Authors: Jennifer Hattan BSc RN RM, Independent Midwife, The Birth Centre, London; Lindy King PhD BN RN, Senior Lecturer School of Nursing and Midwifery, Flinders University, Adelaide, Australia; Peter Griffiths BA PhD RGN, Senior Lecturer Primary and Intermediate Care, Head of Graduate Studies (taught programmes), School of Nursing and Midwifery, King’s College London

Abstract

Background: Due to the widely presumed association between heart disease and psychological wellbeing, the use of so-called ‘complementary’ therapies as adjuncts to conventional treatment modalities have been the subject of considerable debate. The present study arose from an attempt to identify a safe and effective therapeutic intervention to promote wellbeing, which could be practicably delivered by nurses to patients in the post-operative recovery period following coronary artery bypass graft (CABG) surgery.

Aim: To investigate the impact of foot massage and guided relaxation on the wellbeing of patients who had undergone CABG surgery.

Method: Twenty-five subjects were randomly assigned to either a control or one of two intervention groups. Psychological and physical variables were measured immediately before and after the intervention. A discharge questionnaire was also administered.

Results: No significant differences between physiological parameters were found. There was a significant effect of the intervention on the calm scores (ANOVA p=0.014). Dunnett’s multiple comparison showed that this was attributable to increased calm among the massage group. Although not significant the guided relaxation group also reported substantially higher levels of calm than control. There was a clear (non-significant) trend across all psychological variables for both foot massage and, to a lesser extent, guided relaxation to improve psychological wellbeing. Both interventions were well received by the subjects.

Conclusions: These interventions appear to be effective, non-invasive techniques for promoting psychological wellbeing in this patient group. Further investigation is indicated.

Preschoolers showed enhanced cognitive performance after receiving massage therapy, as evidenced by greater accuracy on skills tests than those in a control group.

The research study “Preschooler’s Cognitive Performance Improves Following Massage,” was conducted by researchers at the Touch Research Institute in conjunction with Texas Tech University, Nova Southeastern University and the University of Miami School of Medicine. It was originally published in the journal Early Child Development and Care.

Twenty preschoolers ages 3 to 5 were randomly assigned to either a massage therapy group or a story-reading group. The children were given a temperament rating based on how their behavior was seen by their teachers, along a scale that ranged from calm and easygoing to anxious and high-strung.

Those in the massage group were given one 15-minute massage. Beginning in the supine position, the children were massaged along their faces, including circular strokes on the nose, cheeks, jaw and chin; their stomachs, including paddlewheel-fashion hand strokes; their legs, including massage of the feet and toes and stroking the legs up toward the heart; and their arms, including strokes from shoulders to hands. Finishing in the prone position, each child was massaged along the back, hands, sides, shoulders and neck, ending with strokes from the head to the feet.
Children in the control group were read a Dr. Seuss story for 15 minutes, while sitting close together in a carpeted area.

The skills pre-test was given to both groups prior to the reading or massage. Following the reading or massage, a skills post-test was given. Assessment included the Wechsler Preschool and Primary Scale of Intelligence-Revised, which measured the children’s performance on three timed skill and abstract reasoning tests: block design, animal pegs and mazes.

Results showed that children who received massage were more accurate on the tests, in contrast to those in the control group, whose scores either stayed the same or decreased in each post-test. Researchers reasoned that the children were more alert following massage, and thus showed improved performance on the tests. The children who had been rated by teachers as anxious and high-strung showed the greatest improvement in scores following the massage. Massage possibly alleviated stress among these children, the study authors concluded.

Researchers noted that little touch takes place in preschools. “Whether touch deprivation is a source of stress among preschoolers is an important question for future research,” the study authors wrote. “Since the long-term effects of massage therapy have not yet been established, further studies are needed to determine the extent to which touch therapy needs to be incorporated in the preschool curriculum.”

- Source: The Touch Research Institute. Originally published in Early Child Development, 1998, Vol. 143, pp. 59-64.

After six weeks of reflexology sessions, children with chronic constipation and encopresis, or fecal incontinence, experienced a significant decrease in soiling and a significant increase in bowel movements, according to a recent study.

“Reflexology in the management of encopresis and chronic constipation” was conducted by Eileen Bishop, Evelyn McKinnon, Evelyn Weir and Denise Brown of Ayrshire and Arran Acute Hospitals Trust in the United Kingdom.

Fifty children between the ages of 3 and 14 with a diagnosis of encopresis/chronic constipation participated in the study. They were given 30 minutes of reflexology to their feet once a week for six weeks.

With the help of their parents, the children completed questionnaires on bowel movements and soiling patterns before, during and after the six sessions of reflexology. The questionnaires were designed to record the number of bowel movements and the incidents of soiling in each seven-day period before, during and after the reflexology treatment.

Before the start of reflexology, 78 percent of the participants reported soiling at least daily. Sixteen percent reported soiling one-to-three times a week, and six percent reported no soiling in seven days.

After the reflexology sessions, 20 percent of the group reported soiling at least once a day, 30 percent reported soiling one-to-three times a week, and 48 percent reported no soiling in seven days.
“The results show that soiling episodes reduced significantly,” state the study’s authors. “This may result in more socially acceptable behavior.”

As for bowel movements, the group, before starting reflexology, reported 36 percent with no bowel movement in a period of seven days, 46 percent with one-to-four bowel movements per week, and 18 percent having daily bowel movements.

After the reflexology sessions, two percent had no bowel movement in one week, 72 percent had one-to-four bowel movements per week, and 24 percent reported daily bowel movements.

“The frequency of bowel motions has also significantly increased, with 72 percent now passing motions regularly,” state the study’s authors.

It was noted that none of the children required an enema during the study, and many parents said their child’s appetite increased and sleep pattern improved.

“Administering reflexology to the children has been achieved with ease and there have been no adverse reactions observed or reported,” state the study’s authors. “Reflexology for childhood encopresis and chronic constipation is now an established service with five pediatricians and two staff grade doctors referring children of all ages for treatment.”

- Source: Ayrshire and Arran Acute Hospitals Trust, United Kingdom. Authors: Eileen Bishop, Evelyn McKinnon, Evelyn Weir and Denise Brown. Originally published in Paediatric Nursing, April 2003, Vol. 15, pp. 20-21.

Reflexology significantly improved paresthesia, urinary symptoms and spasticity in people with multiple sclerosis, according to recent research.

“Reflexology treatment relieves symptoms of multiple sclerosis: a randomized controlled study” was conducted by staff at the Department of Orthopedic Rehabilitation, Complementary Medicine Clinic and the Multiple Sclerosis Center at Sheba Medical Center in Tel-Hashomer, Israel; and the Gertner Institute for Epidemiology and Health Policy Research.

Seventy-one people with multiple sclerosis were randomly assigned to receive either reflexology or control treatment for 45 minutes once a week, for 11 weeks. Fifty-three of the subjects completed the study. Thirty-six reflexologists participated in the study, each treating one reflexology and one control subject.

The reflexology sessions consisted of manual pressure on specific points of the feet and massage of the calf area. The control sessions consisted of nonspecific massage of the calf area, a sham treatment to control for the effects of touch and relaxation.

Outcome measures were the mean intensity of paresthesias (sensory deficits), evaluated by the Visual Analogue Scale; urinary symptoms, evaluated by the American Urological Association symptom score; sum muscle strength of the iliopsoas, quadriceps, hamstrings and adductor muscles, each evaluated by the British Medical Research Council scale; and spasticity, evaluated by the Ashworth scale.
A masked assessment was performed before the study period; at the start of the study period; six weeks into the study; at the end of 11 weeks; and three months after the study period ended.

The reflexology group showed significant improvements at the end of the study period for scores of paresthesias, urinary symptoms and spasticity. Muscle strength scores for the reflexology group showed borderline improvement. The improvement in the intensity of paresthesia remained significant at the three-month follow-up.

Subjects in the control group showed no significant improvements on any of the outcome measures.

“It is of interest to note such positive effects of single intervention on a broad range of symptoms,” state the study’s authors. “Further clinical and laboratory studies are needed to validate these results and to understand the mechanisms by which reflexology improves symptoms secondary to [multiple sclerosis].”

- Source: Department of Orthopedic Rehabilitation, Complementary Medicine Clinic, Multiple Sclerosis Center at Sheba Medical Center in Tel-Hashomer, Israel; and Gertner Institute for Epidemiology and Health Policy Research. Authors: I. Siev-Ner; D. Gamus; L. Lerner-Geva; and A. Achiron. Originally published in Multiple Sclerosis, 2003, Vol. 9, pp. 356-361.