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Massage’s Effectiveness and Shoulder ROM

Researcher Young-Ran Yeun (2017) recently released a systematic review with a meta-analysis regarding research studies and shoulder ROM (or range of motion) treatment via massage therapy. Shoulder pain is a common condition across the globe: modern day work stations and other factors can contribute to this familiar ailment (Typical trigger points around the shoulder are: the rotator cuff, latissimus dorsi, teres major, deltoids, and pectoral muscle). Shoulder pain can be chronic and disabling, with severe pain easily limiting a person’s ROM. It is important that treatment of shoulder pain be undertaken as soon as possible, so as to avoid an escalation of pain and/or damage.

Researcher Yeun began his research by looking for appropriate studies for his review. He included studies where shoulder flexion, extension, abduction, internal rotation, and external rotation were measured. After combing through hundreds of studies with certain criteria in mind, the end result found seven studies that could be applied to the review.

Overall, Yeun could conclude that the studies supported the idea that massage therapy is effective at improving shoulder ROM, especially in terms of flexion and abduction.

Sports massage appeared to have the most significant effect. The studies primarily focused on soft-tissue massage using effleurage, petrissage, and friction. These techniques can help with smoothening scar tissue and can loosen deep adhesion in ligaments and tendons.

Another important discovery was that three of the seven studies had participants with a mean age of 60 or over. This research could indicate that massage therapy is especially significant for the elderly. With the physiological aging of the body, including the musculoskeletal system and joint, pain can become more frequent and common. An increase of pain may in turn lead to a decrease in physical movement, which might exacerbate pains further, thereby decreasing a person’s quality of life. Massage therapy might prove an effective complementary treatment for elderly individuals undergoing such disorders.

With massage being a commonly used treatment for shoulder pain and ROM improvement, it is important that the appropriate evidence exists to support its efficacy. Further studies will be needed to truly cement massage therapy’s effectiveness, but this review/meta-analysis seems to indicate that massage is an effective therapy method for improving shoulder ROM, especially flexion and abduction.

Reference:

Yeun, Y. (2017). Effectiveness of massage therapy on the range of motion of the shoulder: a systematic review and meta-analysis. Journal of Physical Therapy Science, 29(2), 365-369. doi:10.1589/jpts.29.365

Aromatherapy Massage for Post-Surgery ICU Patients

Researchers Özlü and Bilican (2017) know about the empirical evidence that indicates massage’s efficacy as an alternative or complementary therapy. Numerous studies have been conducted that verify massage’s ability to alleviate physiological and sometimes emotional ailments, such as quality of life or pain. However, none of these studies had researched ICUs, or intensive care units. The researchers argue that ICUs are the perfect place to implement massage as many of the patients can experience relief via a combination of massage and aromatherapy.

The researchers focused on post-surgery patients in the ICU. ICUs, while incredibly important, can also be uncomfortable for its patients. Many patients have restricted movement after surgery and may experience significant pain. The environment itself can be quite loud, yet also isolated. Sensory deprivations may also become an issue for some patients – having the ability to hear commotions going on in the ICU, but unable to see or understand what is happening. Because of these conditions, many patients can become aggressive and irritated, or even depressed. Another large concern is that of sleep: due to active nature of the ICU, sleep can easily be interrupted and patients may not get enough rest.

For these reasons, researchers wanted to investigate aromatherapy massage’s effectiveness for quality of sleep and physiologic parameters.

The researchers found 60 patients to participate in their study, with half of the sample (30 patients) going to a control group and the other half going to the experimental group. The control group received only routine standard care. The experimental group received a 10-15 minute aromatherapy massage all over the body. Researchers spread a diluted lavender oil with soft, circular motions across the participants’ bodies, including: deltoids, arms, backs, shoulders, thighs, palms, fingers, legs, forearms, belly, chest, feet, and neck. Data was gathered before pre- and post-test.

Researchers found a significant difference in the patients’ quality of sleep. Those who had received the aromatherapy massage scored their sleep quality nearly twice as high as that of the control group. In terms of physiologic parameters, researchers only found a significant difference for patients’ blood pressure, with the experimental group’s blood pressure faring better.

The results of this study implicate that aromatherapy massage can be of incredible benefit to post-surgery patients in an ICU. Surgical pain can easily interfere with sleep, as pain and restricted movement can cause extreme discomfort. Sleep deprivation is especially important to patients recovering in the ICU: lack of sleep can interfere with the body’s immune system and its wound-healing abilities.

Of course, more research will be needed to verify/replicate the results of this study. However, this research provides a great foundation for incorporating aromatherapy massage into hospitals and ICUs.

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Reference:

Ozlu, Z. K., & Biliacn, P. (2017). Effects Of Aromatherapy Massage On The Sleep Quality And Physiological Parameters Of Patients In A Surgical Intensive Care Unit. African Journal of Traditional, Complementary and Alternative medicines, 14(3), 83-88. doi:10.21010/ajtcam.v14i3.9

massage low back pain

“Real-World” Massage for Chronic Low Back Pain

Lower back pain is no unknown culprit – many have found themselves battling this common condition. Yet, while most recover from this pain quickly, some are left with lower back pain for extended periods of time. Chronic lower back pain is experienced as pain in the sacral or lumbar regions with symptoms lasting over three months.

Massage is a common treatment option for chronic lower back pain relief. Massage’s effectiveness at treating this condition is well-known and well-documented; this explains why massage is commonly recommended. However, almost no empirical evidence exists supporting massage as a treatment option in “real world” primary health care. That is, those interested in chronic lower back pain treatment wanted to see more evidence of massage’s effectiveness in “real-world” scenarios.

Researchers Elder et al. (2017) recruited 104 participants with chronic lower back pain from their primary care physicians. 85 participants remained at the 12-week measurement, and 76 completed the full study after 24 weeks. Participants would receive 10 massages within 12 weeks then take measurements; they would then return 12 weeks later for a follow-up measurement.

Participants were assigned to licensed massage therapists in their respective communities. Massage therapists had to have at least five years of professional experience and had to schedule and develop treatment plans. Massage therapists were allowed to apply any massage technique they preferred; because of this, techniques varied widely, from the more common techniques like Swedish massage to the less common like lymphatic drainage or Reiki. By recruiting from participants’ actual primary care physicians, and assigning participants to local massage therapists, researchers were hoping to recreate an authentic experience, as would be experienced by an actual primary care patient.

The researchers measured for variables like pain, quality of life, and physical functionality/disability. At the end of 12 weeks (and 10 massages), participants reported clinically significant improvements across all measures. After 24 weeks, however, these improvements had begun diminishing. Although measurements did not return to baseline scores, they did begin to weaken. It is important to note, though, that improvements of disability/functionality and pain were still considered clinically significant at the 24-week measurement in comparison to the original, baseline scores.

The researchers also noticed that older participants were more likely to achieve better results than their younger counterparts. Participants age 50 and older were 3.75x more likely to achieve clinically significant improvements than their younger counterparts. Another interesting discovery was the effect of prescribed pain medications on score improvements. Researchers found that participants who were continuously prescribed at least one pain medication (including opioids) were 2.46x less likely to achieve clinically significant results.

It is important to understand that this study is only a pilot study – larger, more controlled studies will need to be conducted in order to determine that massage as a primary care treatment is beneficial, accessible, and feasible. Regardless, Elder et al. have established a foundation for future investigations into massage therapy’s effectiveness as a “real-world” treatment option for primary care physicians.

References

Elder, W. G., Munk, N., Love, M. M., Bruckner, G. G., Stewart, K. E., & Pearce, K. (2017). Real-World Massage Therapy Produces Meaningful Effectiveness Signal for Primary Care Patients with Chronic Low Back Pain: Results of a Repeated Measures Cohort Study. Pain Medicine. doi:10.1093/pm/pnw347