miércoles, 24 de abril de 2013

ITM Thai Hand Charity Workshops.

KI would like to thank all of you that have donated through the Thai Hand Charity Workshop. We received an incredible 700 Euros. These funds will be invaluable in providing support to our next batch of 10 volunteers.  Every year, our volunteers assist over 30,000 people in need across Mindanao, e.g.  by providing support to disaster victims, working on improving Muslim Christian relations and developing livelihood projects in some of the poorest areas of the country. Your donation will contribute to the 4 weeks training given to our new volunteers, provide them with basic equipment and travel to the community.

Our 7th batch of volunteers have now completed their placements but most are continuing to work in peace and development.  It is a sign of the success of our program that 7 of them are continuing to work with their host organization and2 are now working for an International NGO here in North Western Mindanao. We are proud of them all as this is a fantastic achievement.

Recent project impact 

Several KI Alumni who are working in NGOs in Mindanao have been involved in the disaster response to Typhoon Pablo (International code name Bopha) which devastated parts of Eastern Mindanao in Dec 2012 with over 1000 dead. Their experience in responding with the devastation caused by the previous typhoon that hit North Western Mindanao has proved invaluable. Ki is delighted to see former volunteers working alongside or as staff of international relief agencies such as Red Cross and Save the Children

2013 and beyond

 We will soon begin the process of recruiting our next batch of volunteers (we have already had 35 applicants without even making an announcement!)  Please tell your friends about our project, we need their support.

For more information about our work, please visit:

Website: www.ki-volunteer.org
Facebook: www.facebook.com/Kapamagogopa

Thank you once again on behalf of everyone at KI

Mariam Barandia
Executive Director

viernes, 19 de abril de 2013

The immediate effects of traditional Thai massage for reducing pain on patients related with episodic tension-type headache


Tension-type headache (TTH) is the most common type of headache syndrome. It leads to impairment in functional, emotional and social activities. Traditional Thai massage (TTM) is an alternative treatment of this disorder. However, there is a lack of strong methodology evidence supporting its efficacy. The purpose of this study was to investigate the immediate effects of TTM on headache intensity (VAS), pressure pain threshold (PPT) and cervical range of motion among patients with episodic tension-type headache (ETTH). Sixty patients with ETTH were randomly assigned to either the TTM group or resting group. Results indicated that both groups showed a significant decrease in VAS after the treatments (1.97 + 1.40, 3.07 + 1.92 score; P < 0.01). VAS between the groups also exhibited a significant difference after the treatments (0.89 score, 95 % CI was 0.30 to 1.48; P < 0.01). PPT was shown a significant increase after the treatment in the TTM group (2.14 + 0.76 kg/cm2; P < 0.01) whereas no significant difference was found in the resting group. Significant difference in PPT between the groups was found after the treatment (0.46 kg/cm2, 95% CI was 0.23 to 0.70; P < 0.01). Moreover, improvement in cervical range of motion among the patients receiving TTM was significantly greater than the other group (P < 0.05). It was concluded that the TTM can reduce pain, and improve pain related parameters in patients with ETTH. Keywords: Traditional Thai massage, Tension-type headache Physical Therapy Program, Graduate School, 2School of Physical Therapy, Faculty of Associated Medical Sciences,

3 Department of Attending Physician of Emergency Medicine, Faculty of Medicine, Khon Kean University

** Back, neck and other joint pain research group *Corresponding author (e-mail: uraiwon@kku.ac.th) 1

jueves, 18 de abril de 2013

The immediate effects of traditional Thai massage on heart rate variability and stress-related parameters in patients with back pain associated with myofascial trigger points.

AuthorsButtagat V, et al. Show all Journal
J Bodyw Mov Ther. 2011 Jan;15(1):15-23. doi: 10.1016/j.jbmt.2009.06.005. Epub 2009 Jul 22.

Division of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen 40002, Thailand. ball3001_4@hotmail.com

The purpose of this study was to investigate the immediate effects of traditional Thai massage (TTM) on stress-related parameters including heart rate variability (HRV), anxiety, muscle tension, pain intensity, pressure pain threshold, and body flexibility in patients with back pain associated with myofascial trigger points. Thirty-six patients were randomly allocated to receive a 30-min session of either TTM or control (rest on bed) for one session. Results indicated that TTM was associated with significant increases in HRV (increased total power frequency (TPF) and high frequency (HF)), pressure pain threshold (PPT) and body flexibility (p<0.05) and significant decreases in self-reported pain intensity, anxiety and muscle tension (p<0.001). For all outcomes, similar changes were not observed in the control group. The adjusted post-test mean values for TPF, HF, PPT and body flexibility were significantly higher in the TTM group when compared with the control group (p<0.01) and the values for pain intensity, anxiety and muscle tension were significantly lower. We conclude that TTM can increase HRV and improve stress-related parameters in this patient population.

lunes, 15 de abril de 2013

Thai Massage Reduces Pain

By Massage Therapy Foundation Contributor

Have your clients reported having pain between their shoulder blades? Have your clients ever asked about the effects associated with Thai massage? Do you provide Thai massage as a modality in your practice? If you answered yes to any of these questions, we at the Massage Therapy Foundation (MTF) are reporting on a new study that may be of interest to you.

The study we're reporting provides evidence that Thai massage reduces pain, muscle tension, and anxiety in patients who had myofascial trigger points in the scapular region.
This study from Thailand investigates the effects of traditional Thai massage on scapulocostal syndrome (SCS), a musculoskeletal pain syndrome in the posterior shoulder area. Buttagat and colleagues compared the effectiveness of Thai massage to physical therapy treatments using ultrasound and heat packs in treating pain localized to the medial superior border of the scapula. Previous studies by the same research team showed that traditional Thai massage promotes relaxation and reduces stress in patients with back pain associated with trigger points.

In this pilot study, the authors recruited patients aged 18-50 years old who had "spontaneous scapular pain which had lasted longer than 12 weeks, and had at least one trigger point in the scapular region." An independent assessor, who was blind to which treatment the patient would receive and had no knowledge or effect on the outcome of the study, examined each patient for associated myofascial trigger points in the serratus posterior superior, rhomboid and levator scapula muscles on the affected side. Trigger points were defined as "the presence of tender points within palpable taut bands of muscle in areas that the patient identified as painful." A total of 20 patients were included in the study because they lacked any other known cause of their pain, nor had any contraindication for Thai massage — e.g. fracture or contagious skin disease.

The 20 participants were randomly assigned into two groups of 10 – a traditional Thai massage group (TTM) or the PT modalities group (PT). The TTM patients "received a 30-min session of TTM for nine sessions over a period of three weeks around the scapula region while lying on their side [in a position of] transverse adduction of their arm, plus protraction of the scapula." The same certified Thai massage therapist performed all nine treatments for each of the ten participants. The PT patients "received a 30-minute session of a hot pack and ultrasound therapy [for 10 min] for nine sessions over a period of three weeks in the same environment as the TTM group."

One common critique of any study investigating pain, especially those involving bodywork therapy, is that pain is inherently subjective. Buttagat and colleagues considered this objection and collected data using five different physiological and psychological outcome measures to assess the participants' experience of pain. Pain and tension were assessed using a horizontal visual analogue scale (VAS). The scale ranged from 0 to 10, with 0 indicating no pain or muscle tension, and 10 indicating the most pain or muscle tension ever experienced. The patients marked the line indicating their levels of pain intensity and muscle tension. Pressure pain threshold (PPT) was assessed using a pressure algometry technique involving participants giving a verbal signal when they began to feel pain or any discomfort (at which point the compression was stopped). State Anxiety Inventory (STAI), Thai version, was measured using a 20 item inventory of how the participant felt at the moment. Characteristic items included "I feel calm" and "I am regretful," and were answered in scale of severity (not at all, a little, somewhat, etc.). Patient satisfaction was determined through a questionnaire consisting of a 5-point scale (not satisfied at all, not satisfied, satisfied, very satisfied, and most satisfied).

All outcome measures were compared at three points – after the first treatment session (immediate effects on day one), one day after the last treatment session (short-term effects at three weeks), and two weeks after the last treatment session (long-term effects at five weeks). Patients were similar at baseline; the TTM group reported pain intensity of 5.2 and muscle tension of 5.5; slightly more compared to the PT group's pain of 4.4 and tension of 4.5.

The pain intensity, muscle tension, and state anxiety all showed significant improvements with treatment among patients in both groups at all time points. However, there was no change in PPT for the PT group. When comparing each outcome measure individually, the researchers found a significant improvement in the TTM group compared to the PT group, except for the STAI (immediate and long term effect). Just as important, patients were much more satisfied with the TTM therapy – all TTM patients indicated they were "most satisfied" or "very satisfied," compared to the majority of PT patients who reported that they were only "satisfied."

The PPT for the PT modalities group did not change at any point: there was no immediate response, nor was there response after nine sessions. For TTM, however, the pressure needed to elicit pain doubled after nine sessions. Compared to baseline, this was a highly significant change that was also significantly more than the PPT of the PT group at three weeks and at five weeks. Objectively, TTM reduced the pressure sensitivity of these chronically painful areas in only nine half-hour sessions.

While the study size was small, involving only ten people per group, it is highly likely that the effects shown here will be duplicated. Often, a large sample size is necessary to reveal small differences between groups. The differences between TTM and PT modalities were highly significant even with only the twenty participants. The major limitation of this design was that it is impossible to blind the therapists and the patients to the treatments, as is the case in the majority of massage studies. The authors concede that further study should include a "resting condition" or relaxation group where the patients would simply lie on their side for nine sessions of 30-minutes.

Buttagat and colleagues write, "We may therefore conclude that the treatment by TTM among patients with SCS was superior to the PT." However, the two PT modalities used here – heat pack and ultrasound for ten minutes – would likely not be the only treatments that these patients would receive in out-patient physical therapy practice.

If you use Thai massage, you can refer to resources such as this article to support Thai massage as an evidence-based practice. If you want to use Thai massage in your practice, the specific treatment protocols used in this study are included in the research article. However, these protocols are part of traditional Thai massage, which requires knowledge, skill and training for best results to result from this modality. Pursuing continuing education in Thai massage could be worthwhile in order to offer added pain relief benefits to your clients.

Source: Buttagat V, Eungpinichpong W, Chatchawan U, Arayawichanon P. Therapeutic effects of traditional Thai massage on pain, muscle tension and anxiety in patients with scapulocostal syndrome: a randomized single-blinded pilot study. J Bodyw Mov Ther. 2012;16:1:57-63.

For more information about the Massage Therapy Foundation, visit www.massagetherapyfoundation.org.

Click here for more information about Massage Therapy Foundation Contributor.

domingo, 14 de abril de 2013

Juvenile Rheumatoid Arthritis: Benefits from Massage Therapy.

Tiffany Field,2 Maria Hernandez-Reif, Susan Seligman, Josh Krasnegor, and William Sunshine
University of Miami School of Medicine
Rafael Rivas-Chacon
Miami Children's Hospital
Saul Schanberg and Cynthia Kuhn
Duke University Medical School
Received October 2. 1996; accepted February 25, 1997
Studied children with mild to moderate juvenile rheumatoid arthritis who were massaged by their parents 15 minutes a day for 30 days (and a control group engaged in relaxation therapy). The children's anxiety and stress hormone (cor- tisol) levels were immediately decreased by the massage, and over the 30-day period their pain decreased on self-reports, parent reports, and their physician s assessment of pain (both the incidence and severity) and pain-limiting
Juvenile rheumatoid arthritis (JRA) is the most common rheumatic disease of childhood and one of the most common chronic diseases of childhood (Cassidy & Petty, 1995; Lovell & Walco, 1989). The JRA diagnosis is based on the observation of persistent arthritis (6 or more weeks duration) in one or more
'This research was supported by National Institute of Mental Health Research Scientist Award MHOO33I to Tiffany Field and a grant from Johnson & Johnson. The authors thank the subjects, parents, and researchers who participated in this study.
2AII correspondence should be sent to Tiffany Field, Touch Research Institute, University of Miami School of Medicine, P.O. Box 016820, Miami, Florida 33101.
0I46-8693/97/I0OO-O607SI2.5O/0 © 1997 Plenum Publishing Corporalion

jueves, 11 de abril de 2013

Pain Management

This preliminary study evaluated the effect of the use of massage therapy on inpatient pain levels in the acute care setting. The study was conducted at Flagstaff Medical Center in Flagstaff, Arizona—a nonprofit community hospital serving a large rural area of northern Arizona.


A convenience sample was used to identify research participants. Pain levels before and after massage therapy were recorded using a 0 – 10 visual analog scale. Quantitative and qualitative methods were used for analysis of this descriptive study.


Hospital inpatients (n = 53) from medical, surgical, and obstetrics units participated in the current research by each receiving one or more massage therapy sessions averaging 30 minutes each. The number of sessions received depended on the length of the hospital stay.


Before massage, the mean pain level recorded by the patients was 5.18 [standard deviation (SD): 2.01]. After massage, the mean pain level was 2.33 (SD: 2.10). The observed reduction in pain was statistically significant: paired samples t52 = 12.43, r = .67, d = 1.38, p < .001. Qualitative data illustrated improvement in all areas, with the most significant areas of impact reported being overall pain level, emotional well-being, relaxation, and ability to sleep.


This study shows that integration of massage therapy into the acute care setting creates overall positive results in the patient’s ability to deal with the challenging physical and psychological aspects of their health condition. The study demonstrated not only significant reduction in pain levels, but also the interrelatedness of pain, relaxation, sleep, emotions, recovery, and finally, the healing process
Pain management within the acute care setting is a concern that is being carefully examined not only by individual hospitals, but also by accreditation organizations across the United States(1). Massage therapy is one of the complementary and integrative medicine (CIM) therapies most often prescribed by physicians, and it is noted to be the most likely to be beneficial and the least likely to be harmful(2). Studies have examined the experience of hospitalized patients and found that high levels of stress and anxiety can increase pain(3,4) and slow a patient’s recovery by limiting “physical functioning, including the ability to cough and breathe deeply, move, sleep, and perform self-care activities”(5).

The Mayo Clinic of Rochester, Minnesota, conducted a systematic evaluation of the patient hospital experience and found that “tension, stress, pain, and anxiety were key challenges for patients”(6). The integration of massage therapy into the team approach in patient care constitutes a move forward that recognizes pain as the fifth vital sign after pulse, blood pressure, temperature, and respiratory rate(5). Although each patient’s healing process is unique(7), common themes of healing recognized in the present study underlie the significance of a holistic approach to patient care.

Research has documented the use of massage therapy as an effective tool for pain management(8–10), with the added benefit of producing few adverse reactions(11–13). When, with cardiac surgery patients, opioid medications are initially necessary, the continued use of large doses can delay the recovery process and lead to prolonged hospitalization(11). Patients with increased blood pressure because of stress may also benefit from massage therapy(14,15). A study at the Mayo Clinic, in which 58 cardiac surgery patients postoperatively received 1 – 3 massage therapy sessions of 20 minutes each, created evidence compelling enough for the Mayo Clinic to hire a full-time massage therapist to be available on the inpatient unit(6).

Cardiac surgery patients often complain of back, shoulder, and neck pain from manipulation of the body during the surgical procedure and from physical manifestations of tension and stress(11). When massage therapy is incorporated as part of the postsurgical protocol, fewer medications may be needed, providing an added advantage of fewer adverse side effects and acting as an effective adjunct or alternative to pharmaceuticals(10).

The gate-control theory of pain postulates that massage may be effective in “closing the gate”—that is, inhibiting the transmission of noxious stimuli by stimulating large nerve fibers that have been shown to alter pain perception(13). In the acute care setting, health care professionals have a tendency to touch patients only when performing procedures, which can be uncomfortable and even painful. As White wrote, “Touch is often the most neglected or assaulted sense of the hospitalized patient”(16).

The relaxation response (RR) is the body’s mechanism to decrease the level of psycho-physiologic arousal produced by stress(17). Massage therapy can produce a RR that creates a calm state and enhances the ability to rest, qualities that are so essential for healing to occur(4). In addition, the RR elicits physiological changes, including lower blood pressure and heart rate, decreased oxygen consumption and muscle tension, and lower levels of cortisol and noradrenaline(15). “The majority of studies show that back massage induces a physiological or psychological relaxation response and that it is not injurious for critically ill patients with heart disease”(17).

Stressors experienced by hospital patients include excessive noise, lack of sleep, social isolation, enforced immobility, and pain from procedures. Anxiety and stress during cardiac catheterization can lengthen the hospital stay and increase the use of sedative medication before and during the procedure(3). Hamel’s research using a randomized clinical trial design with 46 participants demonstrated that a 20-minute back massage successfully reduced blood pressure before cardiac catheterization(3). Studies note that fear and anxiety are common emotions felt by cardiac surgery patients(6), and as Moyer suggests, “There is much agreement that how a person feels, emotionally, is at least partly a function of that person’s bodily state”(18). When patients have higher postoperative mobility, they may also have fewer serious postoperative complications, as demonstrated by Mitchinson and his colleagues in a randomized controlled trial of 605 veterans undergoing major surgery at Department of Veterans Affairs hospitals(5).

Lack of sleep in the hospital environment is a well-known phenomenon and can delay a patient’s recovery(4,9,17). Hospital-induced sleep deprivation is generally remedied with medications(17). Critically ill and elderly patients are a vulnerable population and may benefit from non-pharmacologic methods to promote sleep(17). By studying the amount of REM and NREM sleep in 69 elderly men, Richards found that sleep efficiency was 14.7% higher in patients who received a 6-minute back massage than in a control group(17). That study is comparable with another that followed 30 patients with fibromyalgia who received 30 minutes of massage therapy twice weekly for 5 weeks. The patients experienced decreased depression, improved sleep (a greater number of sleep hours and fewer sleep movements) and decreased symptoms, including pain, fatigue, and stiffness(8). Another study of 41 hospitalized oncology patients illustrated that sleep quality, pain, symptom distress, and anxiety all improved when massage therapy was given during the hospital stay(19).

Egnew concludes that healing may be defined as “the personal experience of the transcendence of suffering”(7), and therefore each individual will have a personal concept of what “healing” means to them. Some aspects of healing are subjective and intensely personal, with different meanings for each person(7). Integration of massage therapy may improve the healing environment for the patient, thus allowing the deeper aspects of psychological healing to occur along with physical healing.

As authors, we felt that it was important to include both quantitative and qualitative investigation. The value of including qualitative research is reflected by Kania and her colleagues in an article that describes how the use of the mixed methods approach “can provide highly valuable insights and a more complete understanding of the effectiveness of an intervention”(20). Using the mixed methods approach, the present study tests the research hypothesis “Does the use of massage therapy in an inpatient setting improve patient perception of pain management?”

This preliminary study enrolled a convenience sample of 65 inpatients admitted between October 1, 2006, and March 31, 2007, at a nonprofit community hospital serving a large rural area in the southwestern region of the United States. Criteria for inclusion in the study were a physician order for massage therapy, the patient’s (or a family member’s) ability to complete and sign a consent form, and willingness on the part of the patient to give feedback on the experience of hospital massage therapy and to return the qualitative survey after hospital discharge. Table 1 presents demographic data for the research participants.

Demographic Data of Research Participants
The plan for the current study was submitted and approved by the hospital’s institutional review board. Participation in the research project was voluntary. Informed consent, including confidentiality and the right to withdraw from the study at any time, was obtained, and forms were completed before the initiation of any session for the research project. Participants were told that, whether they chose to partake or not to partake in the research, their regular treatment would continue unaffected. Standardization was assured by having each of the massage therapists use the same scripted dialogue when approaching potential subjects for the study. Visual analog scale (VAS) scores were obtained by the therapists before and after therapy. Participants were given the post-hospitalization survey at the end of their last session.

Three licensed massage therapists employed by the hospital provided the therapy sessions. The experience in massage therapy of the therapists (all female) ranged from 2 years to more than 20 years. Each had received additional training for working with hospitalized or medically frail patients, and all had worked in the acute care setting for 1 to 3 years.

Massage interventions consisted of 15-minute to 45-minute therapeutic massage sessions given at the bedside. Because of the disruptive nature of the hospital environment, the length of the sessions varied based on each participant’s energy level and availability. Treatments included gentle Swedish effleurage or petrissage, acupressure, craniosacral therapy, or cross-fiber myotherapy with light-pressure effleurage and pressure points being the most commonly used modalities. The treatment area on the body varied according to participant need or concern, taking into consideration any contraindications, including but not limited to areas of acute injury and surgical and intravenous sites. Head, neck, shoulders, back, and feet were the areas most commonly chosen, with participants in either supine or side-lying positions. Participants were given a choice of unscented or lightly scented oils, and relaxing music was offered.

The survey used in this research project (Patient Survey for Massage Therapy Research) was adapted from a survey used by Motsinger in her Capstone Project, titled Development of an Inpatient Massage Therapy Program in an Allopathic Hospital.a The survey asked about length of hospital stay, number of massages received, and whether massage therapy had improved, had had no effect, or had worsened the participant’s overall pain levels, emotional well-being, ability to move, ability to participate in therapies, relaxation, ability to sleep, and recovery. Additionally, participants were asked if they felt that massage therapy had had an effect on their need for pain medication, how long the effects of the massage had lasted, and whether they planned to continue using massage therapy as part of their healing process. An open-ended inquiry at the end of the survey encouraged participants to comment freely about massage.

Quantitative and qualitative methods were used for analysis of this descriptive study. Demographic data, number of massage sessions, before-and-after pain levels using the VAS scale, survey data, and nursing comments were analyzed. Inferential statistical analysis was conducted using the paired t-test, with the significance level preset at p < .05.

Qualitative data drawn from nursing comments in a retrospective chart review and participant comments from the post-hospitalization survey were analyzed using the grounded theory method to code and label categories. “Grounded theory” can be described as a method of analysis that aims to develop middle-range theories from qualitative data. The founders of grounded theory, Glaser and Strauss, not only intended to conceptualize qualitative data, but also planned to demonstrate relationships between conceptual categories and to specify conditions within which theoretical relationships emerge(21) (pp. 311–312). We used the grounded theory method to group qualitative responses into several categories to guide the analysis. These categories reflected responses by the participants and nurses regarding reactions to the massage therapy session or sessions the participant received while hospitalized. The themes generated demonstrate an interrelationship between categories and an overall theoretical sensitivity that supports the overriding theme that “massage therapy promotes recovery.” Finally, all data were triangulated to determine whether massage therapy improves patient perception of pain management while in hospital.

Quantitative Data

From the initial sample of 65 participants, 53 completed the research project. Pain levels reported by the participants using the VAS ranged from 0 – 10. The mean score before massage was 5.18 [standard deviation (SD): 2.01]. The mean score after massage was 2.33 (SD: 2.10). A comparison of pain levels before and after massage shows the individual responses by massage session (Fig. 1). The observed reduction in pain was statistically significant: paired samples t52 = 12.43, r = .67, d = 1.38, p < .001 (Table 2).

Pain level on a 1 – 10 visual analog scale before and after massage therapy in 65 inpatient research participants. Of the 65 charts reviewed, 53 charts contained complete data (before/after pain levels) and are shown here.

Analysis of Pain Level Before and After Massage Therapy
The data show that most participants in the survey received 1 massage (50.8%). Another 40% received 2 – 3 massage sessions, and 6 participants (9.2%) received more than 3 massage sessions. Most sessions (83.9%) lasted 30 minutes, 14 sessions lasted 45 minutes (14.9%), and 1 session lasted 15 minutes.

The effects of massage therapy were felt to last 1 – 4 hours by 34 participants (53.1%), and 4 – 8 hours, by 13 participants (20.3%). According to 9 participants (14.1%), the effects lasted 8 – 24 hours, and according to 7 (10.9%), more than 24 hours. One person felt no effect. The response to the question “Do you plan to continue using massage therapy in your healing process?” was yes in an impressive 67.2% of participants. Another 14.1% responded no, and 18.8% didn’t know if they would continue with massage therapy after their hospitalization.

The survey reported participant perceptions concerning the effects of massage therapy on overall pain level, emotional well-being, ability to move, ability to participate in therapies, relaxation after massage, ability to sleep, contribution to faster recovery, and less need for pain medication after massage. Participants were asked if there was improvement, no change, or a worsening in the foregoing factors because of the massage. In all areas surveyed, a majority of participants reported an improvement, although some participants stated that they could not remember. Notably, no participant indicated a negative effect from massage therapy. The most significant areas of reported effect were overall pain level, emotional well-being, relaxation, and ability to sleep.

Patient survey results. Black bars = improved; white bars = no change; gray bar = cannot remember.
Findings from the current preliminary study parallel existing research showing that pain levels significantly improved with a massage intervention as an adjunct to conventional treatments(5,19). Other noteworthy observations included improved relaxation, emotional well-being, ability to sleep, and a reduction in the perception of use of pain medications.

Qualitative Data

Using the grounded theory method, “massage therapy promotes recovery” was the main theme identified. Within that theme, several subthemes emerged, including pain management (Table 3), ability to sleep, relaxation, emotional well-being, and healing. Each category is represented with comments from nurses or participants or both. Of the 65 participants in the study, 45 (72.3%) returned surveys. At the end of the survey, an open-ended question encouraged participants to comment freely about their experience of massage therapy. Qualitative responses were received from 33 participants.

Qualitative Theme of Pain Management with Massage for Hospitalized Patients
In the medical charts of participants, 25 nursing comments relevant to the research project were found. All comments were categorized into themes and subthemes. Interrelating themes were also acknowledged.

Pain Management
Of the 33 qualitative responses from participants, 16 were related directly to pain management. Participants mentioned improved pain levels after surgery (n = 9), lessening of breast engorgement after a cesarean section (n = 1), decreased body and headache pain and intensity (n = 4), and decreased pain associated with cancer (n = 2). One cancer patient commented, “I looked forward to the massages I received while in ICU—each helped to reduce the pain.” Another patient commented, “After three days in the hospital I was suffering a migraine, nausea, and a lot of body pain. After the massage my headache was lessened and my body pain was greatly reduced.” While still hospitalized, one patient noted that “I’ve never had anything take this pain away completely.” Still another noted that “I’m very much supportive of massage therapy as a healing and pain relief procedure.” Not only was perception of pain lowered, but also perception of the need for pain medication. Significantly, more than half the participants (52.7%) felt that they needed less pain medication after receiving massage therapy.

The responsibility of nurses for pain management plays a significant role in quality health care. Managing pain is a team effort between physicians, nurses, and other health care providers. Of the 25 comments by nursing staff, 16 referred to decreased pain levels or decreased necessity for pain medications after massage therapy. Nursing comments included “Patient states his neck pain lessened with massage,” “Denies pain or needs ... had massage therapy this am, in no apparent distress,” and “Massage therapy ordered and given with good relief.”

Comments about ability to sleep were often associated with pain relief. One patient noted that “massage brought dramatic pain relief and ability to sleep and an overall sense of well-being in a stressful environment.” Another commented that “I fell asleep almost immediately after [the massage therapist] left.” Nursing observations confirmed what patients stated on the survey. Nursing comments included “Patient reports relaxation and pain relief after massage—slept for three hours” and “Patient stated the massage was a big help in decreasing his pain and allowed him to relax enough to get a good nap today.”

Relaxation can play a significant role in a patient’s healing and recovery process. More than half the participants surveyed mentioned relaxation in their qualitative responses (n = 17). Patients mentioned relaxation, relief from muscle tension, and increased feelings of well-being and calm. Overall nervous tension and the stressful environment of the hospital were also mentioned. Remarks from patients relating to relaxation included “[massage therapy] was very helpful, soothing, comforting, and relaxing,” and “this was very helpful to me, in that this is so pleasurable during an unpleasurable experience.” A quadriplegic patient who received massage therapy commented that “overall well-being (emotional, physical, spiritual, patience, decreased anxiety, and decreased pain and spasticity) was improved immeasurably by massage therapy and subsequent relaxation.”

In 10 comments from the nursing staff, the benefits of relaxation for their patients were mentioned. Nursing notes reflecting the benefits included “Patient seemed calmer tonight,” “Patient reports improved muscle relaxation post massage therapy,” and “Massage made her relaxed, resting comfortably, no distress.”

Emotional Well-being
The interrelatedness of themes becomes apparent in how patient and nursing comments alike reflect the connection between emotional well-being and relaxation, pain relief, and ability to sleep. Participants mentioned emotional well-being 8 times in connection with decreased anxiety, state of mind, attitude improvement, and human contact. One patient commented “[massage therapy] was one of the few times I could look forward to human contact without the potential for pain (as opposed to shots, IV’s ...).” Another patient described her experience with massage therapy this way: “I was so relieved and grateful. I was no longer crying and felt much better. I was so grateful for the body and mind relief.” One of the participants in the research project was in advanced stages of cancer. Although she died, her husband returned the survey, commenting that his “wife appreciated the pain relief, and that ‘the massage brought a smile to her face’,” also noting his own appreciation of the therapy.

Although nursing comments focused mainly on pain management and relaxation, 2 nursing notes articulated improved emotional well-being. A nurse in the Women’s and Infant Center noted that “patient has been teary about infant in special care nursery, had a massage, now coping a little better.” Another nurse commented “Patient seemed calmer tonight, not agitated, or hostile.”

References to healing and subthemes of healing including spirituality, recovery, and therapeutic benefits were found in responses from 10 participants. One participant noted that “I feel massage is very important to helping patients heal, in so many ways,” and another commented that “[massage therapy] was a very healing experience emotionally and physically.” Other participant comments included “Reduction of stress also was very helpful in recovery,” “It was very therapeutic,” and “It is such a healing process and definitely relaxing.” No nursing comments on the theme of healing were found.

The experience of hospitalization creates pain and anxiety for many people, regardless of their underlying medical condition. The goal of the present study was to explore how massage therapy would affect a patient’s perception of pain in the acute care setting. Previous studies have established the benefits of massage therapy for patients suffering from particular illnesses—for example, cancer(19)—and cardiac surgery or procedures(3,6,17). Other studies have focused on patient experiences within particular hospital units including transplantation, neuroscience, and rehabilitation(4). By selecting research participants in units throughout the hospital, with a wide variety of diagnoses and reasons for hospitalization, our project provides a unique picture of how massage therapy may benefit any patient coping with the pain and stress associated with hospitalization, offering a strong argument that massage is an effective adjunct therapy for pain management.

The primary findings of this preliminary study show a strong correlation between reduction of pain levels after massage therapy and statistically significant differences in pain scores before and after massage. The perception among participants of improved pain levels and less need for pain medication underscore the promise of massage therapy’s positive effect on pain management protocols. In addition, a majority of patients felt that massage therapy contributed to increased relaxation, emotional well-being, ability to sleep, ability to move and to participate in other therapies, and faster recovery. For most patients, the effects of the session lasted 1 – 4 hours, with some participants experiencing benefits for more than 24 hours.

Reports of improved levels of relaxation after massage therapy were received from 98% of the research study participants. The fact that patients throughout the various hospital units, with a wide variety of pre-massage pain levels, experienced relaxation through massage therapy indicates the true potential for massage to support healing for hospitalized patients. This finding was reiterated in comments from patients and nurses alike. By accessing a patient’s ability to relax, massage therapy addresses a variety of needs. Indeed, the RR may be the most profound mechanism through which massage therapy helps the hospitalized patient.

In addition to relaxation, massage therapy also counters another fundamental aspect of hospitalization, the sense of isolation experienced by many patients. In the present research study, participants reported an improvement in emotional well-being—an aspect of healing that may speak to the need for human touch. More and more hospitals are recognizing the importance of touch for the hospitalized patient(4,6). As the face of health care changes in the coming years, it is a hopeful sign that safe, skillful touch is being recognized as a mechanism of healing for patients in the acute care setting.

Participation in our research study was limited to adults whose medical circumstances allowed them to receive massage therapy and to complete the study paperwork. The study does not reflect the perceptions of patients whose energy or pain levels precluded them from participation. Patients whose level of pain did not allow for participation may have found less benefit from massage therapy, revealing the need for fully integrative services in which massage is merely one component of a comprehensive pain management protocol.

Another limitation of the present study is the lack of collection of physiological data, including heart rate, blood pressure, and oxygen levels. The absence of data on the physiological indicators of pain and the RR means that the study relied on participant perceptions without additional external measures to verify participant responses to massage therapy. Pain is an inherently subjective experience that includes physical and emotional elements. Within the hospital environment, health care workers rely on patient perceptions for pain management. The present study thus reflects current standards for assessing the effectiveness of various interventions to address pain in patients.

The current project, designed to gather preliminary data on the research hypothesis, did not use a control group. The selection of additional patients in units throughout the hospital, combined with randomization to groups, would have required substantial additional resources. However, future studies on massage therapy in an acute care setting may benefit from the addition of a control group. Such research may also help to identify specific types of massage therapy that are most effective in the acute care setting.

Evidence-based research continues to confirm the importance of human touch to balance the high technology of today’s health care practices. The further integration of CIM therapies such as massage into the hospital offers the possibility to improve the experience for patients who face physical, psychological, and social challenges in an unfamiliar environment. A large and growing body of research, including the current project, justifies the use of massage therapy for pain management in the acute care setting. Massage therapy can provide pain relief and relaxation, can support a patient’s emotional well-being and recovery, and can ultimately aid in the healing process for hospitalized patients.

This research was conducted at Flagstaff Medical Center, Flagstaff, Arizona, from October 2006 to March 2007.

The authors thank Alisha Witcomb, LMT, for her contribution as one of the three massage therapists involved in this study and as an integral collaborator in the data collection process. The authors also express their gratitude to Lori Pearlmutter, PT, MPH. Lori was inspirational and supportive throughout the process, as a co-investigator and a mentor.

The authors declare that no conflicts of interest are associated with this research project or publication of findings.

aMotsinger S. Unpublished report for the Capstone Project for DPT. Flagstaff, AZ: Northern Arizona University; 2003.

1. Pearson Education American Academy of Pain Management accreditation helps pain organizations meet JCAHO standards. Pearson Education, Bridging the Gap website. http://test.pearsonassessments.com/bridginggap/fall2001-p1.htm. Published Fall 2001. Updated n.d Accessed July 12, 2007.
2. Ezzo J. What can be learned from Cochrane systematic reviews of massage that can guide future research? J Altern Complement Med 2007; 132: 291–295. [PubMed]
3. McCaffrey R, Taylor N. Effective anxiety treatment prior to diagnostic cardiac catheterization. Holist Nurs Pract 2005; 192: 70–73. [PubMed]
4. Smith MC, Stallings MA, Mariner S, Burrall M. Benefits of massage therapy for hospitalized patients: a descriptive and qualitative evaluation. Altern Ther Health Med 1999; 54: 64–71. [PubMed]
5. Mitchinson AR, Kim HM, Rosenberg JM, Geisser M, Kirsh M, Cikrit D, et al. Acute postoperative pain management using massage as an adjuvant therapy: a randomized trial. Arch Surg 2007; 14212: 1158–1167. [PubMed]
6. Cutshall SM, Fenske LL, Kelly RF, Phillips BR, Sundt TM, Bauer BA. Creation of a healing enhancement program at an academic medical center. Complement Ther Clin Pract 2007; 134: 217–223. [PubMed]
7. Egnew TR. The meaning of healing: transcending suffering. Ann Family Med 2005; 33: 255–262. [PMC free article] [PubMed]
8. Field T, Diego M, Cullen C, Hernandez-Reif M, Sunshine W, Douglas S. Fibromyalgia pain and substance P decrease and sleep improves after massage therapy. J Clin Rheumatol 2002; 82: 72–76. [PubMed]
9. Hernandez-Reif M, Field T, Krasnegor J, Theakston H. Lower back pain is reduced and range of motion increased after massage therapy. Int J Neurosci 2001; 1063–4: 131–145. [PubMed]
10. Melancon B, Miller LH. Massage therapy versus traditional therapy for low back pain relief: implications for holistic nursing practice. Holist Nurs Pract 2005; 193: 116–121. [PubMed]
11. Anderson PG, Cutshall SM. Massage therapy: a comfort intervention for cardiac surgery patients. Clin Nurse Spec 2007; 213: 161–165. [PubMed]
12. Cassileth B, Trevisan C, Gubili J. Complementary therapies for cancer pain. Curr Pain Headache Rep 2007; 114: 265–269. [PubMed]
13. Ferrell-Torry AT, Glick OJ. The use of therapeutic massage as a nursing intervention to modify anxiety and the perception of cancer pain. Cancer Nurs 1993; 162: 93–101. [PubMed]
14. Aourell M, Skoog M, Carleson J. Effects of Swedish massage on blood pressure. Complement Ther Clin Pract 2005; 114: 242–246. [PubMed]
15. Benson H. The Relaxation Response. New York, NY: William Morrow and Company; 1975: 99–110.
16. White JA. Touching with intent: therapeutic massage. Holist Nurs Prac 1988; 23: 63–67. [PubMed]
17. Richards KC. Effect of a back massage and relaxation intervention on sleep in critically ill patients. Am J Crit Care 1998; 74: 288–299. [PubMed]
18. Moyer CA. Affective massage therapy. Int J Ther Massage Bodyw 2009; 12: 4.
19. Smith MC, Kemp J, Hemphill L, Vojir CP. Outcomes of therapeutic massage for hospitalized cancer patients. J Nurs Scholarsh 2002; 343: 257–262. [PubMed]
20. Kania A, Porcino A, Vehoef MJ. Value of qualitative research in the study of massage therapy. Int J Ther Massage Bodyw 2008; 12: 6–10. [PMC free article] [PubMed]
21. Charmaz K. Qualitative interviewing and grounded theory analysis. In: Holstein A, Gubrium JF, editors. , eds. Inside Interviewing : New Lenses, New Concerns. Thousand Oaks, CA: Sage Publications; 2003: 311–30.

miércoles, 10 de abril de 2013

Pain management

With the aging baby boomer population, it is not surprising that pain management remains a critical issue for hospitals. And baby boomers are demanding alternative health care options to complement more traditional medicine, and hospitals are turning to providing massage therapy options for pain management into the team-centered approach of patient care.
In a recent research study, the effect of the use of massage therapy on inpatient pain levels in the acute care setting was studied at the Flagstaff Medical Center. Located in northern Arizona, the medical center is a nonprofit community hospital serving a large rural area. In the study of 53 inpatients, pain levels were measured before and after receiving a 30-minute massage session using a 0 – 10 visual analog scale. Quantitative and qualitative methods were used for analysis of this descriptive study.
The pain level before and after massage was significant reduced with the mean pain level recorded prior to massage at 5.18 and after massage as 2.33. Furthermore, qualitative data reflected improvement in all areas, including overall pain level, emotional well-being, relaxation, and ability to sleep.
Not surprisingly to consumers of massage, the study confirmed that including massage therapy into the acute care can create positive results for patients dealing with pain management associated with both physical and psychological aspects of their health. To see the full report titled “The Effects of Massage Therapy on Pain Management in the Acute Care Setting” by Rose Adams, MHA, BSW, LMT, Barb White, MS, LMT, Cynthia Beckett, PhD, RNC-OB, LCCE, visit http://www.ijtmb.org/index.php/ijtmb/article/view/54/96.

Massage Therapy for Infants and Children


Journal of Developmental & Behavioral Pediatrics . April 1995

Data are reviewed on the effects of massage therapy on infants and children with various medical conditions. The infants include: premature infants, cocaine-exposed infants, HIV-exposed infants, infants parented by depressed mothers, and full-term infants without medical problems. The childhood conditions include: abuse (sexual and physical), asthma, autism, burns, cancer, developmental delays, dermatitis (psoriasis), diabetes, eating disorders (bulimia), juvenile rheumatoid arthritis, posttraumatic stress disorder, and psychiatric problems. Generally, the massage therapy has resulted in lower anxiety and stress hormones and improved clinical course. Having grandparent volunteers and parents give the therapy enhances their own wellness and provides a cost-effective treatment for the children. J Dev Behav Pediatr 16:105-111. 1994. Index terms: infant massage, massage therapy.

(C) Lippincott-Raven Publishers.

martes, 9 de abril de 2013

Effect of therapeutic massage in alleviating musculoskeletal pain and discomfort associated with wearing lead aprons in the cardiac cath lab

The purpose of this study is to evaluate the effect of therapeutic massage in alleviating musculoskeletal pain and discomfort associated with wearing lead aprons in the cardiac cath lab. We also want to evaluate if therapeutic massage will reduce fatigue, stress, and anxiety while improving the level of relaxation in cardiac cath lab employees who wear lead aprons.

Condition Intervention
Procedure: Massage

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Crossover Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Measuring the Effect of Therapeutic Massage on Pain and Discomfort in Cardiac Cath Lab Staff - A Pilot Study

MedlinePlus related topics: Anxiety Fatigue
U.S. FDA Resources

Primary Outcome Measures:
Compare and contrast the level of pain and discomfort in staff that wear lead aprons at baseline, end of first 5-weeks of massage therapy, end of the second 5-weeks of massage therapy and to those that do not get massage during that same period. [ Time Frame: 10 Weeks ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
Compare the level of stress, anxiety, and relaxation in staff that wear lead aprons, at baseline, end of first 5-weeks of massage therapy, end of the second 5-weeks of massage therapy and to those that do not get massage during that same period. [ Time Frame: 10 Weeks ] [ Designated as safety issue: No ]

Enrollment: 60
Study Start Date: April 2008
Study Completion Date: July 2008
Primary Completion Date: July 2008 (Final data collection date for primary outcome measure)
Arms Assigned
Active Comparar:10 massages
This group consists of individuals that wear lead aprons, and they will receive ten, 30-minute scheduled massage appointments during the hours the participant is working in the cardiac lab, over a 10 week period.
Procedure: Massage
Chair Massage
Active Comparator:5 Massages
This group consists of individuals that wear lead aprons, and they will receive five, 30-minute scheduled massage appointments, during the hours the participant is working in the cardiac lab, over a 5 week period. This arm will not receive massages for the first 5 weeks and then will receive their massages during the second 5 week period.
Procedure: Massage
Chair Massage
No Intervention: Control Group
This group will consist of those individuals that wear lead aprons with no desire to participate in the massage study yet are willing to provide information through questionnaires. They will be given the same questionnaire as those in the two massage therapy arms of the study, at the beginning, middle, and end of study.

Detailed Description:

The cardiac catheterization laboratory is a very dynamic work environment. The physical and psychosocial demands of the work environment place a significant amount of stress on the physical well being of the employee. The nature of the work involved includes that of responding to rapidly changing patient clinical conditions which are often urgent, and require repetitive actions in an ergonomically challenging environment. In addition, employees who are directly exposed to the radiation required to perform diagnostic and interventional procedures wear lead aprons weighing on average 10-15 pounds.

A constant build-up of tension in the muscles from regular, repetitive activity may lead to stresses on the muscles, joints, ligaments and tendons. Adding to this, working while wearing lead aprons, with elements of repetitive use and non-optimal ergonomic situations, Cardiac Cath Lab employees are at higher risk for muscle imbalances. The accumulation of tension and imbalance leads to joint wearing and muscle fatigue that result in injuries. Massage therapy, applied skillfully, is one of the most effective forms of therapy for releasing muscle tension, restoring balance to the musculoskeletal system, while creating awareness of musculoskeletal balance in the employee. Massage provided regularly may help employees prevent injuries caused by overuse.

As muscle imbalances develop they often go undiagnosed until they are serious enough to cause the employee discomfort or impede performance. Frequently the discomfort is masked with pain medications and ultimately leads to injuries. A skilled massage therapist will detect variations in the soft tissues and by using the correct techniques, help the employee maintain a much healthier physical state and prevent injury.

Massage therapy is purported to affect both the structure and function of the musculoskeletal system by promoting the relaxation response and reducing muscle tension and fatigue while improving posture. Given the potential benefits of massage therapy, many work environments are implementing massage therapy programs to improve the health and well being of their employees.


Ages Eligible for Study: 18 Years and older
Genders Eligible for Study: Both
Accepts Healthy Volunteers: Yes
Inclusion Criteria:

Diagnostic and interventional cardiology staff including:

cardiology fellows
technical staff
and a core group of CRNA's employed by the Cardiac Catheterization Laboratory.
These staff members, per their job descriptions, wear lead aprons while caring for patients during the weeks of the massage therapy pilot study.

Exclusion Criteria:

Individuals that decline to participate in the study.
Massage therapy has contraindications that require a physician's order before the therapist is allowed to see the person for massage. The following total contraindications will be total exclusions for this study unless the individual gains a physician's order that negates the exclusions or defines it to a local
Total Contraindications

Acute sprain with swelling
Lymphatic cancer

Local Contraindications do not exclude the person from the study. These are area exclusions that disallow the therapist to work on a specific part of the body and/or the therapist needs to adjust techniques. The therapist will track all local contraindications.

Local contraindications:

Varicose veins
Trapped or pinched nerve (radicular symptoms)
Skin abrasions, open wounds
Venous thrombus

The use of therapeutic massage as a nursing intervention to modify anxiety and the perception of cancer pain

Ferrell-Torry, Andrea T. M.A., R.N.; Glick, Orpha J. Ph.D., R.N.

Cancer Nursing . April 1993

The purpose of this exploratory study was to examine the effects of therapeutic massage (consisting of effleurage, petrissage, and myofascial trigger point therapy) on pain perception, anxiety, and relaxation levels in hospitalized patients experiencing significant cancer pain. Thirty minutes of therapeutic massage was administered on two consecutive evenings to nine hospitalized males diagnosed with cancer and experiencing cancer pain. The subjects' self-reports of pain and relaxation (measured by Visual Analogue Scales) as well as anxiety (measured by the Spielberger State Anxiety Inventory) were recorded before and immediately after the intervention. The objective physiologic measures of heart rate, respiratory rate, and blood pressure were obtained before, immediately after, and, finally, 10 min after the massage intervention. Massage therapy significantly reduced the subjects' level of pain perception (average = 60%) and anxiety (average = 24%) while enhancing their feelings of relaxation by an average of 58%. In addition to these subjective measures, all physiological measures (heart rate, respiratory rate, and blood pressure) tended to decrease from baseline, providing further indication of relaxation. In conclusion, although the exact mechanism is not known, therapeutic massage is a beneficial nursing intervention that promotes relaxation and alleviates the perception of pain and anxiety in hospitalized cancer patients.

jueves, 4 de abril de 2013

How do the benefits of massage help the organ systems?

Benefits of Massage...
The Physiological Benefits

How do the benefits of massage help the organ systems?

Massage has specific effects on the different organ systems of the body. It helps by keeping the organ tissues healthy and enhances healing to improve the function of the system as a whole.

Since organ systems interact in myriad ways, the benefits of massage on any system impact others as well. There is an overlapping function taking place within the different organ systems while a massage is being received.

For example: certain organ systems have pairings such as muscular-skeletal, circulatory-lymphatic, nervous-endocrine, and respiratory-circulatory-muscular.

Trust me... I understand the feeling of not quite understanding the terms used medically.
I was once a student myself learning all these new big words that I could hardly even pronounce at one time.

My goal here is to put these medical terms into a way that you can best understand them. Just for YOU!

What is the Physiological Benefits of Massage?

There are 11 major organ systems that compose the human body. This is where the term "physiological" comes in to play. It makes up the organic processes of the body on a cellular, tissue, or organ system level.

Example: The activation of the Parasympathetic Nervous System - releases endorphins (and so on).

The benefits of massage can stimulate, increase, improve, develop, regenerate, and relax these organ systems. This improves the overall function of the organ systems.

They all sound the same don't they? Don't let that confuse you like it did me the first time I was learning about the benefits of massage on a "physiological" level.

Merriam-Webster's Dictionary - Physiological

Stimulate: to act as a stimulant, to invigorate, to excite (an organ, part, etc.) to activity
Increase: to become greater in size, amount, degree, etc. (to increase one's confidence)

Improve: to rise to a better quality or condition; make better

Develop: to make stronger or more effective; strengthen (muscles)

Regenerate: to grow anew(a part to replace one hurt or lost), to produce again

Relax: to make looser, or less firm or tense (muscles)

The Benefits of Massage:

The Muscular System

Relieves soreness, tension, and stiffness
Improves muscle tone
Increases flexibility and range of motion of joints
Improves the flow of nutrients to muscles and joints, accelerating recovery from fatigue and injury
Reduces scar tissue
Breaks down or prevents adhesions (knots)
Speeds recovery from exercise
Enhances freedom of movement
Prevents or delays muscular atrophy, resulting from inactivity caused by injury, age, surgery, or illness
Increases physical confidence
Relieves cramps and muscle spasms
Reduces pain and swelling

The Skeletal System

Improves posture/body alignment
Relieve stiff joints
Decreases inflammation
Restores range of motion (increasing joint movement)
Releases joint strain (releasing tight muscles and tendons)
Releases restrictions in the fascia (connected tissues)
Improves the circulation and nutrients of your joints

The Integumentary System

Improves skin tone by removing dead cells and improving circulation
Regenerates tissue, including burns, wounds, and wrinkles
Helps to normalize glandular functions
Improve elasticity of skin
Stimulates blood flow to nourish the skin

The Circulatory System

Increases blood flow (to tissues and organs), which can relieve much muscular and joint pain (especially associated with swelling)
Increases the flow of oxygen and nutrients (to cells and tissues), improving and relieving congestion throughout the body
Increases the number of red blood cells, especially in cases of anemia
Lower blood pressure
Reduces heart rate (helps develop a stronger heart)
Elimination of metabolic waste

The Lymphatic System

Cleanse the body of wastes and toxic debris in the body
Increases the circulation of lymph
Stimulates the immune system (strengthens resistance to disease)
Reduces edema of the extremities (arms and legs)
Removal of lactic acid from fatigued and sore muscles (allows for a quick recovery)
Increases kidney action to remove wastes of protein metabolism
Increases retention of nitrogen phosphorus, and sulfur to aid in bone repair
Speeds recovery from illness

The Respiratory System

Develops respiratory muscles
Regulates respiration
Promotes deeper and easier breathing

The Nervous System

Stimulates Nervous System = boosting energy
Calms the Nervous System = relaxing
-- Massage may have a sedative, stimulating or an exhausting effect on the nervous system depending on the type and length of massage treatment given
Relieves restlessness and insomnia
Relieves pain due to pinched nerves
Decreases chronic pain
Stimulates the release of endorphins (the body's natural painkiller)

The Endocrine System

Helps the body to restore and heal itself
Develops of a restful sleep pattern
Promotes appropriate levels of hormones (bringing the immune system back in balance)

The Digestive System

Relieves constipation (specifically if a abdominal massage is given)
Relaxes the abdominal and intestinal muscles (therefore releasing tension in this area)
Eliminates waste materials
Stimulates activity of liver and kidneys

The Urinary System

Elimination of metabolic waste
Cleanses the body of wastes and toxic debris in the body
Increases kidney action to remove wastes of protein metabolism

The Reproductive System

Reduces depression and anxiety associated with PMS
Reduces excess fluid retention
Helps prepare for the birthing process
This list is just the beginning to how the benefits of massage can help you. The ever expanding research continues...

Disclaimer: The information presented on this website is not intended to replace
the advice of your doctor. Please always consult your health care professional first.

miércoles, 3 de abril de 2013

How massage helps heal muscles and relieve pain.

The word massage alone elicits deep relaxation and stress relief, and now a new study sheds light on how deep touch works to ease pain and promote healing in sore muscles.

Researchers at McMaster University in Canada found that massage affects the activity of certain genes, directly reducing inflammation in muscles — the same result you’d get by taking aspirin or ibuprofen — and boosting their ability to recover from exercise.

The study involved 11 young men who were willing to engage in what the researchers described as “exhaustive aerobic exercise” — the equivalent of an intense spinning class. The men rode stationary bikes to the point of exhaustion.

After the workout, each man received a 10-minute Swedish-style massage on only one leg; the other leg served as the control. They also had biopsies taken from their leg muscles before and after exercise, immediately after massage and then again two and a half hours later.

MORE: Aching Back? Try Massage for Chronic Pain

Researchers found that massage set off a series of molecular events in muscles that helped reverse discomfort related to exercise. Massage dampened the activity of proteins known as inflammatory cytokines, which cause inflammation and pain. It also increased levels of proteins that signal the muscles to produce more mitochondria, the cell structures that produce energy and help muscles recover from activity.

Tiffany Field, a leading researcher on the effects of massage and director of the Touch Research Institute at the University of Miami Medical School, says she found the results “very believable.” She was not associated with the new research. (Field notes that her group is planning to study the effect of massage on some of the same inflammatory cytokines in HIV-positive pregnant women.)

Massage basically has the same pain-relieving effect as drugs like aspirin, ibuprofen (Advil) and naproxen (Aleve), says Field. Known as NSAIDS, for nonsteroidal anti-inflammatory drugs, these medications work by reducing levels of substances called prostaglandins that increase levels of inflammatory cytokines. “By reducing the inflammation — or the pro-inflammatory cytokines, to be specific — you would reduce pain,” says Field.

Mainstream medicine has often dismissed massage as a bona fide therapy, but “these findings will have an impact on traditional medicine, as every ‘beneath-the-skin’ finding helps,” says Field.

The study was published in Science Translational Medicine.

martes, 2 de abril de 2013

ITM, International Training Massage school Amsterdam, Berlin and Chiang Mai

Massage and The lymphatic system.

The lymphatic system is considered a "shadow system" to the blood system. Its function is to collect as much as three litres of waste, toxins and lymphatic fluid every day. This material is obtained from the circulating blood and tissues; and thereafter disposed off within the large intestine.

It is well known that massaging the muscles also simelatenously massages the lymphatic system as well. This promotes better functionality and fluidity.

The various forms of massage are still practiced throughout Asia. eg. Thai Massage, Indian Head Massage and many more. All these different variations originate from Ayurveda teachings.

Massage is a profoundly effective technique to help increase the body's natural flow of lymph by increasing lymphatic circulation through the body's natural filtration systems. This increased circulation assists in detoxifying the body and supports our health through a better functioning immune system.

Massage has been proven to be helpful for clients suffering from lack of energy, a sluggish immune system, emotional stress and depression, sports related injuries and cases where auxiliary lymph nodes have been removed.

Other applications include:
Depressed immune response due to poor production of white blood cells
Chronic fatigue syndrome and frequent colds or flu
Skin disorders including acne, eczema, poor complexion, etc.
Digestive disorders
Edema (swelling) of all kinds
Sinus congestion
Tension headaches
Muscle sprains or broken bones (above and below the site of the break)
Circulatory problems
Emotional stress and depression.


Lymph: A clear fluid that travels through lymph vessels carrying immune system cells and tissue waste products.

Lymph nodes: Small, pea-sized collections of tissue found near the breast under the arm, above the collarbone, in the chest, and in many other parts of the body. Lymph nodes filter lymph, and store immune cells such as lymphocytes.

Lymphatic system: Tissues and organs that produce and carry white blood cells that fight infection. The system includes a network of thin tubes that carry lymph and white blood cells. The tubes branch into all tissues of the body.

Lymphedema: A condition in which fluid does not drain from the lymph nodes, causing swelling. Sometimes this happens in the arm after lymph nodes have been removed from the underarm. It can also happen after radiation therapy.

Lymphocyte: A type of white blood cell. Lymphocytes are responsible for certain types of immunity; they also produce antibodies and other substances that fight infection and disease.

Physiological Effects of Therapeutic Massage.

The term therapeutic massage (TM) is a general, nonspecific term referring to any type of massage, from superficial to deep, that may have a healing effect. Most massage therapists1 "train in multiple programs and therapies and there is high variability in the training programs and in what therapies practitioners choose to learn."2 Methods of massage include, among others, effleurage, petrissage, friction and tapotement. TM also can refer to most hands-on therapies including fascial manipulation, Graston, structural integration, active release, Swedish massage and others.
Claims regarding the effects of TM include changes in hormones, neurotransmitters, blood flow and cortisol, among others. However, as with most other mechanical pressure methods used on humans, there is a paucity of research supporting its efficacy, optimal treatment parameters and underlying physiologic responses.

Recent studies have added to the body of knowledge regarding the effects of mechanical load, showing definite physiological and clinical changes2-3 related to TM. An important effect of TM is thought to be its effect on peripheral blood flow. While skin temperature correlates with skin blood-flow studies, skin probes and their effect on the skin are questionable.4 A recent study using dynamic infrared thermography2 compared the effects of a 20-minute massage that included a deep muscle combination of friction, gliding (effleurage), kneading (petrissage), direct pressure and passive stretching to the neck and shoulders versus light touch (just the hands placed in contact with the skin) or a control scenario in which the patient rested quietly in the treatment position.

Light touch produced some changes in temperature, but the most significant changes occurred with the deeper massage treatment. What is most interesting is that the areas not massaged (posterior right arm, C6 to C8 dermatomes, and thoracic middle back T1 to T8 dermatomes) showed an increase in skin temperature and peripheral blood perfusion similar to the areas massaged, indicating a possible neural as well as a circulation component. The areas receiving a deeper massage showed increased temperature for 35 minutes and remained above baseline levels after 60 minutes.

One of the effects of deep massage is temperature elevation that changes hyaluronic acid molecules, which are responsible for the gel phase causing tissue restriction. The increase in temperature with associated pressure changes the gel to a fluid phase and creates the necessary tissue sliding. One study found that massage to a depth of between 1.5 cm and 2.5 cm caused changes in muscle temperature significantly greater than ultrasound.5

Some of the same authors of the above study submitted another significant paper on deep massage that recently appeared in Manual Therapy.3 This study compared the same three groups as the previous study: deep massage and light touch over the neck and upper trapezius areas, along with a control group. This time, the authors measured flexor carpi radialis α-motor neuron pool excitability (Hoffmann's reflex, otherwise known as the H-reflex), electromyography (EMG) signal amplitude of the upper trapezius during maximal muscle activity, and cervical ROM to help assess physiological changes and clinical effects of deeper massage compared to light touch.

The H-reflex is similar to the stretch reflex (knee jerk reflex), but differs in that it bypasses the muscle spindle and is used to assess monosynaptic reflex activity in the spinal cord. Electrical stimulation causing the H-reflex measures the efficacy of synaptic transmission as the stimulus travels along the Ia fibers, through the dorsal root ganglion, and is transmitted across the central synapse to the anterior horn cell, which fires it down along the alpha motor axon to the muscle. This measurement can be used to assess the response of the nervous system to various neurologic conditions, musculoskeletal injuries, application of therapeutic modalities, pain, exercise training, and performance of motor tasks.

In this study,3 even though the upper trapezius area was massaged, the H-reflex for this area is difficult to elicit, so the authors checked the motor neuron pool excitability in an outlying area that was not massaged: the flexor carpi radialis muscle (FCR), which generates a reliable reflex. They reasoned that massaging the trapezius and neck area would affect the cervical and brachial plexus and the median nerve, which innervates the FCR.

The H-reflex test did show a decrease in FCR α-motor neuron pool excitability compared to the light-touch and control groups. The fact that there was a decrease in neuron excitability in a non-massaged area suggests the possibility that massage was producing a centralized effect on the nervous system, affecting spinal-cord response in another area. This same neuronal possibility was expressed in the change in peripheral blood perfusion in non-massaged areas in the previous study.2

Another finding was the decrease in EMG signal amplitude in the upper trapezius muscle with deep massage, which did not occur with light touch or control. The EMG change was probably due to the decrease in -motor neuron pool activation, which has an influence on electrical activity. Additionally, compared to light touch and control, deep massage increased ROM in all cervical directions.

One caveat is that all of the studies were performed on people without known pathology, but the neurological implications of deep massage affecting circulation and the nervous system are important. The fascial manipulation hypothesis is based on the release of restricted fascia that houses mechanoreceptors and proprioceptors, thereby influencing the CNS' effect on myofascia.

Everyone who seriously uses deep massage is aware of positive changes. Science may finally be proving why there are clinical results.


Porcino AJ, Boon HS, Page SA, Verhoef. Meaning and challenges in the practice of multiple therapeutic massage modalities: a combined methods study. BMC Complement Altern Med, 2011;11:75.
Sefton JM, Yarar C, Berry JW, Pascoe DD. Therapeutic massage of the neck and shoulders produces changes in peripheral blood flow when assessed with dynamic infrared thermography. J Alterative & Complementary Med, 2010;16(7):723-732.
Sefton JM, Yarar C, Carpenter DM, Berry JW. Physiological and clinical changes after therapeutic massage of the neck and shoulders. Manual Therapy, 2011;16:487-494.
Pascoe DD, Mercer JB, de Weerd L. Physiologies of Thermal Signals. In: Bronzino JD, editor. Medical Devices and Systems. 3rd Edition. Boca Raton, FL: CRD Taylor & Francis, 2006:21-7.
Drust B, Atkinson G, Gregson W, et al. The effects of massage on intra muscular temperature in the vastus lateralis in humans. Int J Sports Med, 2003;24:395-399.
Click here for more information about Warren Hammer, MS, DC, DABCO.

lunes, 1 de abril de 2013

Effects of Therapeutic Massage on the Quality of Life Among Patients with Breast Cancer During Treatment

Michele Sturgeon, M.P.H., N.C.T., M.B.,1 Ruth Wetta-Hall, R.N., Ph.D., M.P.H., M.S.N.,2 Traci Hart, Ph.D.(C),2 Marge Good, R.N., M.P.H., O.C.N.,3 and Shaker Dakhil, M.D., F.A.C.P.4

The Journal of Alternative and Complementary Medicine
Vol. 15: 373-380 (Volume publication date: April 2009)
DOI: 10.1089/acm.2008.0399

Objective: Therapeutic massage has demonstrated positive physical and emotional benefits to offset the effects of treatments associated with breast cancer. The goal of this study was to assess the impact of therapeutic massage on the quality of life of patients undergoing treatment for breast cancer.

Design: Using a pre/post intervention assessment design, this prospective, convenience sample pilot study measured anxiety, pain, nausea, sleep quality, and quality of life. Treatment consisted of one 30-minute treatment per week for 3 consecutive weeks.

Outcome measures: Instruments selected for this study were used in previous massage therapy studies to measure quality of life/health status and have documented validity and reliability.

Results: Participants experienced a reduction in several quality of life symptom concerns after only 3 weeks of massage therapy. Respondents' cumulative pre- and post-massage mean for state anxiety, sleep quality, and quality of life/functioning showed significant improvement. Among study participants, there was variability in reported episodes of nausea, vomiting, and retching; although participants reported decreased pain and distress, changes were non-significant.

Conclusions: Therapeutic massage shows potential benefits for ameliorating the effects of breast cancer treatment by reducing side affects of chemotherapy and radiation and improving perceived quality of life and overall functioning.

The effect of massage in the Nervous System,

The human body is amazingly aware of change and responds via the Nervous System, which has the ability to activate millions of appropriate chemical reactions in order to establish homeostasis or balance in your body.

The Nervous System which is made up of the brain, spinal chord and the nerves and their minute nerve endings, works hand in hand with the Endocrine System which regulates all the functions of the entire body by releasing hormones, or chemicals that produce the desired physical response in our bodies in order to achieve homeostasis.

Research has shown that therapeutic massage stimulates the nervous system to produce hormones that have tremendous benefit on the entire body while at the same time reduces unwanted or out of balance levels of chemicals that can have a detrimental effect on us.

Dopamine-the happy hormone

For instance many may be aware of the biochemical substance called dopamine, which influences mood in terms of inspiration, joy and enthusiasm. Low levels of dopamine can result in clumsiness, inability to focus and a lack of motor control. Massage increases the available levels of dopamine and explains the pleasure and satisfaction experienced during and after a massage.

Serotonin-the calming hormone

Serotonin regulates mood in terms of appropriate emotions and has a calming effect, reducing irritability and a number of different cravings. A low serotonin level has been implicated in depression, eating and obsessive compulsive disorders.

Massage seems to increase the level of available serotonin, producing an overall sense of calm.

Endorphins-the body’s pain reliever

Endorphins are produced by the body to reduce pain and give an overall sense of wellbeing. Again massage increases the available levels of these natural chemicals and can promote healing, reduce swelling and speed recovery.

Cortisol-fight or flight hormone.

Cortisol is a stress hormone used to arouse the senses in the face of danger or opposition. High levels of cortisol have been linked to many stress-related symptoms and illnesses including sleep deprivation, anxiety, inflammation and aggression. Massage has been shown to reduce levels of cortisol, returning the body and mind to a more balanced state. Many people who suffer from anxiety and depression, report that massage has an extremely beneficial impact on their state of wellbeing.

An Ancient Answer to Modern Illnesses

There is good reason why massage has been used for thousands of years by tribes and cultures the world over. It is because it really does promote health and wellbeing. Not only do people feel better after a massage but massage can accelerate the recovery from a number of illnesses. While massage practitioners do not claim that massage can heal every disease or problem, it could be argued that massage can be used effectively as a complimentary treatment for many modern day ills.

It is only in recent years that science has been able to understand some of the reasons why massage is so beneficial to its recipients, but the stimulation of natural chemicals in our bodies to support our overall sense of physical and mental wellbeing provides a strong case to consider remedial massage as part of your regular body maintenance programme.