This reference file was created as part of the Massage Medical Applications Project (MMAP). Not all references may be pertinent to the professional provision of massage. Some references are included to facilitate sociological research. In general, only references with abstracts have been included. Links to the journal title will do a Google search on the title. Most doi, uri, and url links will successfully link to the article online. This file contains references for 2001-2002, last modified 21 January 2006. Richard Elliott author 2002-Mar text continuing periodical academic journal 1496-399X 2002-Mar 6 3 60 61 In August 2001, the Tax Court of Canada issued its most recent judgment on the tax deductability of expenses for complementary/alternative therapies. The decision in Pagnotta v Canada is significant for people with HIV/AIDS who use such therapies. It also illustrates how provincial and federal laws regulating health-care practitioners and natural health products have a financial impact on the cost of accessing treatment. Elliott2002 V Shenoy author D Ravichandran author D N L Ralphs author 2002-Jun text continuing periodical academic journal 0960-9776 2002-Jun 11 3 273 274 In sentinel node biopsy of breast cancer, massaging of the dye injection site following subdermal injection of blue dye does not improve sentinel node detection rate or the time needed for sentinel node biopsy. It may reduce the number of false negative sentinel nodes. Shenoy2002 10.1054/brst.2002.0415 Vivette Glover author Katsuno Onozawa author Alison Hodgkinson author 2002-Dec text continuing periodical academic journal 1084-2756 2002-Dec 7 6 495 495 Infant massage by the mother has been popular in many cultures, especially India, and is growing in popularity in the West. Mothers with postnatal depression often have problems interacting with their infants. A small controlled study has shown that attending a massage class can help such mothers relate better to their babies. The mechanisms by which this is achieved are not clear but may include learning to understand their babies' cues and the release of oxytocin. Glover2002 Tiffany Field author 2002-Dec text continuing periodical academic journal 1084-2756 2002-Dec 7 6 487 494 Preterm infants have been noted to benefit from massage therapy. Following massage therapy protocols using moderate pressure preterm infants have gained 31-49% more weight on average. Some studies have also shown length and head circumference growth and bone mineral density increases associated with massage therapy. These studies are reviewed in this paper along with discussion of potential underlying mechanisms. Field2002c Cherry Bond author 2002-Dec text continuing periodical academic journal 1084-2756 2002-Dec 7 6 477 486 There is now a general trend towards a more baby friendly, family centred approach in the Neonatal Unit. Aspects of that approach-including positive touch and massage- are gaining in popularity. This has caused much debate due to the ambiguity surrounding the implementation and validity of the interventions. Here the impact of these complementary practices (not to be confused with complementary therapies) is discussed. A review of the author's approach and potential guidelines for implementation is provided. Bond2002 T Farr author C Nottle author K Nosaka author P Sacco author 2002-Dec text continuing periodical academic journal 1440-2440 2002-Dec 5 4 297 306 This study Investigated the effects of a therapeutic massage on delayed onset muscle soreness and muscle function following downhill walking. Eight male subjects performed a 40-min downhill treadmill walk loaded with 10% of their body mass. A qualified masseur performed a 30-min therapeutic massage to one limb 2 hours post-walk. Muscle soreness, tenderness, isometric strength, isokinetic strength, and single leg vertical jump height were measured on two occasions before, and 1, 24, 72 and 120 hours post-walk for both limbs. Subjects showed significant (p < 0.004) increases in soreness and tenderness for the non-massaged limb 24 hours post-walk with a significant (p < 0.001) difference between the two limbs. A significant reduction In isometric strength was recorded for both limbs compared to baseline 1 hour post-walk. Isokinetic strength at 60 degrees/sec and vertical jump height were significantly lower for the massaged limb at 1 and 24 hours post-walk. No significant differences were evident in the remaining testing variables. These results suggest that therapeutic massage may attenuate soreness and tenderness associated with delayed onset muscle soreness. However it may not be beneficial in the treatment of strength and functional declines. Farr2002 L Brosseau author L Casimiro author S Milne author V Robinson author B Shea author P Tugwell author G Wells author 2002 text continuing periodical academic journal 1469-493X 2002 4 CD003528 BACKGROUND: Deep transverse friction massage (DTFM) is one of several physiotherapy interventions suggested for the management of tendinitis pain. OBJECTIVES: To assess the efficacy of DTFM for treating tendinitis. SEARCH STRATEGY: We searched the MEDLINE, EMBASE, HealthSTAR, Sports Discus, CINAHL, the Cochrane Controlled Trials Register, PEDro, the specialized registry of the Cochrane musculoskeletal group and the Cochrane field of Physical and Related Therapies up to the end of June 2002. The reference list of the trials and key experts in the area were also consulted for additional studies. SELECTION CRITERIA: All randomized controlled trials (RCTs) and controlled clinical trials (CCTs) comparing therapeutic ultrasound with control or another active intervention in patients with all types of tendinitis, such as iliotibial band friction syndrome and extensor carpi radialis tendinitis (i.e. tennis elbow or lateral epicondylitis or lateralis epicondylitis humeri), were selected. DATA COLLECTION AND ANALYSIS: Two reviewers determined the studies to be included based upon the inclusion and exclusion criteria (LB, VR). Data were independently abstracted by two reviewers (VR, LB), and checked by a third reviewer (BS) using a pre-developed form of the Cochrane Musculoskeletal Group. The two reviewers, using a validated checklist, assessed the methodological quality of the RCTs and CCTs independently. The pooled analysis was performed using weighted mean differences (WMDs) for continuous outcomes. MAIN RESULTS: One RCT included patients with ITBFS. DTFM combined with rest, stretching exercises, cryotherapy and therapeutic ultrasound was compared to the control group (rest, stretching exercises, cryotherapy and therapeutic ultrasound only). This trial showed no statistical difference in the three types of pain relief measured after four consecutive sessions of DTFM combined with other physiotherapy modalities for runners. There was a clinically important relative percentage difference in pain while running of 22%. A RCT on ECRT showed no statistical difference in pain relief, grip strength and the three types of functional status measured after 9 consecutive sessions within 5 weeks of DTFM compared with other physiotherapy modalities. REVIEWER'S CONCLUSIONS: DTFM combined with other physiotherapy modalities did not show consistent benefit over the control of pain, or improvement of grip strength and functional status for patients with ITBFS or for patients with ECRT. These conclusions are limited by the small sample size of the included RCTs. No conclusions can be drawn concerning the use or non use of DTFM for the treatment of ITBFS. Future trials, utilizing specific ITBFS methods and adequate sample sizes are needed, before conclusions can be drawn regarding the specific effect of DTFM on tendinitis. Brosseau2002 Sari Goldstein Ferber author Moshe Laudon author Jacob Kuint author Aron Weller author Nava Zisapel author 2002-Dec text continuing periodical academic journal 0196-206X 2002-Dec 23 6 410 415 The objective of this study was to investigate the effect of massage therapy on phase adjustment of rest-activity and melatonin secretion rhythms to the nocturnal period in full-term infants. Rest-activity cycles of infants (measurement 1, n = 16) were measured by actigraphy before and after 14 days of massage therapy (starting at age 10 [+/-4] d) and subsequently at 6 and 8 weeks of age. 6-Sulphatoxymelatonin excretion was assessed in urine samples at 6, 8, and 12 weeks of age (measurement 2, n = 21). At 8 weeks the controls revealed one peak of activity at approximately 12 midnight (11 p.m.-3 a.m.) and another one at approximately 12 noon (11 a.m.-3 p.m.), whereas in the treated group, a major peak was early in the morning (3 a.m.-7 a.m.) and a secondary peak in the late afternoon (3 p.m.-7 p.m.). At 12 weeks, nocturnal 6-sulphatoxymelatonin excretions were significantly higher in the treated infants (1346.38 +/- 209.40 microg/night vs 823.25 +/- 121.25 microg/night, respectively; <.05). It is concluded that massage therapy by mothers in the perinatal period serves as a strong time cue, enhancing coordination of the developing circadian system with environmental cues. Ferber2002b Rosalie O Mainous author 2002-Oct text continuing periodical academic journal 0887-9311 2002-Oct 16 5 1 1 Infant massage has been practiced for centuries by segments on the continents of Africa and South America and in the Far East. Infant massage is a relatively new modality in North America. Numerous studies support its use in preterm infants, who have exhibited decreased stress levels, increased weight gain, and improved motor function when compared with non-massaged controls. Research has recently turned to the benefits of massage in the cocaine-exposed population and in those with human immunodeficiency virus. Massage in ill preterms has been targeted for clinical testing. Mainous2002 Pauline Stuttard author 2002-Nov text continuing periodical academic journal 1353-6117 2002-Nov 8 4 185 190 In view of changing policy and recommendation for complementary medicine, the moves towards regulatory mechanisms and an evidence base for practice, there is a need to establish the extent to which this is happening within professions and identify away forward that will benefit the individuals and organisations involved. This paper outlines the views and opinions of professional masseurs at the Northern Institute of Massage in the North of England and discusses how such a professional organisation for massage can work in partnership with Higher Education to develop a stronger evidence base for practice. The study concludes that a significant number of practitioners of the Northern Institute are aware of the need for an evidence base for practice but need to be supported in finding, reading and applying research findings to their practice. A partnership between professional organisations for massage and higher education can benefit both parties and help to facilitate change for the future. Stuttard2002 Daniel C Cherkin author Richard A Deyo author Karen J Sherman author L Gary Hart author Janet H Street author Andrea Hrbek author Roger B Davis author Elaine Cramer author Bruce Milliman author Jennifer Booker author Robert Mootz author James Barassi author Janet R Kahn author Ted J Kaptchuk author David M Eisenberg author text continuing periodical academic journal 0893-8652 2002 15 6 463 472 BACKGROUND: Despite growing popularity of complementary and alternative medical (CAM) therapies, little is known about the patients seen by CAM practitioners. Our objective was to describe the patients and problems seen by CAM practitioners. METHODS: We collected data on 20 consecutive visits to randomly sampled licensed acupuncturists, chiropractors, massage therapists, and naturopathic physicians practicing in Arizona, Connecticut, Massachusetts, and Washington. Data were collected on patient demographics, smoking status, referral source, reasons for visit, concurrent medical care, payment source, and visit duration. Comparative data for conventional physicians were drawn from the National Ambulatory Medical Care Survey. RESULTS: In each profession, at least 99 practitioners collected data on more than 1,800 visits. More than 80% of visits to CAM providers were by young and middle-aged adults, and roughly two thirds were by women. Children comprised 10% of visits to naturopathic physicians but only 1% to 4% of all visits to other CAM providers. At least two thirds of visits resulted from self-referrals, and only 4% to 12% of visits were from conventional physician referrals. Chiropractors and massage therapists primarily saw musculoskeletal problems, while acupuncturists and naturopathic physicians saw a broader range of conditions. Visits to acupuncturists and massage therapists lasted about 60 minutes compared with 40 minutes for naturopathic physicians and less than 20 minutes for chiropractors. Most visits to chiropractors and naturopathic physicians, but less than one third of visits to acupuncturists and massage therapists, were covered by insurance. CONCLUSIONS: This information will help inform discussions of the roles CAM practitioners will play in the health care system of the future. Cherkin2002b Miguel A Diego author Tiffany Field author Maria Hernandez-Reif author Jon A Shaw author Eugenio M Rothe author Daniel Castellanos author Linda Mesner author 2002 text continuing periodical academic journal 0001-8449 2002 37 147 597 597 Seventeen aggressive adolescents were randomly assigned to a massage therapy group or a relaxation therapy group to receive 20-minute therapy sessions, twice a week for five weeks. The massaged adolescents had lower anxiety after the first and last sessions. By the end of the study, they also reported feeling less hostile and they were perceived by their parents as being less aggressive. Significant differences were not found for the adolescents who were assigned to the relaxation group. Diego2002b Lynn Dunwoody author Angus Smyth author Robin Davidson author 2002-Oct text continuing periodical academic journal 1357-6321 2002-Oct 8 10 497 497 Many patients suffering from cancer make use of complementary therapies, with aromatherapy being a popular choice. Quantitative studies, using questionnaire data, have shown that aromatherapy may reduce psychological distress and enhance symptom control in cancer patients. However, little is known about the personal meanings patients associate with the therapy. This study explored the patients' experiences of aromatherapy using of a focus group interview. Eight themes emerged from the analysis, six of which have been acknowledged to some extent by previous authors: de-stressing effects of aromatherapy, the counselling role of the aromatherapist, aromatherapy as a reward, patient empowerment, communication through touch, and negative aspects of the service. Two apparently new themes emerged concerned with security of context (where the aromatherapy took place) and preconceived perceptions of the value of aromatherapy as a treatment of cancer patients. The implications of the findings are discussed in relation to the perceived role of counselling, collaborative practice and training in complementary therapies. Dunwoody2002 Cherry Bond author 2002 text continuing periodical academic journal 1474-9114 2002 12 2 44 47 The significance and benefits of touch and massage for preterm infants in Neonatal Intensive Care Units and in the community are discussed. The article emphasises the value of massage in helping parents to bond with their baby and as part of family-centred care. A bibliography is included. Bond2002 Tim Hideaki Tanaka author Gerry Leisman author Hidetoshi Mori author Kazushi Nishijo author 2002-Oct-14 text continuing periodical academic journal 1472-6882 2002-Oct-14 2 9 BACKGROUND: There is not enough evidence to support the efficacy of massage for muscle fatigue despite wide utilization of the modality in various clinical settings. This study investigated the influence of massage application on localized back muscle fatigue. METHODS: Twenty-nine healthy subjects participated in two experimental sessions (massage and rest conditions). On each test day, subjects were asked to lie in the prone position on a treatment table and perform sustained back extension for 90 seconds. Subjects then either received massage on the lumbar region or rested for a 5 minute duration, then repeated the back extension movement. The median frequency (MDF), mean power frequency (MNF), and root mean square (RMS) amplitude of electromyographic signals during the 90 second sustained lumbar muscle contraction were analyzed. The subjective feeling of fatigue was then evaluated using the Visual Analogue Scale (VAS). RESULTS: MDF and MNF significantly declined with time under all conditions. There was no significant difference in MDF, MNF or RMS value change between before and after massage, or between rest and massage conditions. There was a significant increase in fatigue VAS at the end of the 2nd back extension with rest condition. There was a significant difference in fatigue VAS change between massage and rest condition. CONCLUSIONS: A significant difference was observed between massage and rest condition on VAS for muscle fatigue. On EMG analysis, there were no significant differences to conclude that massage stimulation influenced the myoelectrical muscle fatigue, which is associated with metabolic and electrical changes. Tanaka2002 Christopher Quinn author Clint Chandler author Albert Moraska author 2002-Oct text continuing periodical academic journal 0090-0036 2002-Oct 92 10 1657 1661 OBJECTIVES: The effect of massage therapy on chronic nonmigraine headache was investigated. METHODS: Chronic tension headache sufferers received structured massage therapy treatment directed toward neck and shoulder muscles. Headache frequency, duration, and intensity were recorded and compared with baseline measures. RESULTS: Compared with baseline values, headache frequency was significantly reduced within the first week of the massage protocol. The reduction of headache frequency continued for the remainder of the study (P =.009). The duration of headaches tended to decrease during the massage treatment period (P =.058). Headache intensity was unaffected by massage (P =.19). CONCLUSIONS: The muscle-specific massage therapy technique used in this study has the potential to be a functional, nonpharmacological intervention for reducing the incidence of chronic tension headache. Quinn2002 Ruth Remington author text continuing periodical academic journal 0029-6562 2002 51 5 317 323 BACKGROUND: Agitated behavior is a widespread problem that adversely affects the health of nursing home residents and increases the cost of their care. OBJECTIVE: To examine whether modifying environmental stimuli by the use of calming music and hand massage affects agitated behavior in persons with dementia. METHOD: A four group, repeated measures experimental design was used to test the effect of a 10-minute exposure to either calming music, hand massage, or calming music and hand massage simultaneously, or no intervention (control) on the frequency and type of agitated behaviors in nursing home residents with dementia (N = 68). A modified version of the Cohen-Mansfield Agitation Inventory was used to record agitated behaviors. RESULTS: Each of the experimental interventions reduced agitation more than no intervention. The benefit was sustained and increased up to one hour following the intervention (F = 6.47, p<.01). The increase in benefit over time was similar for each intervention group. When types of agitated behaviors were examined separately, none of the interventions significantly reduced physically aggressive behaviors (F = 1.93, p=.09), while physically nonaggressive behaviors decreased during each of the interventions (F = 3.78, p< 01). No additive benefit resulted from simultaneous exposure to calming music and hand massage. At one hour following any intervention, verbally agitated behavior decreased more than no intervention. CONCLUSION: Calming music and hand massage alter the immediate environment of agitated nursing home residents to a calm structured surrounding, offsetting disturbing stimuli, but no additive benefit was found by combining interventions simultaneously. Remington2002 Daniel C Cherkin author Richard A Deyo author Karen J Sherman author L Gary Hart author Janet H Street author Andrea Hrbek author Elaine Cramer author Bruce Milliman author Jennifer Booker author Robert Mootz author James Barassi author Janet R Kahn author Ted J Kaptchuk author David M Eisenberg author text continuing periodical academic journal 0893-8652 2002 15 5 378 390 BACKGROUND: Despite the growing popularity of complementary and alternative medical (CAM) therapies, little is known about the professionals who provide them. Our objective was to describe the characteristics of the four largest groups of licensed CAM providers in the United States and to compare them with the characteristics of conventional physicians. METHODS: Random statewide samples of licensed acupuncturists, chiropractors, massage therapists, and naturopathic physicians living in Arizona, Connecticut, Massachusetts and Washington were interviewed by telephone. Sociodemographic, training, and practice characteristics of CAM providers were elicited and compared with data on conventional physicians published by the American Medical Association. RESULTS: More than 160 providers in each profession were interviewed. Participation rates ranged between 78% and 94% except for Arizona chiropractors (61%). The proportion of female respondents was highest for massage therapy (85%) and acupuncture and naturopathy (almost 60%) and was lowest for chiropractic (about 25%) and conventional medicine (23%). Except for acupuncturists, only 5% of CAM providers were nonwhite. CAM providers were more likely than conventional physicians to practice solo (51%-74% vs 26%, respectively), and less than 10% practiced with medical physicians. Massage therapists saw the fewest patients per week (about 14), and chiropractors and conventional physicians the most (about 100). Chiropractors and conventional physicians saw about 3 patients per hour compared with roughly 1 patient per hour for the other CAM professions. Interstate differences were small. CONCLUSIONS: This characterization of CAM providers will help inform decisions about the future role of CAM providers in the health care system. Cherkin2002a Miguel A Diego author Tiffany Field author Maria Hernandez-Reif author Sybil Hart author Bernard Brucker author Tory Field author Iris Burman author 2002-Feb text continuing periodical academic journal 0020-7454 2002-Feb 112 2 133 142 The present study assessed the effects of massage therapy on depression, functionality, upper body muscle strength and range of motion on spinal cord injury patients. Twenty C5 through C7 spinal cord injury individuals recruited from a University outpatient clinic were randomly assigned to a massage therapy group or an exercise group. Patients in the massage therapy group received two 40-min massage therapy sessions per week for 5 weeks. Patients in the control group practiced a range of motion exercise routine targeting the arms, neck, shoulders, and back 2 times per week for 5 weeks. Although both the massage and exercise group appeared to benefit from treatment, only the massage group showed lower anxiety and depression scores and significantly increased their muscle strength and wrist range of motion. Diego2002a Marlaine C Smith author Janet Kemp author Linnea Hemphill author Carol P Vojir author 2002 text continuing periodical academic journal 1527-6546 2002 34 3 257 262 PURPOSE: To examine the effects of therapeutic massage on perception of pain, subjective sleep quality, symptom distress, and anxiety in patients hospitalized for treatment of cancer. ORGANIZING CONSTRUCT: Rogers' Science of Unitary Human Beings and Watson's theory of human caring. METHODS: Quasiexperimental. The sample consisted of 41 patients admitted to the oncology unit at a large urban medical center in the United States for chemotherapy or radiation therapy. Twenty participants received therapeutic massage and 21 received the control therapy, nurse interaction. The outcome variables were measured on admission and at the end of 1 week via the following instruments: a Numerical Rating Scale for pain intensity and Likert-type scale for distress from pain; The Verran Snyder-Halpern Sleep Scale, McCorkle and Young's Symptom Distress Scale, and the Speilberger State Anxiety Inventory. ANOVA and t tests were used to analyze between and within group differences in mean scores and main effects on outcome variables. FINDINGS AND CONCLUSIONS: Mean scores for pain, sleep quality, symptom distress, and anxiety improved from baseline for the subjects who received therapeutic massage; only anxiety improved from baseline for participants in the comparison group. Statistically significant interactions were found for pain, symptom distress, and sleep. Sleep improved only slightly for the participants receiving massage, but it deteriorated significantly for those in the control group. The findings support the potential for massage as a nursing therapeutic for cancer patients receiving chemotherapy or radiation therapy. Smith2002 Andrea D Furlan author Lucie Brosseau author Marta Imamura author Emma Irvin author 2002-Sep-01 text continuing periodical academic journal 1528-1159 2002-Sep-1 27 17 1896 1910 BACKGROUND: Low back pain (LBP) is one of the most common and costly musculoskeletal problems in modern society. Proponents of massage therapy claim it can minimize pain and disability and speed return-to-normal function. OBJECTIVES: To assess the effects of massage therapy for nonspecific LBP. SEARCH STRATEGY: We searched MEDLINE, Embase, Cochrane Controlled Trials Register, HealthSTAR, CINAHL, and dissertation abstracts through May 2001 with no language restrictions. References in the included studies and in reviews of the literature were screened. Contact with content experts and massage associations was also made. SELECTION CRITERIA: The studies had to be randomized or quasirandomized trials investigating the use of any type of massage (using the hands or a mechanical device) as a treatment for nonspecific LBP. DATA COLLECTION AND ANALYSIS: Two reviewers blinded to authors, journals, and institutions selected the studies, assessed the methodologic quality using the criteria recommended by the Cochrane Collaboration Back Review Group, and extracted the data using standardized forms. The studies were analyzed in a qualitative way because of heterogeneity of population, massage technique, comparison groups, timing, and type of outcome measured. RESULTS: Nine publications reporting on eight randomized trials were included. Three had low and five had high methodologic quality scores. One study was published in German, and the rest, in English. Massage was compared with an inert treatment (sham laser) in one study that showed that massage was superior, especially if given in combination with exercises and education. In the other seven studies, massage was compared with different active treatments. They showed that massage was inferior to manipulation and transcutaneous electrical nerve stimulation; massage was equal to corsets and exercises; and massage was superior to relaxation therapy, acupuncture, and self-care education. The beneficial effects of massage in patients with chronic LBP lasted at least 1 year after the end of the treatment. One study comparing two different techniques of massage concluded in favor of acupuncture massage over classic (Swedish) massage. CONCLUSIONS: Massage might be beneficial for patients with subacute and chronic nonspecific LBP, especially when combined with exercises and education. The evidence suggests that acupuncture massage is more effective than classic massage, but this needs confirmation. More studies are needed to confirm these conclusions, to assess the effect of massage on return-to-work, and to measure longer term effects to determine cost-effectiveness of massage as an intervention for LBP. Furlan2002b Joyce Preece author 2002-May text continuing periodical academic journal 1353-6117 2002-May 8 2 101 105 Constipation and its associated problems affect approximately 50% of patients admitted to hospices in the United Kingdom. It is common practice in many hospices to offer a range of complementary therapies of which aromatherapy massage is one. Abdominal massage for the relief of constipation was once a commonly practised therapy but its use declined over time, like other complementary therapies there is now a rekindling of interest in the role that abdominal massage may play in relieving constipation. This paper will explain how a safe non-invasive easily learnt technique of abdominal massage was introduced in a palliative care setting to help relieve some of the problems associated with constipation. Despite the number of patients involved in this project being small, relief from some of the symptoms associated with constipation was experienced by some patients. A formal study of the benefits of abdominal massage in palliative care far the relief of constipation is needed. Preece2002 Gary L Darmstadt author Samir K Saha author 2002-Jun text continuing periodical academic journal 1606-0997 2002-Jun 20 2 184 188 Topical application of natural oils is practised routinely in many countries and may either improve skin barrier function and health or have detrimental cutaneous and systemic effects, depending on the composition of the oil. Little literature on the epidemiology, practice, and perceptions of traditional neonatal oil massage is available. This study was undertaken to gain insights into the epidemiology, practice, and perceptions regarding traditional oil massage of Bangladeshi neonates. A questionnaire was administered verbally to the primary caretaker of 332 outpatients at the Dhaka Shishu Hospital, and to 20 women with children encountered at the Matlab Health Complex in Bangladesh. More than 96% (340/352) of the caregivers practised oil massage, irrespective of socioeconomic status and place of residence. Among those at the Dhaka Shishu Hospital who practised oil massage, mustard oil was used alone or in combination by 95% (303/320) over the entire body, 1-3 time(s) daily (96%), starting in the first three days of life (72%) in both term and preterm neonates. Perceived benefits included prevention of infections (69%) and hypothermia (2%). Oil massage is an important traditional domiciliary practice used annually on more than three million newborns in Bangladesh. Given its potential for beneficial and harmful effects, further research is needed on the value of this practice, and ways to optimize its beneficial effects. Darmstadt2002 Iréne Lund author Y Ge author Long-Chuan Yu author Kerstin Uvnas-Moberg author Jing Wang author Cheng Yu author Mieko Kurosawa author Greta Agren author Annika Rosén author Magnus Lekman author Thomas Lundeberg author 2002-Jul text continuing periodical academic journal 0953-816X 2002-Jul 16 2 330 338 Massage-like stroking induces acute antinociceptive effects that can be reversed by an oxytocin antagonist, indicating activation of oxytocin on endogenous pain controlling systems. We now demonstrate an increase in hindpaw withdrawal latencies (HWLs), in response to thermal and mechanical stimuli, which was present after six treatments of massage-like stroking every other day and which continued to increase through the remaining seven treatments. Repeated massage-like stroking also resulted in increased oxytocin-like immunoreactivity (oxytocin-LI) levels in plasma and periaquaductal grey matter (PAG). Furthermore, increases in HWLs were also present after injections of oxytocin into the PAG (0.1, 0.5 and 1.0 nmol). Intra-PAG oxytocin injection of 1 nmol followed by 1 or 20 nmol of naloxone attenuated the increments in HWL. Also, there was a dose-dependent attenuation of the oxytocin-induced antinociceptive effects following intra-PAG injection of the mu-opioid antagonist beta-funaltrexamine (beta-FNA) and the kappa-opioid antagonist nor-binaltorphimine (nor-BNI) but not the delta-antagonist naltrindole. The long-term antinociceptive effects of massage-like stroking may be attributed, at least partly, to the oxytocinergic system and its interaction with the opioid system, especially the mu- and the kappa-receptors in the PAG. Lund2002 Paula Mullins author text continuing periodical academic journal 0954-7762 2002 98 22 36 37 This article describes the properties of essential oils and the use of aromatherapy in a ward setting to treat patients with a variety of conditions. It outlines some of the benefits and risks to patients. Mullins2002 Junko Inagaki author Junko Yoneda author Misae Ito author Hiroshi Nogaki author 2002-Aug text continuing periodical academic journal 1441-0745 2002-Aug 4 3 Suppl A5 A6 The purpose of this study was to examine the psychophysiological effects of shiatsu and massage while in the prone position. Twenty-four healthy women gave informed written consent to participate. After resting in the prone position for 50 min, each subject was massaged and given shiatsu for 15 min and again rested for 15 min in the prone position. Every 5 min, skin temperature was measured along the neck and back. Blood pressure and pulse rate also were measured every 5 min throughout the procedure. A visual analog scale was used to assess the severity of pain experienced before the massage and shiatsu as well as at completion of the procedure. The subject's favorite sleeping posture and previous physical pain experienced during massage and shiatsu were assessed. The findings revealed that significant differences were found in skin temperatures (elevated 0.5 degrees) along the back after the procedure. Systolic blood pressure was found to be significantly lower after the massage and shiatsu when compared with systolic blood pressure prior to the procedure. No significant differences before and after the procedures were found in either the diastolic blood pressure or pulse rate. The procedure was found to give the subjects relief from pain. No significant differences were noted in the subject's favorite sleeping posture, the experience of previous physical pain, or the experience of the massage and shiatsu. Inagaki2002 Prapasri Jirayingmongkol author Supatra Chantein author Nuppawan Phengchomjan author Nitaya Bhanggananda author 2002-Aug text continuing periodical academic journal 1441-0745 2002-Aug 4 3 Suppl A4 Proactive health-care services emphasize health promotion and the prevention of disabling conditions. Currently, in Thai society, the number of elderly with deteriorating health has increased. Therefore, self-care health promotion activities have become essential in order for the elderly to maintain their well-being. The purpose of this study was to investigate the effects of foot massage with biofeedback. Foot massage, a Thai primary self-care custom, has been found to enhance blood circulation, relaxation, and one's own healing power. In addition, touch has been found to stimulate secretion of endorphins and reduce pain and anxiety. It appears therefore that foot massage, or reflexology, promotes a healthy lifestyle for all age groups. An experimental study, utilizing a pilot project in elderly health care, was employed to investigate the effects of biofeedback using foot massage. A pretest/post-test quasi-experimental design was used. The sample consisted of four men and 16 women (age range 61-69 years). Four trained researchers massaged the feet of the subjects and measured vital-sign changes. Biofeedback also was investigated before and after the foot massages. Results showed that the average biofeedback and temperature were lower before than after the foot massage (P < 0.01). The average pulse rate, respiratory rate, and blood pressure, however, were found to be higher before rather than after the foot massage ( P < 0.01). It was concluded that the foot massage provided good circulation, relaxation, and comfort. All subjects expressed positive feelings when they received the foot massage (i.e. 'It is very nice that foot massage can relieve my joint pain, I am happy and comfortable'). These findings appear to indicate that foot massage is beneficial both for physical and mental conditions. Foot massage, however, is just one key to achieving a full range of primary health-care services. It needs to not only be performed by nurses. Families, also, can provide foot massage for the elderly, anywhere and anytime. Jirayingmongkol2002 Jenny Buckley author 2002-Jun text continuing periodical academic journal 1357-6321 2002-Jun 8 6 276 280 This article begins by reviewing the place of complementary therapies in palliative care from the perspective of UK professional organizations, namely the Nursing and Midwifery Council (NMC) (formerly the United Kingdom Central Council for Nursing, Midwifery and Health Visiting (UKCC)) and the British Medical Association (BMA). It then reviews recent research on the use of massage and aromatherapy massage in palliative care and comments on their credibility and implications, thereby addressing nursing science. The art of nursing is explored through four case histories where massage was used intuitively when words were difficult or seemed inadequate. To conclude, by focusing on the therapies provided by a UK hospice, there is consideration of the practicalities of implementing massage and aromatherapy massage in a specialist palliative care unit. Buckley2002 Neena Khanna author Siddhartha Datta Gupta author 2002-Jul text continuing periodical academic journal 0011-9059 2002-Jul 41 7 407 410 BACKGROUND: Facial massage is an extremely popular form of beauty treatment and is thought to rejuvenate the skin. We decided to study the benefits and untoward effects of this form of facial beauty treatment. METHODS: One hundred and forty-two women (aged 17-63 years), who had received facial beauty treatment in three well-established beauty parlours in New Delhi, were entered into the study and observed for a period of 12 weeks after the facial beauty treatment. Twenty-seven of the subjects had a repeat facial beauty treatment 4-6 weeks after entry into the study, giving a total of 169 massage episodes observed. Immediate and delayed effects of the beauty treatment were examined. RESULTS: Facial beauty treatment generally consists of three steps: vigorous massaging of the face with creams, steaming (using a hot towel or a steaming gadget), and application of a face mask containing adsorbents and astringents. In our study, the creams used for massage included "off the shelf" creams manufactured by standard cosmetic companies in 95 (56.3%) subjects, herbal creams in 61 (36.1%), and creams containing exotic ingredients, such as gold salts, in 13 (7.7%). Sixty-one (36.1%) patients developed erythema and puffiness within 15 min to 2 h after the beauty treatment. This lasted for 2-6 h. Forty-one (24.3%) women underwent the procedure of comedone extraction after steaming. In 12 (7.1%) of these women, persistent erythema was noticed at the site of comedone extraction. Eight (4.7%) women developed mild dermatitis on the face, 2-7 days after the facial beauty treatment. Patch testing with constituents used in the facial beauty treatment was positive in four patients (herbal cream, 1; witch hazel, 1; orange face pack, 1; and gold cream, 1). In 47 (33.1%) subjects, an acneiform eruption was observed 3-10 weeks after the facial beauty treatment (mean, 6.1 +/- 3 weeks). Thirteen (27.7%) of these subjects had taken the facial beauty treatment for the first time, whereas 34 (72.3%) developed an acneiform eruption after every facial massage. The predominant lesions were deep-seated nodules, although a few comedones, especially closed ones, were present in some patients. Lesions were always present on the cheeks, an area of focus during the facial massage, and healed with hyperpigmentation. The benefits of facial beauty treatment, as mentioned by the subjects, included a feeling of freshness and rejuvenation in 84 (59.1%), keeping the skin supple in 76 (53.5%), feeling of warmth and tightening of the skin in 71 (50%), and delaying the onset of wrinkles in 21 (14.8%). CONCLUSIONS: Although there are several subjective benefits with facial beauty treatment, there may be immediate side-effects, such as erythema and edema, as well as delayed problems, such as dermatitis and acneiform eruption, in about one-third of patients. Khanna2002 A D Furlan author L Brosseau author M Imamura author E Irvin author 2002 text continuing periodical academic journal 1469-493X 2002 2 CD001929 BACKGROUND: Low-back pain is one of the most common and costly musculoskeletal problems in modern society. Proponents of massage therapy claim it can minimize pain and disability, and speed return to normal function. OBJECTIVES: To assess the effects of massage therapy for non-specific low-back pain. SEARCH STRATEGY: We searched Medline, Embase, Cochrane Controlled Trials Register, HealthSTAR, CINAHL and Dissertation abstracts from their beginning to May 2001 with no language restrictions. References in the included studies and in reviews of the literature were screened. Contact with content experts and massage associations was also made. SELECTION CRITERIA: The studies had to be randomized or quasi-randomized trials investigating the use of any type of massage (using the hands or a mechanical device) as a treatment for non-specific low-back pain. DATA COLLECTION AND ANALYSIS: Two reviewers blinded to authors, journal and institutions selected the studies, assessed the methodological quality using the criteria recommended by the Cochrane Back Review Group, and extracted the data using standardized forms. The studies were analysed in a qualitative way due to heterogeneity of population, massage technique, comparison groups, timing and type of outcome measured. MAIN RESULTS: Nine publications reporting on eight randomized trials were included. Three had low and five had high methodological quality scores. One study was published in German and the rest in English. Massage was compared to an inert treatment (sham laser) in one study that showed that massage was superior, especially if given in combination with exercises and education. In the other seven studies, massage was compared to different active treatments. They showed that massage was inferior to manipulation and TENS; massage was equal to corsets and exercises; and massage was superior to relaxation therapy, acupuncture and self-care education. The beneficial effects of massage in patients with chronic low-back pain lasted at least one year after the end of the treatment. One study comparing two different techniques of massage concluded in favour of acupuncture massage over classic (Swedish) massage. REVIEWER'S CONCLUSIONS: Massage might be beneficial for patients with subacute and chronic non-specific low-back pain, especially when combined with exercises and education. The evidence suggest that acupuncture massage is more effective than classic massage, but this need confirmation. More studies are needed to confirm these conclusions and to assess the impact of massage on return-to-work, and to measure longer term effects to determine cost-effectiveness of massage as an intervention for low-back pain. Furlan2002a V R Antoniv author 2002 text continuing periodical academic journal 1019-5297 2002 2 93 96 Our objectives in this study were to establish validated methods of massotherapy of the neck, to determine its action on the neck structures, and to conduct a comparative evaluation of results of the control and study groups after performing massotherapy. It has been found out that in 80 (85%) patients the skin comes to be tinged with healthy pink, the cutaneous-and-muscle tone getting improved, which event makes the skin smooth and elastic following the above massage. Over the first ten days of the massoprocedures 44 (48%) subjects demonstrated resolution of the edema and swelling, with the thickened skin fold as a roller dissappearing by the end of the second month. Dispelling of hypothyrosis phenomena made for reduction of dosages of hormonal preparations. We consider it mandatory that massotherapy of the neck be instituted in all those patients who had undergone operation on the neck and thyroid. Antoniv2002 Feng Liu author Leaf Huang author 2002-Jun text continuing periodical academic journal 0270-9139 2002-Jun 35 6 1314 1319 With the recent completion of the human genome project and the tremendous growth of biotechnology, the desire to extract information concerning gene expression, protein level, subcellular localization, and functionality in the liver will demand the development of efficient gene transfer to this organ with minimal toxicity. In this report, we show that significant gene expression in the liver could be achieved by simple mechanical massage after intravenous injection of naked plasmid DNA into mice. This method is simple, highly reproducible, repeatable, and, more importantly, free of toxicity. Hepatic gene transfer with hepatocyte growth factor (HGF) plasmid DNA prevented endotoxin-induced lethal fulminant hepatic failure, leading to dramatically enhanced survival in mice. Liu2002 10.1053/jhep.2002.33467 Gregory Plaugher author Cynthia R Long author Joel Alcantara author Alyssa D Silveus author Herbert Wood author Kapildeo Lotun author J Michael Menke author William C Meeker author Stephen H Rowe author 2002-May text continuing periodical academic journal 0161-4754 2002-May 25 4 221 239 OBJECTIVE: To determine the feasibility of conducting a randomized clinical trial in the private practice setting examining short- and long-term effects of chiropractic adjustments for subjects with essential hypertension compared with a brief soft tissue massage, as well as a nontreatment control group. DESIGN: Randomized controlled-comparison trial with 3 parallel groups. SETTING: Private practice outpatient chiropractic clinic. PATIENTS: Twenty-three subjects, aged 24 to 50 years with systolic or diastolic essential hypertension. INTERVENTIONS: Two months of full-spine chiropractic care (ie, Gonstead) consisting primarily of specific-contact, short-lever-arm adjustments delivered at motion segments exhibiting signs of subluxation. The massage group had a brief effleurage procedure delivered at localized regions of the spine believed to be exhibiting signs of subluxation. The nontreatment control group rested alone for a period of approximately 5 minutes in an adjustment room. MAIN OUTCOME MEASURES: Cost per enrolled subject, as well as systolic and diastolic blood pressure (BP) measured with a random-0 sphygmomanometer and patient reported health status (SF-36). Pilot study outcome measures also included an assessment of cooperation of subjects to randomization procedures and drop-out rates, recruitment effectiveness, analysis of temporal stability of BPs at the beginning of care, and the effects of inclusion/exclusion criteria on the subject pool. RESULTS: Thirty subjects enrolled, yielding a cost of $161 per enrolled subject. One subject was later determined to be ineligible, and 6 others dropped out. In both the chiropractic and massage therapy groups, all subjects were classified as either overweight or obese; in the control group there were only 2 classified as such. SF-36 profiles for the groups were similar to that of a normal population. The mean change in diastolic BP was -4 (95% confidence interval [CI]: -8.6, 0.5) in the chiropractic care group, 0.5 (95% CI: -3.5, 4.5) in the brief massage treatment group, and -4.9 (95% CI: -9.7, -0.1) in the no treatment control group. At the end of the study period, this change was -6.3 (95% CI: 13.1, 0.4), -1.0 (95% CI: -7.5, 15.6), -7.2 (95% CI: -13.3, -1.1) in the 3 study groups. The mean improvements in the chiropractic care and no treatment control groups remained consistent over the follow-up period. CONCLUSIONS: This pilot study elucidated several procedural issues that should be addressed before undertaking a full-scale clinical trial on the effects of chiropractic adjustments in patients with essential hypertension. A multidisciplinary approach to recruitment may need to be used in any future efforts because of the limited subject pool of patients who have hypertensive disease but are not taking medications for its control. Measures need to be used to assure comparable groups regarding prognostic variables such as weight. Studies such as these demonstrate the feasibility of conducting a full-scale 3-group randomized clinical trial in the private practice setting. Plaugher2002 S G Ferber author J Kuint author A Weller author R Feldman author S Dollberg author E Arbel author D Kohelet author 2002-APR text continuing periodical academic journal Background: The method of "massage therapy" has consistently shown increased weight gain in preterm infants. The weight gain was apparent during massages administered by professionals. Aims: To replicate the results of increased weight gain in the course of "massage therapy" in preterm infants, and utilize a new, cost-effective application of this method by comparing maternal to nonmaternal administration of the therapy. Study design: Random cluster design. Subjects: The study comprised 57 healthy, preterm infants assigned to three groups: two treatment groups-one in which the mothers performed the massage, and the other in which a professional female figure unrelated to the infant administered the treatment. Both these groups were compared to a control group. Results: Over the 10-day Study period, the two treatment groups gained significantly more weight compared to the control group (291.3 and 311.3 vs. 225.5 g, respectively). Calorie intake/kg did not differ between groups. Conclusions: Mothers are able to achieve the same effect size as that of trained professionals, allowing cost-effective application of the treatment within the neonatal intensive care unit. (C) 2002 Elsevier Science Ireland Ltd. All tights reserved. Ferber2002a 2002-APR 67 1-2 37 45 T Field author M Diego author C Cullen author M Hernandez-Reif author W Sunshine author S Douglas author 2002-APR text continuing periodical academic journal Massage therapy has been observed to be helpful in some patients with fibromyalgia. This study was designed to examine the effects of massage therapy versus relaxation therapy on sleep, substance P, and pain in fibromyalgia patients. Twenty-four adult fibromyalgia patients were assigned randomly to a massage therapy or relaxation therapy group. They received 30-mmiute treatments twice weekly for 5 weeks. Both groups showed a decrease in anxiety and depressed mood immediately after the first and last therapy sessions. However, across the course of the study, only the massage therapy group reported an increase in the number of sleep hours and a decrease in their sleep movements. In addition, substance P levels decreased, and the patients' physicians assigned lower disease and pain ratings and rated fewer tender points in the massage therapy group. Field2002b 2002-APR 8 2 72 76 Tiffany Field author 2002-Jan text continuing periodical academic journal 0025-7125 2002-Jan 86 1 163 171 The author and other investigators have documented improvement in several medical and psychiatric conditions after massage therapy, including growth in preterm infants, depression and addictive problems, pain syndromes, and immune and autoimmune conditions. Although some potential underlying mechanisms have been explored for the massage therapy-improved clinical condition relationship, including decreased stress (and decreased cortisol), improved sleep patterns, and enhanced immune function, further research is needed in this area. Field2002a B Kriederman author T Myloyde author M Bernas author L Lee-Donaldson author S Preciado author M Lynch author B Stea author P Summers author C Witte author M Witte author 2002-MAR text continuing periodical academic journal Lack of a standardized experimental counterpart of peripheral lymphedema (LE) in a small animal has hampered research into treatment of this debilitating condition. We recently refined a rodent model consisting of radical unilateral lymphatic/nodal groin excision in conjunction with a circumferential integumental gap, followed by regional irradiation of the groin to reproduce stable unilateral hindlimb LE (1). In the current study, Wistar-Fuzzy rats with established right hindlimb LE, were subdivided into five groups and subjected to one of the following daily physical regimens over a 5-day period: pneumatic compression pumping at 30 torr (PCP); low-stretch multi-layered compressive bandaging using Coban (CB); manual lymphedema drainage (MLD) or a light massage consisting of stationary circular motions using the fingertips; combined physiotherapy (CPT consisting of MLD + CB); and a no treatment or control group (CTRL). Hindlimb and LE volumes were serially measured before and after treatment. Whereas CTRL showed progressive worsening of hindlimb swelling, PCP, CB, CPT and MLD each produced similar and substantial edema reduction over the 5 day interval. PCP, CB and CPT induced vacillating edema reduction which, however, exceeded rebound swelling on a daily basis. MLD, on the other hand, showed a steady gradual daily decline in LE volume. Kriederman2002 2002-MAR 35 1 23 27 Results of a randomized study I Le Blanc-Louvry author B Costaglioli author C Boulon author A M Leroi author P Ducrotte author 2002-JAN-FEB text continuing periodical academic journal The aim of this study was to determine the effectiveness of mechanical abdominal massage on postoperative pain and ileus after colectomy. We hypothesized that parietal abdominal stimulation could counteract induced pain and postoperative ileus, through common spinal-sensitive pathways, with nociceptive visceral messages. After preoperative randomization, 25 patients (age 52 +/- 5 years) underwent active mechanical massage by intermittent negative pressure on the abdominal wall resulting in aspiration (Cellu M50 device, LPG, Valence, France), and 25 patients (age 60 +/- 6 years) did not receive active mechanical massage (placebo group). Massage sessions began the first day after colectomy and were performed daily until the seventh postoperative day. In the active-massage group, amplitude and frequency were used, which have been shown to be effective in reducing muscular pain, whereas in the placebo group, ineffective parameters were used. Visual analogue scale (VAS) pain scores, doses of analgesics (propacetamol), and delay between surgery and the time to first passage of flatus were assessed. Types and dosages of the anesthetic drugs and the duration of the surgical procedure did not differ between groups. From the second and third postoperative days, respectively, VAS pain scores (P < 0.001) and doses of analgesics (P < 0.05) were significantly lower in patients receiving active massage compared to the placebo group. Time to first passage of flatus was also significantly shorter in the active-massage group (1.8 +/- 0.3 days vs. 3.6 +/- 0.4 days, P < 0.01). No adverse effects were observed. These results suggest that mechanical massage of the abdominal wall may decrease postoperative pain and ileus after colectomy. Le Blanc-Louvry2002 2002-JAN-FEB 6 1 43 49 A psychometric analysis C Violato author L Salami author S Muiznieks author 2002-FEB text continuing periodical academic journal Objective: To describe the components of the Alberta Registered Massage Therapists Society (ARMTS) examination and their psychometric properties. Methods: All 3 components of the ARMTS examination (knowledge, clinical judgement, and clinical skills) were administered to 112 candidates. The examination consisted of 2 written components (140 multiple-choice questions on basic science knowledge and 60 multiple-choice questions on clinical judgment) and a clinical competency assessment of the following practical skills with standardized patients: (1) taking a case history, (2) assessing physical condition, and (3) treating the condition. All components of the examination were criterion-referenced with the methods of minimum performance level (MPL). Results: The internal consistency reliability coefficients (Cronbach alpha) ranged from 0.60 to 0.88 for all test components. The descriptive statistics, performance levels, and reliability estimates indicate that the examination is functioning well. Concurrent, criterion-related validity evidence was provided by correlations between the examination components that ranged from r = 0.24 (P < .05) to r = 0.78 (P < .01). Factor analysis produced 3 factors: information processing, clinical treatment, and follow-up management. Conclusions: The results provide evidence of adequate-to-good internal consistency reliability and content validity. Empirical validity evidence based on concurrent, criterion-related measures is provided by the correlational analysis. The significant correlations indicate that although performance is related across the examination, the various components do assess unique and independent domains. This is further supported by the results of the factor analysis that provide evidence for discriminant validity of the measures (ie, they discriminate between domains of measurement such as information processing, treatment, and basic knowledge). Taken together, these results indicate that the ARMTS examination has evidence for both reliability and validity. Violato2002 2002-FEB 25 2 111 115 Judy M Lovas author Ashley R Craig author Yvette D Segal author Robert L Raison author Kathryn M Weston author Margaret R Markus author 2002-07 text continuing periodical academic journal Little scientific investigation has been conducted to examine objectively the belief that massage therapy can effect the immune system of healthy people. If there are any links between massage therapy and improved immune function, the mechanisms by which they operate are not known. This study evaluated the effects of massage therapy on immune functions of two healthy females.Using a single-case experimental ABAB design, two subjects received a relaxing massage during the experimental phases (B) and no massage during baseline phases (A). Assays were conducted for T and B lymphocyte mitogen-induced proliferation, enumeration of T and B lymphocyte subsets, quantification of immunoglobulins A, G and M (IgA, IgG, IgM) and cortisol levels. Trait and state anxiety levels were also examined.The results indicated a consistent and significant trend of increased activity of both T and B lymphocytes and levels of serum IgG for both subjects during the B phases compared to the A phases. There were no other significant differences between experimental and control conditions for the remaining measures, although serum IgM levels approached significance (P=0.06). Both subjects demonstrated a reduction in trait anxiety over the period of massage therapy.Further studies with larger sample sizes in control and experimental groups, over a longer experimental period are necessary. The study of the effects of massage therapy poses an exciting challenge in psychoneuroimmunology. Lovas2002 10.1054/jbmt.2001.0251 2002-7 6 3 143 150 a pilot study Maria Hernandez-Reif author Tiffany Field author Shay Largie author Christy Cullen author Julia Beutler author Chris Sanders author William Weiner author Dinorah Rodriguez-Bateman author Lisette Zelaya author Saul Schanber author Cynthia Kuhn author 2002-07 text continuing periodical academic journal Sixteen adults diagnosed with idiopathic Parkinson's disease (M AGE=58) received 30-min massage therapy or progressive muscle relaxation exercise sessions twice a week for 5 weeks (10 sessions total). Physicians rated participants in the massage therapy group as improved in daily living activities by the end of the study. The massaged group also rated themselves as improved in daily functioning, and having more effective and less disturbed sleep. Urine samples revealed that at the end of the 10 sessions, the massage therapy group had lower norepinephrine and epinephrine (stress hormone) levels, suggesting they were less stressed. The progressive muscle relaxation group had higher dopamine levels, which is interesting in that Parkinson's is associated with a decrease in dopamine. The relaxation group also showed higher epinephrine levels, suggesting that although the relaxation exercises might have been beneficial, some Parkinson's participants might have found the relaxation technique stressful. Hernandez-Reif2002 10.1054/jbmt.2002.0282 2002-7 6 3 177 182 an introduction for health care professionals James L Oschman author 2002-04 text continuing periodical academic journal Clinical application of natural and artificial electric and electromagnetic fields has had a long and controversial history. This presentation will summarize this history and recent research. Sensitive magnetometers, called SQUIDs, are being used by medical researchers to map the biomagnetic environment of the human body in health and disease. The well-known electrical activities in the body, which provide the basis for the electrocardiogram, electroencephalogram, and electromyogram, have biomagnetic counterparts, called the magnetocardiogram, magnetoencephalogram, and magnetomyogram, respectively. These measurable biomagnetic fields extend into the space around the body. After a long period of discouraging clinical application of electric or electromagnetic fields, orthopedic researchers developed a pulsing electromagnetic field therapy (PEMF) that stimulates repair of fracture non-unions. Extensive clinical trials led the FDA to approve this device as ‘safe and effective’ in 1979. The method has been modified for treating soft tissues, such as nerves, ligaments, skin, and capillaries. Research into the mechanisms involved in PEMF therapy has led to a better understanding of the ways cells and tissues respond to minute environmental fields of particular frequencies. This research is beginning to provide a logical scientific basis for some of the subtle effects of complementary therapies such as Reiki, Therapeutic Touch, Polarity Therapy, Massage, and Acupuncture. Oschman2002 10.1054/jbmt.2001.0259 2002-4 6 2 117 125 the experts respond Leon Chaitow author 2002-01 text continuing periodical academic journal In the October 2001 issue of JBMT the editorial raised questions as to the value, validity and accuracy of palpation methods in assessing musculoskeletal dysfunction. The reason for the topic of palpatory reliability being of current interest results from a steady series of published papers, which cast doubt on inter- and intra-rater reliability, and accuracy, in the performance of manual forms of assessment. The trigger for the exercise, which has resulted in this collection of responses on that theme, was an article by Comeaux et al. (2001), which noted relatively poor inter-rater reliability when three similarly trained practitioners evaluated the lower cervical and upper thoracic spine. In the interest of clarification JBMT invited a number of eminent clinicians and researchers to answer a series of questions, which had been compiled in consultation with various experts. Professions represented in the responses include medicine (David Simons and Karel Lewit), osteopathy (Peter Gibbons and Philip Tehan), chiropractic (Craig Liebenson and Don Murphy), physiotherapy (Joanne Bullock-Saxton and Dianne Lee) and massage therapy (Shannon Goosen). Chaitow2002 10.1054/jbmt.2001.0253 2002-1 6 1 18 18 Stephanie J Rexilius author Carla Mundt author Mary Erickson Megel author Sangeeta Agrawal author 2002-Apr text continuing periodical academic journal 1538-0688 2002-Apr 29 3 E35 E44 PURPOSE/OBJECTIVES: To examine the effect of massage therapy and Healing Touch on anxiety, depression, subjective caregiver burden, and fatigue experienced by caregivers of patients undergoing autologous hematopoietic stem cell transplant. DESIGN: Quasi-experimental repeated measures. SETTING: Oncology/hematology outpatient clinic in a large midwestern city. SAMPLE: 36 caregivers: 13 in the control group, 13 in the massage therapy group, and 10 in the Healing Touch group. Average age was 51.5 years; most participants were Caucasian. METHODS: All caregivers completed the Beck Anxiety Inventory, the Center for Epidemiologic Studies Depression Scale, the Subjective Burden Scale, and the Multidimensional Fatigue Inventory-20 before and after treatment consisting of two 30-minute massages or Healing Touch treatments per week for three weeks. Caregivers in the control group received usual nursing care and a 10-minute supportive visit from one of the researchers. MAIN RESEARCH VARIABLES: Anxiety, depression, subjective burden, fatigue, Healing Touch, massage therapy. FINDINGS: Results showed significant declines in anxiety scores, depression, general fatigue, reduced motivation fatigue, and emotional fatigue for individuals in the massage therapy group only. In the Healing Touch group, anxiety and depression scores decreased, and fatigue and subjective burden increased, but these changes did not achieve statistical significance. CONCLUSIONS: Caregivers can benefit from massage therapy in the clinic setting. IMPLICATIONS FOR NURSING: Oncology nurses care for both patients and their caregivers. Although some transplant programs provide services to support lay caregivers, studies indicate that these individuals continue to feel stressed by their situation. Massage might be one intervention that can be used by nurses to decrease feelings of stress in patients' caregivers. Rexilius2002 10.1188/02.ONF.E35-E44 Mei-Yueh Chang author Shing-Yaw Wang author Chung-Hey Chen author 2002-Apr text continuing periodical academic journal 0309-2402 2002-Apr 38 1 68 68 AIMS: To investigate the effects of massage on pain reaction and anxiety during labour. BACKGROUND: Labour pain is a challenging issue for nurses designing intervention protocols. Massage is an ancient technique that has been widely employed during labour, however, relatively little study has been undertaken examining the effects of massage on women in labour. METHODS: A randomized controlled study was conducted between September 1999 and January 2000. Sixty primiparous women expected to have a normal childbirth at a regional hospital in southern Taiwan were randomly assigned to either the experimental (n=30) or the control (n=30) group. The experimental group received massage intervention whereas the control group did not. The nurse-rated present behavioural intensity (PBI) was used as a measure of labour pain. Anxiety was measured with the visual analogue scale for anxiety (VASA). The intensity of pain and anxiety between the two groups was compared in the latent phase (cervix dilated 3-4 cm), active phase (5-7 cm) and transitional phase (8-10 cm). RESULTS: In both groups, there was a relatively steady increase in pain intensity and anxiety level as labour progressed. A t-test demonstrated that the experimental group had significantly lower pain reactions in the latent, active and transitional phases. Anxiety levels were only significantly different between the two groups in the latent phase. Twenty-six of the 30 (87%) experimental group subjects reported that massage was helpful, providing pain relief and psychological support during labour. CONCLUSIONS: Findings suggest that massage is a cost-effective nursing intervention that can decrease pain and anxiety during labour, and partners' participation in massage can positively influence the quality of women's birth experiences. Chang2002 G E Stamp author G S Kruzins author 2001-Mar text continuing periodical academic journal 1445-4386 2001-Mar 14 1 15 15 A multi-centred randomised perineal massage in labour trial (PMLT) was conducted in which participating midwives randomised eligible women in the second stage of labour. A survey of these midwives was conducted after completion of the PMLT, but before results had been analysed and presented. The aim of the study was to seek from midwives, following the PMLT, their reasons why some eligible women were not randomly allocated to a group; why others did not receive care as allocated and the midwives' views about the massage, including whether significant trial results would influence their clinical practice. (This paper presents the results of this survey.) Stamp2001 N Hadfield author 2001-Jun text continuing periodical academic journal 1357-6321 2001-Jun 7 6 279 285 Research suggests that aromatherapy massage (AM) is increasingly being used by cancer patients, especially in the palliative care setting, although few studies have assessed its effectiveness. I wanted to find out whether AM reduces anxiety in patients with a primary malignant brain tumour attending their first follow-up appointment after radiotherapy. Eight patients were recruited to the study, which comprised three methods of data collection: the measurement of physical parameters; the completion of Hospital Anxiety and Depression Scales (HADS); and semi-structured interviews. The results from HADS did not show any psychological benefit from AM. However, there was a statistically significant reduction in all four physical parameters, which suggests that AM affects the autonomic nervous system, inducing relaxation. This finding was supported by the patients themselves, all of whom stated during interview that they felt 'relaxed' after AM. Since these patients are faced with limited treatment options and a poor prognosis, this intervention appears to be a good way of offering support and improving quality of life. Hadfield2001 F Vendittelli author J L Tabaste author E Janky author 2001-Oct text continuing periodical academic journal 0368-2315 2001-Oct 30 6 565 571 OBJECTIVE: To assess the effectiveness of ante partum perineal massage to reduce the number of perineal injuries and episiotomies through a survey of the existing literature. MATERIEL AND METHODS: A search both in English and French on randomized clinical trials using the Medline and Cochrane Library databases. The key words: "Perineum", "massage", "perineum injuries", "randomized controlled trial" were selected from the years 1966 to November 2000. RESULTS: Four randomized controlled trials were found. The definition of the selected issues, as well as the included and excluded criteria varied according to the authors. Perineal massages seemed to reduce the occurrence of perineal injuries and episiotomies, mostly among primipara: Labrecque et al. in 1999, noted an OR of 0.56; 95% CI: 0.61-1.31 and at the opposite an increased rate of intact perineum in the massage group (OR = 1.79; 95% CI 1.27-2.52]; and Shipman et al. in 1997 stressed among women of > or = 30 years old an augmentation of intact perineum in the intervention group (OR = 1.93; 95% CI 1.08-3.48), and in the logistic regression taking into account age and birth weight they found a reduction of episiotomies and important perineal injuries (p = 0.02). CONCLUSION: Ante partum perineal massages would seem valid but further studies would be necessary to evaluate the utility of this intervention in the avoidance of serious perineal injuries and the women's satisfaction. Vendittelli2001 C M Shirreffs author 2001-May text continuing periodical academic journal 1353-6117 2001-May 7 2 78 78 The following case study will look at the efficacy of aromatherapy massage in a patient diagnosed with Guillian Barré Syndrome admitted to an IntensiveTherapy Unit.The pathophysiology of this disorder will be discussed, medical treatment will be outlined and adjuncts to conventional nursing care will be presented. Aromatherapy massage was used to complement the conventional nursing and medical treatment of joint pain and constipation.The Mead Model for nursing care was used for assessment and the plan of care devised from this. Evaluation of outcomes were incorporated into the implementation protocol to ensure positive outcomes were achieved. Shirreffs2001 R Simpson author 2001-Feb text continuing periodical academic journal 1353-6117 2001-Feb 7 1 25 25 This article describes the role of the International Association of Infant Massage (IAIM) in promoting the importance of touch for the developing relationship between the parents and infants. Infants are unique personalities and it is important that the parent learns how to respond appropriately to the infant's needs. Infant massage classes can demonstrate and promote interaction with infants using eye-to-eye contact, recognizing infant cues, talking and singing, and responding in a loving and sensitive manner. The photographs are of an infant massage class held recently in Leicestershire. Simpson2001 Renee A Gecsedi author text continuing periodical academic journal 1092-1095 6 1 52 54 Patients with cancer often use massage therapy as an adjunct treatment. Oncology nurses can be advocates for patients seeking massage therapy by educating them to be informed consumers of massage therapy. They can stress that patients with cancer use massage therapists who have graduated from accredited programs, meet state licensure requirements, and have specialized training in the massage of patients with cancer. Oncology nurses often are the link between the physician ordering or approving this therapy and the LMT delivering the therapy. LMT's need information about a patient's cancer diagnosis, comorbidities, type of treatment, and reponse to treatment to safely provide massage therapy. Nurses play an important role in conveying this information and information LMT's about any special considerations, such as the presence of neutropenia or thrombocytopenia. Safe and effective massage therapy to patients with cancer only is achieved when the patient, healthcare providers, and LMT collaborate effectively. Gecsedi2001 A Escalona author T Field author R Singer-Strunck author C Cullen author K Hartshorn author 2001-Oct text continuing periodical academic journal 0162-3257 2001-Oct 31 5 513 516 Twenty children with autism, ages 3 to 6 years, were randomly assigned to massage therapy and reading attention control groups. Parents in the massage therapy group were trained by a massage therapist to massage their children for 15 minutes prior to bedtime every night for 1 month and the parents of the attention control group read Dr. Seuss stories to their children on the same time schedule. Conners Teacher and Parent scales, classroom and playground observations, and sleep diaries were used to assess the effects of therapy on various behaviors, including hyperactivity, stereotypical and off-task behavior, and sleep problems. Results suggested that the children in the massage group exhibited less stereotypic behavior and showed more on-task and social relatedness behavior during play observations at school, and they experienced fewer sleep problems at home. Escalona2001 M Henrickson author 2001-Dec text continuing periodical academic journal 0954-0121 2001-Dec 13 6 743 748 This paper uses an innovative methodology to evaluate clinical outcomes and patient perceptions of acupuncture and massage therapies in an HIV medical outpatient setting. Using a quasi-experimental retrospective case control design, treatment subjects were matched by intake date and CD4 count with non-treatment subjects. All subjects had equal opportunity to access HAART therapies and other standard treatments for HIV. There were three treatment groups: acupuncture-only (n = 8), massage-only (n = 34) and acupuncture-and-massage (n = 21). Pre-treatment and post-treatment measures were compared within groups, and treatment and non-treatment group clinical outcomes were compared with each other. Using nonparametric statistical analysis, it was found that the means of the treatment groups' differences in pre- and post-CD4 counts showed improvement when compared with the non-treatment control group's pre- and post-CD4 counts. Treatment subjects were then interviewed and asked to rate their experiences of the therapies; the subjective experience was very positive. The reasons for these findings may be complex, including the possibility that some people may choose to manage their disease more aggressively, and may select a range of treatments. While no large claims are made for this study, these findings may be of interest both to clinicians and funders of acupuncture and/or massage therapies. Henrickson2001 10.1080/09540120120076904 C Goessl author M MÃŒller author R Heicappell author H Krause author B Straub author M Schrader author K Miller author 2001-Sep text continuing periodical academic journal 1527-9995 2001-Sep 58 3 335 338 OBJECTIVES: Promoter hypermethylation of the glutathione-S-transferase P1 (GSTP1) gene is a specific feature of prostate cancer. This epigenetic DNA alteration served as the target for molecular detection of prostate cancer cells in urine sediments after prostatic massage. METHODS: Bisulfite treatment followed by methylation-specific polymerase chain reaction was used to detect GSTP1 promoter hypermethylation in DNA isolated from urine sediments obtained after prostatic massage of men with and without prostate cancer. RESULTS: GSTP1 promoter hypermethylation was demonstrated in the sediments of 1 (2%) of 45 patients diagnosed with benign prostatic hyperplasia, 2 (29%) of 7 patients with prostatic intraepithelial neoplasia, 15 (68%) of 22 patients with early, intracapsular cancer, and 14 (78%) of 18 patients with locally advanced or systemic prostate cancer, resulting in a specificity of 98% and an overall sensitivity of 73% for the detection of prostate cancer. CONCLUSIONS: Urinalysis for GSTP1 promoter hypermethylation constitutes a sensitive and highly specific DNA-based marker for molecular detection of prostate cancer, including early stages. Goessl2001 D Kalauokalani author D C Cherkin author K J Sherman author T D Koepsell author R A Deyo author 2001-Jul-01 text continuing periodical academic journal 0362-2436 2001-Jul-1 26 13 1418 1424 STUDY DESIGN: A subanalysis of data derived from a randomized clinical trial was performed. OBJECTIVE: To evaluate the association of a patient's expectation for benefit from a specific treatment with improved functional outcome. SUMMARY OF BACKGROUND DATA: Psychosocial factors, ambiguous diagnoses, and lack of a clearly superior treatment have complicated the management of patients with chronic low back pain. The authors hypothesized that patient expectation for benefit from a specific treatment is associated with improved functional outcomes when that treatment is administered. METHODS: In a randomized trial, 135 patients with chronic low back pain who received acupuncture or massage were studied. Before randomization, study participants were asked to describe their expectations regarding the helpfulness of each treatment on a scale of 0 to 10. The primary outcome was level of function at 10 weeks as measured by the modified Roland Disability scale. RESULTS: After adjustment for baseline characteristics, improved function was observed for 86% of the participants with higher expectations for the treatment they received, as compared with 68% of those with lower expectations (P = 0.01). Furthermore, patients who expected greater benefit from massage than from acupuncture were more likely to experience better outcomes with massage than with acupuncture, and vice versa (P = 0.03). CONCLUSIONS: The results of this study suggest that patient expectations may influence clinical outcome independently of the treatment itself. In contrast, general optimism about treatment, divorced from a specific treatment, is not strongly associated with outcome. These results may have important implications for clinical trial design and recruitment, and may help to explain the apparent success of some conventional and alternative therapies in trials that do not control for patient expectations. The findings also may be important for therapy choices made in the clinical setting. Kalauokalani2001 D Stewart author J Weeks author S Bent author text continuing periodical academic journal 1078-6791 7 4 66 66 CONTEXT: Increasing numbers of health plans in the United States offer complementary and alternative medicine (CAM) benefits despite limited information. OBJECTIVE: To determine the utilization rates and costs associated with providing CAM services in 2 benefit designs, and to determine the satisfaction of patients in both plans. DESIGN: Two health plans were identified: a traditional indemnity plan offered through a defined preferred provider organization (PPO) of CAM providers and a health maintenance organization (HMO). Costs and utilization rates for CAM services were compared during a 1-year period of coverage beginning November 1, 1996. SETTING AND PARTICIPANTS: 1091 patients in both plans who used CAM services during the month of May 1997 in Washington state. RESULTS: Only 1% of all patients covered for CAM accessed these services during the study period. A significantly higher percentage of patients in the PPO plan (1.2%) used CAM services compared to the HMO plan (0.6%) (P < .001). However, the average total cost of annual CAM services (plan benefit + user contribution) was similar ($347 in the HMO and $376 in the PPO), and the price per member per month was nearly identical ($0.20 in the HMO and $0.19 in the PPO). Most users perceived these services as helpful. CONCLUSIONS: Utilization of CAM services and per member per month costs were lower than expected given the high interest in CAM services reported in consumer surveys. The high level of satisfaction with CAM services and self-reported decrease in the use of pain medications suggests the need for prospective studies examining the effect of CAM treatments. Stewart2001 D Irnich author N Behrens author H Molzen author A König author J Gleditsch author M Krauss author M Natalis author E Senn author A Beyer author P Schöps author 2001-Jun-30 text continuing periodical academic journal 0959-8138 2001-Jun-30 322 7302 1574 1578 OBJECTIVES: To compare the efficacy of acupuncture and conventional massage for the treatment of chronic neck pain. DESIGN: Prospective, randomised, placebo controlled trial. Setting: Three outpatient departments in Germany. PARTICIPANTS: 177 patients aged 18-85 years with chronic neck pain. Interventions: Patients were randomly allocated to five treatments over three weeks with acupuncture (56), massage (60), or "sham" laser acupuncture (61). MAIN OUTCOME MEASURES: Primary outcome measure: maximum pain related to motion (visual analogue scale) irrespective of direction of movement one week after treatment. Secondary outcome measures: range of motion (3D ultrasound real time motion analyser), pain related to movement in six directions (visual analogue scale), pressure pain threshold (pressure algometer), changes of spontaneous pain, motion related pain, global complaints (seven point scale), and quality of life (SF-36). Assessments were performed before, during, and one week and three months after treatment. Patients' beliefs in treatment were assessed. RESULTS: One week after five treatments the acupuncture group showed a significantly greater improvement in motion related pain compared with massage (difference 24.22 (95% confidence interval 16.5 to 31.9), P=0.0052) but not compared with sham laser (17.28 (10.0 to 24.6), P=0.327). Differences between acupuncture and massage or sham laser were greater in the subgroup who had had pain for longer than five years (n=75) and in patients with myofascial pain syndrome (n=129). The acupuncture group had the best results in most secondary outcome measures. There were no differences in patients' beliefs in treatment. CONCLUSIONS: Acupuncture is an effective short term treatment for patients with chronic neck pain, but there is only limited evidence for long term effects after five treatments. Irnich2001 D Adcock author S Paulsen author K Jabour author S Davis author L B Nanney author R B Shack author 2001-Jul text continuing periodical academic journal 0032-1052 2001-Jul 108 1 233 240 Deep mechanical massage has been advocated as an alternative or adjunctive therapy for the contouring of subcutaneous fat and as a treatment for cellulite. We evaluated the effects of deep mechanical massage using two pig models. Yucatan pigs were divided into three groups (n = 4). One side of each body received 4, 10, or 20 treatments and the other side served as a control. Full-thickness tissue sections, including the underlying muscle, were harvested from identical treated and untreated regions. Examination of these regionally matched samples revealed an accumulation of dense, longitudinal collagen bands in the middle dermal and deep subdermal regions, which progressively increased with the number of treatments. Distortion and disruption of adipocytes was noted. In Yorkshire pigs, force-transducing balloon catheters were surgically placed between the deep subcutaneous tissue and muscle fascia. Catheters were inserted into two regions with different skin and subcutaneous tissue characteristics, the midflank and the hip. Standardized maneuvers were performed at suction settings 3, 5, 7, and 9 to record baseline tissue forces. Each maneuver carried a unique force signature. The measurement of tissue forces was repeated on the opposite side after 10 standardized treatment sessions. Analysis showed a significant reduction of measured forces at the midflank after the treatments. The actual force measured with each particular maneuver varied between different operators but not with different suction settings, suggesting that the technique of administering the treatments is the primary factor in creating the force within the tissue. This leads to the conclusion that deep mechanical massage is highly dependent on the individual operator of the device. Adcock2001 S Angus author 2001-Apr text continuing periodical academic journal 0891-8422 2001-Apr 18 2 329 336 Winning the gold medal is everything. The competitive sprinter or runner successfully navigates the road to the gold by relying on talent, dedication, and hard work. Along this steep and difficult road, massage therapy provides a powerful tool that helps the athlete reduce recovery time after a track meet, minimize injury, and improve body movement fluidity. Angus2001 A Billhult author K Dahlberg author 2001-Jun text continuing periodical academic journal 0162-220X 2001-Jun 24 3 180 184 The experience of massage in an oncology ward was the focus of this study. Eight female cancer patients were given massage for 10 consecutive days and then interviewed using phenomenology as a theoretical framework. The essential meaning of getting massage as part of the daily care for female cancer patients was described as getting a meaningful relief from suffering. The findings identified five themes: the relief is meaningful because it offers the patient an experience of being "special." The massage contributes to the development of a positive relationship with the personnel, to feeling strong, and to a balance between autonomy and dependence. The massage also brings about a meaningful relief from suffering because it just "feels good." The findings of this study can be of use to health care professionals as it shows that the relatively short period of massage can result in physical and emotional benefits for cancer patients. Billhult2001 M S Kim author K S Cho author H Woo author J H Kim author 2001-Jun text continuing periodical academic journal 0886-3350 2001-Jun 27 6 884 890 PURPOSE: To evaluate the effects of hand massage on patient anxiety during cataract surgery. SETTING: Kangnam St. Mary's Hospital, Seoul, Korea. METHODS: This study comprised 59 patients having cataract surgery from December 11, 1996, to February 12, 1997. The patients were divided into those having a hand massage 5 minutes before surgery (experimental group, n = 29) and those not receiving a hand massage (control group, n = 30). Patients' anxiety levels were measured using the Visual Analog Scale and by assessing the systolic blood pressure, diastolic blood pressure, and pulse rate before and after the hand massage and 5 minutes before the end of surgery. Epinephrine, norepinephrine, cortisol, blood sugar levels, neutrophil, and lymphocyte percentages in white blood cells were also measured. RESULTS: After the hand massage, the psychological anxiety levels, systolic and diastolic blood pressures, and pulse rate were significantly lower than before the massage. The hand massage significantly decreased epinephrine and norepinephrine levels in the experimental group. Epinephrine, norepinephrine, and cortisol levels increased in the control group. The differences between groups were significant. There were no significant between-group differences in blood sugar levels or neutrophil and lymphocyte percentages in white blood cells. CONCLUSION: The findings indicate that hand massage decreases the psychological and physiological anxiety levels in patients having cataract surgery under local anesthesia. Kim2001 G Stamp author G Kruzins author C Crowther author 2001-May-26 text continuing periodical academic journal 0959-8138 2001-May-26 322 7297 1277 1280 OBJECTIVE: To determine the effects of perineal massage in the second stage of labour on perineal outcomes. DESIGN: Randomised controlled trial. Participants: At 36 weeks' gestation, women expecting normal birth of a singleton were asked to join the study. Women became eligible to be randomised in labour if they progressed to full dilatation of the cervix or 8 cm or more if nulliparous or 5 cm or more if multiparous. 1340 were randomised into the trial. INTERVENTION: Massage and stretching of the perineum during the second stage of labour with a water soluble lubricant. MAIN OUTCOME MEASURES: Primary outcomes: rates of intact perineum, episiotomies, and first, second, third, and fourth degree tears. SECONDARY OUTCOMES: pain at three and 10 days postpartum and pain, dyspareunia, resumption of sexual intercourse, and urinary and faecal incontinence and urgency three months postpartum. RESULTS: Rates of intact perineums, first and second degree tears, and episiotomies were similar in the massage and the control groups. There were fewer third degree tears in the massage group (12 (1.7%) v 23 (3.6%); absolute risk 2.11, relative risk 0.45; 95% confidence interval 0.23 to 0.93, P<0.04), though the trial was underpowered to measure this rarer outcome. Groups did not differ in any of the secondary outcomes at the three assessment points. CONCLUSIONS: The practice of perineal massage in labour does not increase the likelihood of an intact perineum or reduce the risk of pain, dyspareunia, or urinary and faecal problems. Stamp2001 M Labrecque author E Eason author S Marcoux author 2001-May text continuing periodical academic journal 1470-0328 2001-May 108 5 499 499 OBJECTIVE: To determine how women who practised perineal massage during pregnancy assessed the technique. DESIGN: Observational study within one arm of a randomised controlled trial. SETTING: Five secondary and tertiary care hospitals in the Province of Quebec, Canada. PARTICIPANTS: Among 763 women randomised to the massage arm of a clinical trial of perineal massage during pregnancy, 684 (90%) who completed a questionnaire after delivery. MAIN OUTCOME MEASURES: A 20-item questionnaire completed a few days after birth. The first 18 questions elicited opinions using a 6-point Likert scale. Based on a factor analysis, 17 of these questions were classified into four categories: acceptability of perineal massage (8 items); preparation for birth (4 items); relationship with the partner (2 items); and effect of massage on delivery (3 items). Scores of each scale varied between 1 (highly negative assessment) to 6 (highly positive assessment). The last two questions asked whether women would perform the massage in their next pregnancy and whether they would recommend perineal massage to another pregnant woman. In addition, 262 also provided comments about their experience in the daily diary provided to record compliance during the trial. RESULTS: On average, perineal massage was felt to be quite acceptable [mean (standard deviation) 4.09 (0.93)]. Pain and technical problems reported during the first week or two of massage tended to disappear after a few weeks. Women's assessment of the effect of massage on preparation for birth [4.34 (1.08)] and on delivery [4.18 (1.37)] was positive. Women's views about the effect on their relationship with their partner were either positive or negative [3.54 (1.74)] and were proportional to the partner's participation with the massage. Most women said they would massage again if they were to have another pregnancy (79%; 95% CI, 76%-82%) and would recommend it to another pregnant woman (87%; 95% CI 84%-90%). CONCLUSION: Overall, women's assessment of prenatal perineal massage is positive. Labrecque2001 F H Meid author C M Gygi author H J Leisinger author F T Bosman author J Benhattar author 2001-May text continuing periodical academic journal 0022-5347 2001-May 165 5 1802 1805 PURPOSE: Prostate cancer is the most commonly diagnosed cancer in the United States. The diagnosis or followup of prostate cancer in men older than 50 years is based on digital rectal examination, measurement of the free-to-total prostatic specific antigen ratio and transrectal ultrasound assisted needle biopsy of the prostate. We developed and evaluated a noninvasive method for diagnosing prostate cancer based on the measurement of telomerase activity after prostatic massage in fresh voided urine or after urethral washing. MATERIALS AND METHODS: We obtained 36 specimens of cells after prostatic massage in the fresh voided urine of 16 patients who subsequently underwent radical prostatectomy and after urethral washing in 20 who underwent prostate needle biopsies. Ethylenediaminetetraacetic acid was immediately added to the collected urine or washing to a final concentration of 20 mM. After protein extraction by CHAPS buffer each specimen was tested for telomerase activity in a 2-step modified telomeric repeat amplification protocol assay. The 2 prostate cancer cell lines PC-3 and LNCaP with high telomerase activity were used as a positive control. RESULTS: Telomerase activity was detected in 14 of 24 samples with known prostate cancer (sensitivity 58%). In contrast, no telomerase activity was found in the 12 cases without histological evidence of prostate tumor (specificity 100%). Eight of 9 poorly differentiated cancers expressed telomerase activity (89%), while only 6 of 15 well and moderately differentiated cancers showed telomerase activity (40%). CONCLUSIONS: Our data illustrate that telomerase activity may be detected in voided urine or washing after prostatic massage in patients with prostate cancer. Sensitivity was higher for poorly differentiated tumors. This approach is not currently available for detecting prostate cancer in clinical practice. However, these results are promising and further studies are ongoing. Meid2001 B T Mackey author 2001-Mar text continuing periodical academic journal 0029-6465 2001-Mar 36 1 159 170 Massage therapy and reflexology are manual therapeutic approaches used to facilitate healing and health and can be used by nurses in almost any setting. Information about massage therapy and reflexology is shared for the purpose of creating awareness about healing modalities and encouraging the use of basic techniques of these manual therapies. A review of a case study illustrates the safe and effective use of massage therapy and reflexology and familiarizes the nurse with the components of assessment and hands-on practice. Holistic nursing principles related to massage therapy and reflexology are woven throughout the text. Mackey2001 D C Cherkin author D Eisenberg author K J Sherman author W Barlow author T J Kaptchuk author J Street author R A Deyo author 2001-Apr-23 text continuing periodical academic journal 0003-9926 2001-Apr-23 161 8 1081 1088 BACKGROUND: Because the value of popular forms of alternative care for chronic back pain remains uncertain, we compared the effectiveness of acupuncture, therapeutic massage, and self-care education for persistent back pain. METHODS: We randomized 262 patients aged 20 to 70 years who had persistent back pain to receive Traditional Chinese Medical acupuncture (n = 94), therapeutic massage (n = 78), or self-care educational materials (n = 90). Up to 10 massage or acupuncture visits were permitted over 10 weeks. Symptoms (0-10 scale) and dysfunction (0-23 scale) were assessed by telephone interviewers masked to treatment group. Follow-up was available for 95% of patients after 4, 10, and 52 weeks, and none withdrew for adverse effects. RESULTS: Treatment groups were compared after adjustment for prerandomization covariates using an intent-to-treat analysis. At 10 weeks, massage was superior to self-care on the symptom scale (3.41 vs 4.71, respectively; P =.01) and the disability scale (5.88 vs 8.92, respectively; P<.001). Massage was also superior to acupuncture on the disability scale (5.89 vs 8.25, respectively; P =.01). After 1 year, massage was not better than self-care but was better than acupuncture (symptom scale: 3.08 vs 4.74, respectively; P =.002; dysfunction scale: 6.29 vs 8.21, respectively; P =.05). The massage group used the least medications (P<.05) and had the lowest costs of subsequent care. CONCLUSIONS: Therapeutic massage was effective for persistent low back pain, apparently providing long-lasting benefits. Traditional Chinese Medical acupuncture was relatively ineffective. Massage might be an effective alternative to conventional medical care for persistent back pain. Cherkin2001 J D Dishman author R Bulbulian author 2001-Mar text continuing periodical academic journal 0301-150X 2001-Mar 41 2 97 97 The purpose of this study was to compare the magnitude and duration of motoneuron inhibition occurring as a sequel to spinal manipulation or paraspinal and limb massage. The physiologic mechanisms involved in spinal manipulative therapy and massage therapy are largely unknown. One possible hypothesis is based upon the theory that these two distinct and different modalities may attenuate the activity of alpha motoneurons. Both modalities have been reported to produce short-term inhibition of motoneurons. Asymptomatic volunteers were randomly assigned to either a spinal manipulation, massage, or control group. Baseline tibial nerve H-reflex amplitudes were obtained prior to the application of either lumboscaral spinal manipulation or paralumbar and limb massage. Post-interventional H-reflex recordings were recorded immediately following the application of either modality. Spinal manipulation significantly (p < 0.05) attenuated alpha motoneuronal activity immediately post-therapy, as measured by the amplitude of the tibial nerve H-reflex. Massage subjects exhibited no significant reduction in motoneuronal activity immediately following administration. Spinal manipulation produced a transient attenuation of alpha motoneuronal excitability. Paraspinal and limb massage did not inhibit the motoneuron pool as measured immediately post-therapy. These findings support the supposition that spinal manipulation procedures lead to short-term inhibitory effects on motoneuron excitability to a greater magnitude than massage. Dishman2001 M Ludwig author C Steltz author P Huwe author R SchÀffer author M Altmannsberger author W Weidner author 2001-Mar text continuing periodical academic journal 0302-2838 2001-Mar 39 3 277 282 OBJECTIVE: To evaluate the presence of leukocyte subpopulations in urine after prostatic massage (VB 3) in symptomatic patients with > or =10 leukocytes/high power field (magnification x1,000) in expressed prostatic secretions, and who were classified as suffering from chronic bacterial prostatitis or inflammatory chronic pelvic pain syndrome. METHODS: 115 consecutive patients were investigated. Granulocytes in centrifuged midstream urine (VB 2) and VB 3 were counted after Papanicolaou stain. Macrophages, B and T lymphocytes were analyzed after immunocytological staining with monoclonal antibodies according to the alkaline phosphatase anti-alkaline phosphatase method. The counts were quantified as the number of cells per view field at a magnification of x400. In all patients, acute or chronic urethritis had been excluded before enrollment in the study. 16 men without signs or symptoms of urogenital inflammation served as controls. RESULTS: Of the 115 patients, 101 men demonstrated > or =10 leukocytes/view field in VB 3. In comparison to VB 2, the leukocyte subpopulations in VB 3 demonstrated an increase in granulocytes (9.2-fold), macrophages (7.6-fold), T lymphocytes (7.6-fold), and B lymphocytes (4-fold). The increase was statistically significant (p<0.001 each). The proportion of these cells in VB 3 was 81.6, 11.1, 5.5, and 1.8%, respectively. As compared to controls, all leukocyte subsets in VB 3 were significantly elevated (p>0.001 each). CONCLUSION: Elevated numbers of leukocytes in VB 3 are indicative of prostatitis provided that urethral inflammation and leukocyturia in VB 2 are excluded. Granulocytes are the predominant cell type of inflammation. The increase in macrophages, T and B lymphocytes in prostatic secretions indicate the participation of both the cellular and humoral immune system in the inflammatory process. Ludwig2001 M Hernandez-Reif author T Field author J Krasnegor author H Theakston author 2001 text continuing periodical academic journal 0020-7454 2001 106 3-4 131 145 STUDY DESIGN: A randomized between-groups design evaluated massage therapy versus relaxation for chronic low back pain. OBJECTIVES: Treatment effects were evaluated for reducing pain, depression, anxiety and stress hormones, and sleeplessness and for improving trunk range of motion associated with chronic low back pain. SUMMARY of BACKGROUND DATA: Twenty-four adults (M age=39.6 years) with low back pain of nociceptive origin with a duration of at least 6 months participated in the study. The groups did not differ on age, socioeconomic status, ethnicity or gender. METHODS: Twenty-four adults (12 women) with lower back pain were randomly assigned to a massage therapy or a progressive muscle relaxation group. Sessions were 30 minutes long twice a week for five weeks. On the first and last day of the 5-week study participants completed questionnaires, provided a urine sample and were assessed for range of motion. RESULTS: By the end of the study, the massage therapy group, as compared to the relaxation group, reported experiencing less pain, depression, anxiety and improved sleep. They also showed improved trunk and pain flexion performance, and their serotonin and dopamine levels were higher. CONCLUSIONS: Massage therapy is effective in reducing pain, stress hormones and symptoms associated with chronic low back pain. PRECIS: Adults (M age=39.6 years) with low back pain with a duration of at least 6 months received two 30-min massage or relaxation therapy sessions per week for 5 weeks. Participants receiving massage therapy reported experiencing less pain, depression, anxiety and their sleep had improved. They also showed improved trunk and pain flexion performance, and their serotonin and dopamine levels were higher. Hernandez-Reif2001 M A Diego author T Field author M Hernandez-Reif author K Shaw author L Friedman author G Ironson author 2001-Jan text continuing periodical academic journal 0020-7454 2001-Jan 106 1-2 35 35 HIV+adolescents (M CD4=466 mm3) recruited from a large urban university hospital's outpatient clinic were randomly assigned to receive massage therapy (n=12) or progressive muscle relaxation (n=12) two-times per week for 12 weeks. To assess treatment effects, participants were assessed for depression, anxiety and immune changes before and after treatment the 12 weeks treatment period. Adolescents who received massage therapy versus those who experienced relaxation therapy reported feeling less anxious and they were less depressed, and showed enhanced immune function by the end of the 12 week study. Immune changes included increased Natural Killer cell number (CD56) and CD56+CD3-. In addition, the HIV disease progression markers CD4/CD8 ratio and CD4 number showed an increase for the massage therapy group only. Diego2001 A S Matthiesen author A B Ransjö-Arvidson author E Nissen author K UvnÀs-Moberg author 2001-Mar text continuing periodical academic journal 0730-7659 2001-Mar 28 1 13 19 BACKGROUND: Newborns placed skin-to-skin with their mothers show an inborn sequence of behavior similar to that seen in other mammals. The purpose of this study was to make a detailed exploration of hand movements and sucking behavior in healthy term newborns who were placed skin-to-skin on their mothers' chests, and to study maternal oxytocin release in relation to these behaviors. METHODS: Ten vaginally delivered infants whose mothers had not been exposed to maternal analgesia were video-recorded from birth until the first breastfeeding. Video protocols were developed based on observations of the videotapes. Each infant's hand, finger, mouth, and tongue movements, positions of the hand and body, and sucking behavior were assessed every 30 seconds. Maternal blood samples were collected every 15 minutes, and oxytocin levels were analyzed by radioimmunoassay. A statistical test for establishing the relationship between maternal oxytocin levels and infants' hand movements or sucking behavior was developed. RESULTS: Infants used their hands to explore and stimulate their mother's breast in preparation for the first breastfeeding. A coordinated pattern of infant hand and sucking movements was also identified. When the infants were sucking, the massagelike hand movements stopped and started again when the infants made a sucking pause. Periods of increased massagelike hand movements or sucking of the mother's breast were followed by an increase in maternal oxytocin levels (p < 0.005). CONCLUSIONS: The findings indicate that the newborns use their hands as well as their mouths to stimulate maternal oxytocin release after birth, which may have significance for uterine contraction, milk ejection, and mother-infant interaction. Matthiesen2001 K Onozawa author V Glover author D Adams author N Modi author R C Kumar author 2001-Mar text continuing periodical academic journal 0165-0327 2001-Mar 63 1-3 201 207 BACKGROUND: Postnatal depression can have long term adverse consequences for the mother-infant relationship and the infant's development. Improving a mother's depression per se has been found to have little impact on mother-infant interaction. The aims of this study were to determine whether attending regular massage classes could reduce maternal depression and also improve the quality of mother-infant interaction. METHOD: Thirty-four primiparous depressed mothers, median 9 weeks postpartum, identified as being depressed following completion of the Edinburgh Postnatal Depression Scale (EPDS) at 4 weeks postpartum, were randomly allocated either to an infant massage class and a support group (massage group) or to a support group (control group). Each group attended for five weekly sessions. Changes in maternal depression and mother-infant interaction were assessed at the beginning and the end of the study by comparing EPDS scores and ratings of videotaped mother-infant interaction. RESULTS: The EPDS scores fell in both groups. Significant improvement of mother-infant interaction was seen only in the massage group. LIMITATION: The sample size was small and had relatively high dropout. It was not possible to distinguish which aspects of the infant massage class contributed to the benefit. CONCLUSION: This study suggests that learning the practice of infant massage by mothers is an effective treatment for facilitating mother-infant interaction in mothers with postnatal depression. Onozawa2001 S S Bass author C E Cox author C J Salud author G H Lyman author C McCann author E Dupont author C Berman author D S Reintgen author 2001-Jan text continuing periodical academic journal 1072-7515 2001-Jan 192 1 9 9 BACKGROUND: The technique of lymphatic mapping and sentinel lymph node (SLN) biopsy is rapidly becoming the preferred method of staging the axilla of the breast cancer patient. This report describes the impact of postinjection massage on the sensitivity of this surgical technique. STUDY DESIGN: Lymphatic mapping at the H Lee Moffitt Cancer Center is performed using a combination of isosulfan blue dye and Tc99m labeled sulfur colloid. Data describing the rate of SLN identification and the node characteristics from 594 consecutive patients were calculated. Patients who received a 5-minute massage after injection of blue dye and radiocolloid were compared with a control group in which the patients did not receive a postinjection massage. RESULTS: When compared with controls, the proportion of patients who had their SLN identified using blue dye after massage increased from 73.0% to 88.3%, and the proportion of patients who had their SLN identified using radiocolloid after massage increased from 81.7% to 91.3%. The overall rate of SLN identification increased from 93.5% to 97.8%. The proportion of nodes that were stained blue among those removed increased from 73.4% to 79.7% after massage. CONCLUSIONS: As experience increases with this new procedure, the surgical technique of lymphatic mapping continues to evolve. The addition of a postinjection massage significantly improves the uptake of blue dye by SLNs and may also aid in the accumulation of radioactivity in the SLNs, further increasing the sensitivity of this procedure. Bass2001 Tiffany Field author Christy Cullen author Miguel Diego author Maria Hernandez-Reif author Phillippa Sprinz author Kristen Beebe author Bonnie Kissell author Vivian Bango-Sanchez author 2001-10 text continuing periodical academic journal Twenty children with leukemia were provided with daily massage therapy by their parents and were compared to a standard treatment control group. Following a month of massage therapy, depressed mood decreased in the children's parents, and the children's white blood cell and neutrophil counts increased. Field2001 10.1054/jbmt.2001.0228 2001-10 5 4 271 274 squaring the circle of practitioner damage Gerry Pyves author 2001-07 text continuing periodical academic journal Massage therapists are incurring serious injury as a result of using techniques that have not changed in over 200 years. Recent research points to an injury pandemic that is only now coming to the surface. Massage has reinvented itself over the last 100 years into numerous body-therapies that would be unrecognizable to Per Henrik Ling, the father of western massage. Techniques originally designed to be used for only a few minutes are now used throughout the session to the detriment of the practitioner's health. Altering the contact point of massage and the practitioner's own body-movements are essential for healthy practitioners and a healthy profession. These alternative contact points can be safely used for soft and nurturing strokes as well as for deep structural bodywork. The forearm in particular offers a variety of appropriate surfaces that enable the bodyworker to achieve the same effects as conventional hand-based massage strokes. Pyves2001 10.1054/jbmt.2000.0213 2001-7 5 3 173 180 Andrzej Jancewicz author 2001-01 text continuing periodical academic journal Tai Chi Chuan has traditionally been used and is still practised by millions of Chinese people, especially the elderly as an exercise and therapeutic tool. Since the advent of Traditional Chinese Medicine in the west, there has been an increasing interest in its potential health benefits by an increasing number of health professionals, including doctors, nurses, physiotherapists and occupational therapists. This literature review focuses on the increasing evidence of Tai Chi as an exercise activity which can improve fitness, and that with regular application can lead to an increase in functional abilities of coordination and joint mobility, as well as improve self esteem and confidence. The literature review on Tai Chi provides evidence as to the potential for Tai Chi in the prevention and treatment of many conditions associated with ageing, amongst them loss of balance and strength (frailty), and cardiorespiratory function, as well as psychological factors associated with the ageing process.It is concluded that Tai Chi Chuan can prevent many of the problems associated with ageing, but that further research needs to be undertaken into the use of Tai Chi as a therapeutic tool for combating chronic disease. Jancewicz2001 10.1054/jbmt.2000.0178 2001-1 5 1 70 77 prevention and treatment Rona McCandlish author 2001-11 periodical This article examines two aspects of routine midwifery practice: management of the perineum at the end of the second stage of labor and management and repair of perineal injury. Although some aspects of perineal management and repair have been researched and there is reliable evidence on which to base practice, there remains a considerable and urgent collaborative clinical research agenda that midwives should actively pursue. 15269523 McCandlish2001 10.1016/S1526-9523(01)00205-7 2001-Nov/Dec 46 6 396 401 PB - an evidence-based approach Mary C Brucker author 2001-11 periodical The third stage of labor usually is eclipsed by the excitement of the birth of a baby. Evidence shows that management of this stage can directly influence important maternal outcomes such as blood loss, need for manual removal of the placenta, and postpartum hemorrhage. Most of the large trials have compared active management of the third stage to expectant management. Active management includes routine use of cord traction and uterotonins, whereas expectant management can be characterized as one of watchful waiting. The use of herbal therapies and homeopathic remedies lack study; additional factors such as site of birth and hydrotherapy also remain to be explored. However, on the basis of current evidence, if a decrease in postpartum bleeding or avoidance of manual removal is desired, an active approach to third stage is the one that should be adopted until and unless contradictory findings are published. 15269523 Brucker2001 10.1016/S1526-9523(01)00192-1 2001 46 6 381 392 PB - B Holland author M E Pokorny author text continuing periodical academic journal 0278-4807 2001-Sep/Oct 26 5 182 186 A quasi-experimental design was used to determine the effects of three consecutive days of slow stroke back massage (SSBM) on adult patients in a rehabilitation setting. This study used the Huckstadt Touch Instrument to assess physiological and psychological responses to touch, as well as the recipients' perceptions of touch. The convenience sample comprised 24 adult patients in a rehabilitation hospital in southeastern North Carolina. Subjects' ages ranged between 52 and 88 years with a mean of 71.8 years. There was a significant decrease in systolic and diastolic blood pressure after SSBM on all 3 days. There was a statistically significant decrease in mean heart rate and mean respiratory rate on Days 1 and 3. There was no psychological change in any of the patients. Perception scores, however, indicate a positive response to SSBM. Patients perceived it as being comfortable, good, pleasant, and warm. On all occasions, their responses indicated that the intervention made them feel cared for, happy, physically relaxed, less anxious, calm, restful, and gave them a feeling of closeness with the nurse. Holland2001