = 0,000 ( Conclusions According to the findings of this study, the lowest pain score was in intervention group. Breastfeeding and massage was reduce the scale of pain neonatus during intraveinous blood sampling procedures. Breast feeding and massage are recommended to reduce the pain in neonatus during painful procedures administrated.

Currently, greater background is required about the effectiveness of myofascial release (MFR) on muscle flexibility.Our goal was to determine the immediate effect of a direct MFR technique on hip and cervical flexibility in inactive females with hamstring shortening.The sample group included 68 female university students, randomly divided into a control group (n = 34) and an experimental group (n = 34). A placebo technique was used with the control group, and direct MFR on the posterior thigh region was used with the experimental group.The mixed factorial ANOVA did not show significant intergroup differences (p 0.05). In the experimental group, Bonferroni post hoc test showed significant intragroup differences between pre-test and post-test 1, as well as between pre-test and post-test 2 for the three ischiotibial muscle flexibility tests (p 0.001). Cervical flexion range of motion showed significant differences between pre-test and post-test 1 (p 0.001).We conclude that the protocol based on a single direct MFR intervention was no more effective than the placebo in improving flexibility both locally at the hamstring level and remotely at the level of the cervical extensor muscles. Future research should consider different MFR techniques on the immediate increase in muscle flexibility and the long-term effect of MFR, as well as consider different intervention groups.

Objectives Trigger points are thought to be associated with chronic neck pain and can be treated with massage self-care techniques such as trigger point self-care. We sought to examine the feasibility of a developed group training approach for trigger point self-care to inform future efficacy focused clinical trials for chronic neck pain. Methods Self-identified adults with chronic neck pain were recruited to participate in one of two scheduled group training sessions. Data was collected pre- and post-training with follow-up at 1-, 4-, and 8-weeks. Measures included a trigger point self-care training objectives survey, daily self-report logs, and neck disability and pain via the Neck Disability Index. Training included interactive lecture, demonstration, supervised practice, and assessment for an individualized trigger point self-care plan. Handouts and tools were provided for training and home use. Results Five participants (women = 3; ages 22–58; White = 4) enrolled and completed the study. All participants completed each data collection point, attended a post-intervention focus group or interview, submitted their completed daily self-care log, and reported achieving all intended training objectives. All participants felt the downtown university location was convenient and non-clinical environment simulated a real-world educational/training experience. Two participants reported having some discomfort the day after training, most expected the training would help them, and several expressed excitement about learned content and empowerment to manage their own pain. Neck Disability Index scores at week-1 did not change for 1 participant, worsened for 1 participant, and improved for 3 participants. All participants’ Neck Disability Index scores were better than baseline at week-4 and week-8. Conclusions Our trigger point self-care group training approach was acceptable to study participants and is feasible to implement in future clinical trials. Larger studies including participants with more severe neck pain and disability are needed to test the trigger point self-care approach.

Background Postpartum hemorrhage is the most common midwifery hemorrhage that occurs in 1 %–5 % of childbirths, causing an estimated 140,000 deaths per year. After pain is also one of the common postpartum pains and approximately 70 % of women with vaginal delivery complain of it. Due to the side-effects of chemical medications, researchers have a particular interest in using traditional and complementary therapies. Reflexology is one such method. The present randomized clinical trial will be conducted to assess the effectiveness of reflexology on hemorrhage and after pain following vaginal delivery. Methods The present randomized controlled trial will be conducted on women presenting to the maternity wards of Allameh Bohlool Gonabadi and 17th Shahrivar hospitals in Gonanbd and Mashhad, Iran. After obtaining informed consent from the eligible women, sampling will begin through the convenience method. The subjects will be randomly divided into intervention and control groups by permuted blocks of four. The sample size will be 40 per group. After the removal of the placenta, the intervention group will be given a four-minute general massage on each foot, followed by two minutes of specific reflexology on the uterus, pituitary and solar plexus points by exerting rotational pressure. The control group will also be given a four-minute general massage on each foot, followed by six minutes of rotational pressure on a point on the outer edge of the heel. Ten minutes are required for each foot, and this procedure is to be repeated two hours after childbirth. After pain will be measured using the Visual Analogue Scale (VAS) and bleeding by weighing the pads every one to four hours. Data will be analyzed in SPSS 16. Discussion The results will provide accurate scientific evidence for the use of reflexology to control postpartum hemorrhage and after pain. If the results are favorable, the routine use of this technique will be recommended for women in the fourth stage of labor.

Introduction The routine of work inside the clothing industry has been associated with high levels stress perceived by the worker. The parameters of heart rate variability (HRV) are objective markers of the organic response to stress. Objective This trial evaluates if suboccipital fascial release (SFR) technique was able to influence HRV parameters in workers in the clothing industry. Methods Randomized clinical trial. Forty women who worked in clothing industry were randomized into two groups, untreated group (UG, n = 15) and treated group (TG, n = 25). Heart rate (HR) and HRV parameters were measured using a heart rate monitor. Statistical analysis of data distribution and within group and between groups analysis were performed with α adjusted to 0.05. Results Within group analysis in the TG showed significant changes in the following parameters: sympathovagal balance (low frequency/high frequency - LF/HF) (p ≤ 0.01), mean RR intervals (p ≤ 0.01), mean heart rate (Mean HR) (p ≤ 0.01), minimum heart rate (Min. HR) (p = 0.02) and maximum heart rate (Max. HR) (p ≤ 0.01). Between group analysis, on the other hand, showed significant variations in Very Low Frequency (VLF) (p = 0.04) and Max. HR (p = 0.03) in favor of the TG. No significant changes were observed in the UG during the same period. Conclusion The comparison between groups showed that SFR may influence HRV parameters more than rest in workers in the clothing industry and possibly may contribute to the improvement of the stress experienced by them.

Highlights • Intractable hiccups are associated with significant morbidity and may lead to mortality. • Several medical, pharmacological, surgical and novel treatment options are available. • Vagus nerve stimulator placement is a novel surgical option for the treatment of intractable hiccups. • Vagus nerve stimulator is currently not approved for the indication of intractable hiccups., Introduction Intractable hiccups frequently result from an underlying pathology and can cause considerable illness in the patients. Initial remedies such as drinking cold water, induction of emesis, carotid sinus massage or Valsalva manoeuvre all seem to work by over stimulating the Vagus nerve. Pharmacotherapy with baclofen, gabapentin and other centrally and peripherally acting agents such as chlorpromazine and metoclopramide are reserved as second line treatment. Medical refractory cases even indulge in unconventional therapies such as hypnosis, massages and acupuncture. Surgical intervention, although undertaken very rarely, predominantly revolves around phrenic nerve crushing, blockade or pacing. A novel surgical strategy is emerging in the form of Vagus nerve stimulator (VNS) placement with three cases cited in literature to date with varying degrees of success. Here the authors report a case of VNS placement for intractable hiccups with partial success, in accordance with SCARE-2018 guidelines. Presentation of the case An 85-year-old gentleman with a 9-year history of intractable hiccups secondary to pneumonia came to our hospital. The hiccups were symptomatic causing anorexia, insomnia, irritability, depression, exhaustion, muscle wasting and weight loss. The patient underwent countless medical evaluations. All examinations and investigations yielded normal results. The patient underwent aggressive pharmacotherapy, home remedies and unconventional therapies for intractable hiccups but to no avail. He also underwent left phrenic nerve blocking and resection without therapeutic success. The patient presented to our hospital and decision for VNS insertion was taken for compassionate reasons considering patient morbidity. The patient demonstrated significant improvement in his symptoms following VNS insertion. Discussion A temporary hiccup is an occasional happening experienced by everyone. However, intractable hiccups are associated with significant morbidity and often mortality. Several medical, pharmacological, surgical and novel treatment options are available for intractable hiccups. Conclusion VNS insertion is a novel surgical option for the treatment of intractable hiccups.

The human hair follicle (HF) represents a promising drug delivery target as an anatomical entity by itself, but also as a gateway enabling dermal or systemic bioavailability of active cosmetic and pharmaceutical ingredients. Due to its morphological characteristics, the HF provides a mechanically driven transport process of nanoparticles (NPs) when external forces are applied. This mechanism was presented as the so-called ratchet effect within the framework of an in silico study published recently. To investigate the influence of massage frequency on the penetration depth of NPs, and, by this, to validate the results obtained in silico, we implemented a corresponding application protocol on an ex vivo porcine skin model. In this connection, we compared three different skin massage frequencies (4.2 Hz, 50 Hz, 100 Hz) for the topical application of cyanine 5-labeled silica NPs (Cy5-SNPs). To elucidate the interplay of frequency and particle size, we furthermore applied Cy5-SNPs of three different diameters (300 nm, 676 nm, 1000 nm). Confocal laser scanning microscopy was utilized to investigate the follicular penetration depth of Cy5-SNPs on cryohistological slices. By this, we could demonstrate that the massage frequency and the follicular penetration depth exhibit an inverse relation pattern. Thus, the highest follicular penetration depth was observed within the 4.2 Hz group, while the lowest follicular penetration depth was found within the 100 Hz group for each Cy5-SNP size category. Additionally, we found that 676 nm Cy5-SNPs penetrated significantly deeper into HFs than 300 nm Cy5-SNPs and 1000 nm Cy5-SNPs, respectively. Summarizing, our results show that a low massage frequency including a dominant radial direction component leads to deeper follicular penetration depths of NPs than automated 3D-oscillation massage at 50 Hz or 100 Hz. Thus, our findings are in line with recent in silico results. Regarding translational purposes, our results are of high interest, since a massage executed at 250 BPM (4.2 Hz) is within a realizable range for manual application, e.g. for the implementation into clinical routines or the domestic use of drugs or cosmetics. Furthermore, the application of different massage frequencies offers the opportunity of patho-specific targeting as different anatomical parts of the HF can be reached.

Foot pain, mainly flat foot, has been a major health issue of people all over the globe. It has been attributed to their sedentary lifestyle as compared to the past. Prime reasons for foot pain to occur even among normally arched individual are zero exercise, putting on excessive weight, prolonged sitting and standing etc. People in the age group of 60–65 years face the effect of flat foot. It is observed that even people from the middle age group of 40–60 years are also developing this issue because of their lifestyle. People from the age groups lesser than these are also developing flat foot issues in the recent times. Doctors have suggested treatments like performing physical activities, consuming medicines and using orthotic aids to control the problem. Orthotic aids commonly suggested are insoles, cushions, massage pads, medical shoes etc. Utilization of orthotic aids provides relaxation to the foot. Silicon material is typically used for making orthotic aids through injection molding process. However, it is also reported that there is lack of comfort while using these devices. To resolve this issue, an attempt is made to provide an alternative to the traditionally manufactured orthotic aids. Prime focus has been on designing and developing a 3D printed orthotic aid that improves lower limb alignment of foot and also promotes relief to the various foot pain issues. This comprises achieving an optimized design through analysis and manufacturing using 3D printing.

The purpose of the experiment was to study the effect of pulsed ultrasound (PUS) on post-thoracotomy pain and local tissue temperature and to correlate the findings with the alteration in spinal anti-inflammatory and pro-inflammatory cytokines. Mechanical sensitivity, subcutaneous temperature and spinal interleukin-10 (IL-10), IL-6 or tumor necrosis factor-alpha (TNF-α) expression were examined in a rat model of experimental post-thoracotomy pain. Group 1 received a sham surgery where thoracotomy was performed except for rib retraction. Group 2 underwent thoracotomy with rib retraction (TRR). Group 3 received the TRR procedure followed by PUS. Group 4 underwent the TRR procedure followed by only the massage with the ultrasound turned off. Compared with group 1 (sham), groups 2-4 showed a decrease in mechanical withdrawal thresholds on postoperative days (PODs) 10 and 11. On PODs 16, 23 and 30, group 3 (TRR+PUS-1) displayed an increase in mechanical withdrawal thresholds compared with groups 2 and 4. Subcutaneous and body temperatures in group 3 were not prominently different from group 1, group 2 (TRR only) or group 4 (TRR+PUS-0). Compared with group 2, group 3 had an increase in spinal IL-10 level on POD 30 and a decrease in spinal IL-6 or TNF-α expression on PODs 16 and 30. We concluded that mechanical hypersensitivity after TRR is postponed by PUS, and its effect continues for 3 wk. A PUS dose not increase local tissue temperature. The beneficial effect of PUS appears related to upregulation of spinal anti-inflammatory cytokine and downregulation of spinal pro-inflammatory cytokines.

Objectives This study aimed to establish and compare current physiotherapy management of GTPS in Australia, New Zealand (NZ) and Ireland. Design Cross-sectional observational survey of physiotherapists. Methods An online survey was distributed to registered musculoskeletal physiotherapists in Australia, NZ and Ireland. Ordinal and nominal data were analysed using frequency counts or mean ranks; median and interquartile ranges were calculated for numerical data. Inter-country comparisons were made using Chi-squared analyses for nominal/ordinal data and Kruskal–Wallis tests for numerical data. Statistical significance was set at P Results/findings Valid responses were received from 361 physiotherapists, 61% were female and 80% worked in private practice. Overall, consistency in treatment of GTPS was observed across the three countries. All physiotherapists used education and exercise (most commonly strengthening and neuromuscular control) primarily targeting the gluteal muscles. Other interventions included massage (90%), stretching (53%), range of motion (40%), thermal modalities (50%), taping (38%) and electrotherapy (25%), whilst 40% commonly recommended up to 2 to 3 corticosteroid injections per patient/per annum. Physiotherapists used pain severity scales as their primary outcome measure (79%). Single leg stance was the most common physical measure used (68%), and global rating scores or standardised physical measures were less commonly used. Conclusion This international survey established the physiotherapy management of GTPS. Education used in conjunction with exercise is in line with current evidence, but a proportion of clinicians use adjunct treatments without clear rationale or supporting evidence. Results indicate the need to further define optimal management of GTPS using robust methodologies such as randomised controlled trials.

Objective To determine the effect of foot massage on reducing blood pressure in patients with intradialytic hypertension. Method This study is a randomized controlled trial (RCT). Subjects were 32 hemodialyses (HD) patients randomly allocated into two groups: the control group and the intervention group. Foot massage was performed three times in intradialytic phase for 5–10 min in the first, second, and third HD hours. Measurement of blood pressure (BP) used portable sphygmomanometer. The measurement was conducted every hour. Results There is a different effect of foot massage on systolic and diastole blood pressure between the control group and intervention group with p Conclusion The foot massage is beneficial in controlling intradialytic hypertension and can be applied in the management of hemodialysis patients by nurses.

Burn-specific pain anxiety and sleep disorders are common factors in burned patients that affect wound healing process, as well as the severity of burn pain. This study aimed to investigate the effect of foot reflexology massage on burn-specific pain anxiety and sleep condition of patients hospitalized in the burn ICU.In this randomized controlled clinical trial, 52 patients were assigned by permuted block randomization 1:1 to the intervention (n=26) and control (n=26) groups. The intervention group received 20min of foot reflexology massage during 3 days on their third, fourth and fifth days of hospitalization and 15min before changing wound dressings. Patients in the control group merely received routine care. The Burn-Specific Pain Anxiety Scale (BSPAS) was completed for three consecutive days before and after changing wound dressings, and St. Mary's Hospital Sleep Questionnaire (SMHSQ) was filled out for four consecutive days before changing wound dressings for patients in both groups. The data were analyzed by IBM SPSS 16 software, Chicago, independent t, Chi-square, Friedman, Mann-Whitney and Wilcoxon tests.We found no significant difference between pain-anxiety in the two groups before the intervention. The trend of different days in each groups were compared with Friedman test and showed that pain anxiety (p0.001), sleep latency (p0.001), duration of the last day's sleep (p0.001) and satisfaction of the last night sleep (p0.001) had a significant difference. In addition, Mann-Whitney test results showed that there were significant differences between the two groups at different times in terms of the above variables (p0.05). The effect size was=0.82 for pain anxiety between group after the intervention.Based on the results, foot reflexology massage can effectively reduce pain anxiety levels and improve sleep quality and quantity of patients with burn injuries; therefore, this non- pharmacological therapeutic method is recommended to be used in the burn ICUs. (Clinical trial's registration code: IRCT20110906007494N27).

Touch is fundamental to the doctor-patient relationship. Touch can produce neuromodulatory effects that mitigate pain and put patients at ease. Touch begins with a confident handshake and continues throughout the physical examination. Touching patients where they hurt is a clear indication that a provider understands their complaint. Touch often continues as a function of treatment. This article updates evidence surrounding human touch and addresses mechanisms of action for manual therapy, the impact of manual therapy on pain management, health care conditions for which manual therapy may be beneficial, treatment plans with dose-response evidence, and the impact of manual therapy on the health care system.

Objective This case report illustrates an unusual cause of hip adductor muscle injury due to overenthusiastic self-treatment of the previously overloaded adductor muscles. Also, post-injury therapeutic objectives and intervention to facilitate rapid participation in sports after the described process are provided. Case description A 27-year old male, professional soccer player presented with hip adductors pain and impairment due to electromechanical self-treatment of the affected area. He was evaluated using hip-strength assessments, self-report, ultrasonography (US), and magnetic resonance imaging (MRI) until complete functional recovery had occurred. Along with clinical presentation, diagnostic imaging showed evidence of an isolated injury to the adductor longus muscle. A well-structured rehabilitation and readaptation program was followed in order to ensure early recovery and optimal functional outcome. Outcomes The athlete was able to participate in a full soccer training session without any limitation 18 days after his self-treatment session. The patient returned to his previous level of performance by 3rd week post-injury. Conclusion To the authors’ knowledge, this is the first report of muscle strain due to overenthusiasthic therapy. Although this is a rare complication of self-treatment procedures, patients and therapists should be aware of this risk in order to prevent and rapidly identify the lesion.

Massage therapy's ability to mitigate breast imaging associated anxiety has not been previously studied. Anxiety is, however, often cited as a harm of screening mammography with few options offered to diminish anxiety other than not screening. Reducing anxiety may improve compliance, and reduce breast cancer mortality and morbidity. A complimentary massage therapy program evaluated patient acceptance, anxiety perception and perceived value of massage.Over 10 weeks, verbal agreement was obtained from 113 breast imaging patients who desired a hand or shoulder/neck massage. Licensed massage therapists performed massages before, and/or during, or after, or in between imaging tests. After the massage, questionnaires assessed patients' self-rated perceptions of anxiety before and after massage on a scale from 0 to 10. Participants' age-group, reason for appointment, self-rated value of massage service, and willingness to return to and willingness to refer to the facility were reported. Changes in perceived average anxiety were estimated using a linear mixed effects model. Fisher's exact test was used to evaluate associations among categorical variables.A significant decrease in perceived anxiety was observed following massage (d = -3.2, p 0.001). 107/108 (99%) of respondents reported an improved patient experience with massage. 84/106 (79%) reported willingness to pay at least $5 for massage service.Massage therapy improves the patient experience and decreases perceptions of anxiety. It may be associated with improved breast imaging compliance. Patients' willingness to pay for the service may defray some cost of a massage program.

This case study measured the effects of manual laryngeal therapy on the fundamental frequency (f(o)), formant frequencies, estimated vocal tract length, and listener perception of masculinity of a 32- year-old transmasculine individual. The participant began testosterone therapy 1.5 years prior to the study. Two therapy approaches were administered sequentially in a single session: (1) passive circumlaryngeal massage and manual laryngeal reposturing, and (2) active laryngeal reposturing with voicing. Acoustic recordings were collected before and after each treatment and three days after the session. Speaking f(o) decreased from 124 Hz to 120 Hz after passive training, and to 108 Hz after active training. Estimated vocal tract length increased from 17.0 cm to 17.3 cm after passive training, and to 19.4 cm after active training. Eight listeners evaluated the masculinity of the participant’s speech; his voice was rated as most masculine at the end of the training session. All measures returned to baseline at follow-up. Overall, both acoustic and perceptual changes were observed in one transmasculine individual who participated in manual laryngeal therapy, even after significant testosterone-induced voice changes had already occurred; however, changes were not maintained in the follow-up. This study adds to scant literature on effective approaches to and proposed outcome measures for voice masculinization in transmasculine individuals.

Objectives This study aimeded to examine acute and late effects of five consecutive sessions of Swedish massage on hamstring flexibility and agility of players.Methods: Arandom sample of 34 female players having bilateral tight hamstrings [passive straight leg raise ≤70° and active knee extension test ≥ 30°] was randomly allocated to two equal groups. Study design involved 7 minute massage given on each posterior thigh for 5 continuous days; followed by 5 days of no massage. Experimental group received classical Swedish massage whereas control group received only superficial stroking. Outcome measures were Passive straight leg raise [PSLR], Active knee extension test [AKET], Passive knee extension test [PKET], Back saver sit and reach test [BSSR] for flexibility and 5-0-5 change of direction test for agility measured pre and post intervention on each days of massage and also on 10th day. Two way ANOVA with post hoc t-test was the tool of statistical analysis with significance level 0.05.Results: Significant [p ≤ 0.05] post intervention increase in all parameters of flexibility was observed each day in experimental group within PSLR (8%–12% ↑), AKET (10%24% ↓) and PKET (12%–30% ↓) and highly significant (p ≤ 0.001) increase on 5th and 10th day in BSSR (4%–21% ↑) for both legs. Pre and post intervention values for control group were not significantly different. No significant changes were observed in agility performance of both groups.Conclusion: Swedish massage of posterior thigh appears to acutely increase flexibility of hamstrings in female athletes, which persisted for 5 days even after cessation of massage.

Objective The purpose of this study was to assess the effects of 4-week protocol of diacutaneous fibrolysis (DF) compared with simulated DF (sham-DF) on myalgia and mouth opening. Methods In a sham randomized controlled trial, 34 women with temporomandibular disorders and myofascial pain were randomly divided as intervention group (IG) and sham-DF group (SG). The IG received 4 weeks of real DF, and the SG received sham. Pain was assessed through the visual analog scale and pressure pain thresholds (PPTs) on the temporomandibular joint (TMJ), and over the temporal and masseter muscles. The Mandibular Function Impairment Questionnaire was used to classify the participants regarding to the severity of the functional limitation related to TMD. Results Pain scores decreased for both groups, but the IG showed lower values at week 4, with between-group differences. Bilateral temporal PPT showed higher values at week 4, with between-group differences. The SG had lower PPTs but the IG had higher PPTs, both compared to baseline results. The time-by-group interaction and the frequency of participants above 40 mm of mouth opening showed a significant difference for the IG over time with higher results at the 4-week assessment compared to its own baseline. Both groups showed lower MFIQ scores from baseline to 4-week assessment. There was a lower frequency of a moderate level of severity for the IG. No differences were observed for TMJ or for the masseter muscles PPT. Conclusion Improvements were observed for visual analog scale scores and PPTs on temporal muscles. There was a group-by-time interaction in the IG, suggesting a possible potential use of DF for mouth opening.

The aim of the present study was to determine and compare the effects of connective tissue manipulation (CTM) and abdominal massage when combined with usual care on the symptoms of constipation and quality of life (QoL) immediately following a 4-week treatment in patients suffering from chronic constipation.A total of 60 patients with chronic constipation were randomly assigned to CTM, abdominal massage, or control groups. Connective tissue manipulation and abdominal massage were conducted at 5 sessions a week for 4 weeks. Each session was approximately 15 to 20 minutes. The severity of constipation by the Constipation Severity Instrument, symptoms of constipation by a bowel diary and Bristol Stool Scale, and QoL by patient assessment of QoL questionnaire were evaluated at baseline and at the end of 4 weeks.There were significant differences in the changes in constipation severity (P.001), symptoms of constipation (P ≤ .001), and QoL (P.001) among the 3 groups. However, based on pair-wise analysis, there were no significant differences in the changes of the severity and symptoms of constipation and QoL between the CTM and abdominal massage groups (P.05).The findings of the present study revealed that compared to usual care alone, the combination of usual care and CTM or abdominal massage may be more beneficial for chronic constipation. However, the superiority of CTM or abdominal massage was not observed. Further high-quality studies with long-term follow-up are needed to investigate the optimal massage therapy program in patients with chronic constipation.

The effects of aromatherapy on relieving anxiety were controversial. The purpose of this meta-analysis was to evaluate the effects of aromatherapy on anxiety in patients.We searched randomized controlled trials (RCTs) about aromatherapy on decreasing anxiety on PUBMED, WEB OF SCIENCE (January 1990 to October 2019), COCHRANE LIBRARY, EMBASE (updated to October 2019), and the Chinese databases CNKI, WanFang and CBMD. Twenty-five articles (Thirty-two trials) were included in this meta-analysis. The data of scale scores of Spielberger State-Trait Anxiety Inventory (STAI) were extracted. The pooled results demonstrated that inhalation and massage aromatherapy significantly decreased anxiety levels in different conditions. The weighted mean difference was -5.16 for State Anxiety Inventory (SAI) (95%CI: -5.78, -4.55, p0.001) and -2.85 for Trait Anxiety Inventory (TAI) (95%CI: -3.95, -1.75, p0.001). No side effects were mentioned in all of studies.The meta-analysis suggested that aromatherapy with different essential oils could alleviate anxiety significantly no matter the reason of anxiety. However, the proper dosage of essential oils needs further research.

Background Gait impairments following anterior cruciate ligament reconstruction (ACLR) may contribute to reinjury or future osteoarthritis development. Recently, plantar cutaneous sensation deficits have been reported post-ACLR. These sensory deficits may influence gait and represent a mechanism through which to improve gait. Research question Can established sensory interventions change sensation and gait in patients after ACLR and compared to healthy adults? Methods Twenty-two adults (n = 11 post-ACLR, age:20.5 ± 1.9years, body mass index[BMI]:24.5 ± 3.6 kg/m2; n = 11 healthy, age:20.7 ± 1.4years, BMI:23.3 ± 2.7 kg/m2) completed two sessions separated by 48 h. Gait and plantar cutaneous sensation were assessed pre- and post-intervention (massage or textured insoles). Gait analysis was completed using 3D motion capture at 1.4 m/s ± 5% and standard inverse dynamics analysis. Plantar cutaneous sensation was assessed using Semmes Weinstein Monofilaments with a 4−2-1 stepping algorithm at the plantar aspect of the first metatarsal head, base of the fifth metatarsal, and lateral and medial malleoli. Plantar massage was a 5-minute massage to both feet. Textured insoles (coarse grit sandpaper) were worn while walking. Biomechanical data were assessed via mixed-models, repeated measures ANOVAs and 90 % confidence intervals. Wilcoxon Signed Rank tests and Mann-Whitney U tests evaluated plantar cutaneous sensation within and between groups, respectively. Results Knee adduction moment was lower in the ACLR versus the contralateral limb pre-massage. The vGRF was lower during the first half of stance but greater during the second half of stance in the ACLR versus the control group post-massage. Massage improved ACLR limb sensation over the first metatarsal head (P = 0.042) and medial malleolus (P = 0.027). Textured insole application improved ACLR limb sensation over the first (P = 0.043) and fifth (P = 0.027) metatarsals and medial malleolus (P = 0.028). Significance Plantar massage and textured insoles improved plantar cutaneous sensation in the ACLR limb. Neither intervention influenced gait. Improving plantar sensation may be beneficial for patients after ACLR; however, sensory interventions to improve gait are necessary.

Objectives This study aimed to quantify massage service provision by Australian cancer services and explore providers’ and survivors’ views about massage services. Design A mixed-method study design combined data from a national cross-sectional survey of cancer services, an on-line survey of cancer survivors, and focus group or individual interviews with cancer survivors. Methods Quantitative and qualitative analyses of the data were merged using the principles of triangulation analysis for a thematic analysis. Results Three meta-themes were identified: 1) an under provision of high-quality massage services; 2) the perceived benefits of massage extend beyond symptomatic relief; and 3) the interrelated barriers to massage service provision and access reflect different values. Response rate for the national cancer services survey was 93.2% (n = 275/295), of which 18.1% (n = 50/275) provided massage. Service provision was not evenly distributed across the country with gaps in many regions. The 121 survivors who answered the online survey and 31 survivors who participated in the interviews affirmed this finding. Quality control was an important reason why survivors wanted cancer services to offer massage. Survivors reported numerous benefits from massage and valued the ‘human touch’. Overwhelmingly, finance was the greatest barrier that was interrelated with other barriers such as finding suitably qualified massage therapists and various information, evidence and logistical constraints. Conflicting findings included survivors stating the unavailability of massage services was an important barrier, whereas services reported low patient demand as a reason for not providing massage. An explanation given for not funding or using massage was the tendency to downplay the value of massage as a non-essential service; an attitude that was strongly refuted by some. Conclusions Massage is yet to be firmly established in cancer care across Australia. Balancing different views about the value of massage in supportive cancer care will be key to informing appropriate funding and service delivery.